A Letter to Speaker Nancy Pelosi (September 2009)

The effort to achieve health care reform is in serious, perhaps mortal difficulties. The reason is that too much was attempted. The target presented to opponents of was so large and varied, that any attack, however malicious or misleading was certain to obtain wide support. Too much was attempted. The entire effort should be terminated. Recognizing and exploiting the fact that many parts of the problem are disjoint can achieve reform. It can be accomplished step-wise. Present each piece of the assemblage sequentially. In that way, much of the misleading propaganda can be refuted forcefully. Instead of the enemies of reform being able to ride into battle with impunity, their warhorses could be easily hamstrung. A useful sequence might be: enable Medicare to bargain with pharmaceutical companies in the same way as the VA; establish a government insurance plan to serve as a benchmark.