Thursday, July 27, 2017

Proximate Solutions to Insoluble Problems

(first published in North State Journal, 7/26/17)

The essence of politics, said 20th century Christian Realism theologian Reinhold Niebuhr, “is finding proximate solutions to basically insoluble problems.”

Niebuhr was trapped between his inherent pacifism and “turn-the-other-cheekism” of the Christian faith and witnessing the horrors of World Wars I and II and came to the conclusion that men and women of faith need to act to get things done even if it is not the “perfect,” most ideal solution.

If Senate Republican Majority Leader Mitch McConnell has read Niebuhr, perhaps he could challenge his colleagues this way:

The key to ever making health care in America a soluble problem is to set into place the incentives and structures that help people not get sick in the first place.

“The essence of our collective job in the US Senate this July, 2017, is to find the best option we can to get to 50 votes in the Senate, not to make the US health care system ‘perfect,’ but better than what we think it is today under the ACA.”

Many people today think that every time a bill passes Congress and is signed into law by the President, it has to 'solve all of our problems and set us free!'

Nothing could be further from the truth. The best we can and should expect out of any piece of legislation is that it somehow addresses a need and helps as many people possible without harming others in major ways.

Finding the “perfect” health care system is inherently insoluble. Nothing in the ACA, AHCA or BRCA is really getting at the heart of the problem which is reducing the cost of health care in the first place.

We Americans like the fact that we have modern medical technology, medicine and regimens that allows us to live relatively healthy lives despite the fact that the majority of Americans simply do not live healthy lifestyles.

Talk about diametrically opposed forces that make a “perfect” health care system impossible. The heavier we Americans get due to fast food, lack of exercise and excessive consumption of booze and beer, the more we want and need these medical breakthroughs to stay alive.

Until Americans lose about 25 percent of BMI, stop drinking and smoking too much, and start walking at least a couple of miles every day, our health care delivery system will continue to be insoluble. All we can really do is try to manage the health care of millions of unhealthy people as best as we can.

We are stuck with the same problems today that President Obama and the Democrats tried to ‘fix’ with ACA:

How do we provide the maximum amount of health care insurance coverage to the most number of people without bankrupting the national treasury, corporations and individual pocket books?

Here’s some things to think about which will get at the core of the problem:

1. Everyone in the United States should have access to some form of catastrophic health insurance coverage to protect them against the loss of everything in the case of a catastrophic health event.

2. If you want to pay for private health insurance without the benefit of any tax deductions, you can do whatever you want with your body and health.

3. If you receive health coverage from any government source such as Medicare, Medicaid, VA, or get a tax deduction through your business, you will be enrolled in a managed health care organization, that will help you learn how to take better care of yourself.


The key to ever making health care in America a soluble problem is to set into place the incentives and structures that help people not get sick in the first place. That sounds so elemental but sometimes simple solutions are the best.

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