I need to treat this post as a sticky note because I will prob­a­bly come back and post more as I learn more and develop clear thoughts and positions.

Gen­er­ally before I com­ment on some­thing, I like to have as many, if not all, of the facts. I, almost embar­rass­ingly, have to admit that I can­not say that this is the case with the cur­rent health caredebate. There remains a lot of mate­r­ial and posi­tions that I need to cull through. Today, there is a health care sum­mit with the Pres­i­dent and mem­bers of both par­ties from the House and Sen­ate, and I’m try­ing to catch as much as I can while at work in the hopes of learn­ing where politi­cians are com­ing from on the issue.

Just last night, Rachel Mad­dow laid down a poignant per­spec­tive on her show, and it really res­onated with me.

Call me a social­ist if you must, but I think Rachel is on to some­thing. The way we con­duct, or even label, health care in this coun­try is fun­da­men­tally flawed. There is com­pas­sion in ROI (return on invest­ment). You can­not expect a for-profit insur­ance com­pany to have pay­ing out claims to be in it’s best inter­est. When I was inves­ti­gat­ing state insur­ance reg­u­la­tion (or the lack thereof) many years ago, I learned that peo­ple buy insur­ance like a lot­tery ticket–hoping it will pay out in case some­thing hap­pens. Con­versely, insur­ance com­pa­nies take pre­mi­ums bet­ting you won’t get sick or hurt. There’s a rea­son why there are actu­ar­ies. Those indi­vid­u­als are the very rea­son peo­ple don’t get insur­ance, or get dropped. To use gam­bling par­lance, we, as the insured, are basi­cally play­ing with the House’s money. It’s play­ing a game where the odds are stacked–I’d even say FIXED–in the insur­ance com­pa­nies favor.

I am not sug­gest­ing that this is an easy fix. How­ever, we need to strip away the hypocrisy. You can­not sup­port Medicare and Med­ic­aid, but be against health care run by or strictly reg­u­lated by the fed­eral gov­ern­ment. You can’t be against a fed­eral pub­lic option, yet pay fed­er­ally nego­ti­ated low pre­mi­ums as part of the Fed­eral Employ­ees Health Ben­e­fits pro­gram. For all the talk about stand­ing up for small busi­nesses, why is there oppo­si­tion for pooled health insur­ance pro­grams that would cre­ate afford­able options for small busi­ness own­ers to offer to their employees?

There finally appears to be some progress, and some acknowl­edg­ment that the mar­ket can’t cure or solve all prob­lems. Just yes­ter­day the House passed a bill to finally repeal the McCarran-Ferguson Act, which gave insur­ance com­pa­nies an antitrust exemption–meaning they could fix prices and bypass fed­eral reg­u­la­tion, among other things.