By Evan Falchuk

Did you ever read The Cat in the Hat Comes Back?

It’s the sequel to The Cat in The Hat and it’s better than the original.  Kind of like how Empire Strikes Back is better than Star Wars.

In the Cat in the Hat Comes Back, the Cat returns to the scene of his first adventure, and accidentally creates what seems to be a manageable problem – a ring of pink goo in the bathtub.  He tells the children he can clean it up.  But every solution he tries creates a new problem.  Great pink spots of goo keep getting spread all over the place.

The cat brings in more cats to help clean up the spots.  These cats – 25 in all, bring increasingly intricate solutions.  But they only spread the spots around more and more, making the problem much bigger, and much worse.

The spots finally get cleaned up, but only when one final cat – so small that you can’t see him – uses a magical power called “VOOM.”  Unleashing VOOM suddenly puts everything back exactly as it was supposed to be.

Dr. Seuss understood people.  When faced with a problem, people tend to want to do something.  But when this happens, people often seriously undervalue the unintended consequences of whatever it is they’re trying.

It happens in business all the time.  You face a problem and decide some new software will fix it.  You rush to build it.  Then, along the way somewhere, maybe millions of dollars later, you realize the software isn’t helping.  In fact, it’s created a whole host of new issues.  You realize, too late, that your real problem had to do with the way your business was organized in the first place.

Politicians are very susceptible to this, especially when dealing with big, important issues.  Who among them wouldn’t want to champion some giant, historic solution to a giant, historic problem?

So, here are three ways the what’s gone on in health reform in Washington DC is the return of the Cat in the Hat – but without the Voom.

1.  “To take spots off THIS bed will be hard,” said the cat.  “I can’t do it alone,” said the Cat in the Hat.

The reform bills have never been based on a vision of changing American health care into some new, coherently different state.  Instead, they are a collection of big and small deals meant to satisfy the needs of one or another Congressman or constituency.    The most recent of these – the deal to exempt union plans from the “Cadillac” tax underscores the point.  Rising health care costs are the most important fiscal issue we face as a country – well, unless those costs are covered by a union benefit plan.

I don’t know that the Cadillac tax was ever a good idea.  But if you’re going to have it, shouldn’t it apply to everyone equally?  If the reason to have it is to get rid of high-cost insurance plans, how does exempting a huge portion of the high cost marketplace further that goal?  It doesn’t, of course.

2. Oh the things that they did! And they did them so hard.  It was all one big spot now all over the yard!

One of the major reasons why health insurance is so expensive is how it’s regulated.  Today, 50 state agencies dictate what companies can sell in their states, what they have to cover, the terms on which they must accept business, and many other important activities.  It adds a significant amount of cost to all policies.  Worse, it makes the market for health insurance deeply uncompetitive and stagnant.  In short, it’s a terrible deal for consumers, and a great one for insurance companies.   The bills in Congress address this issue….by replicating a federal version of this state system.

Now, instead of dealing with 50 regulators, insurers can work closely with just one regulator, if you know what I mean.  This isn’t progress.  It is a failure of imagination.

3.  “Why, Voom cleans up anything clean as can be!”

As a plot device, using Voom is a sort of cheap way to end the chaos unleashed by the Cat in the Hat in a page or so.  But that was the point.  There’s no such thing as “Voom,” even though we all wish there were.  The lesson is this- cleaning up messes is hard, so be careful not to make them in the first place.  Don’t act without thinking.  Realize that once you have a mess, the only way to fix it is not through dramatic short-cuts, but through the hard, daily work of chipping away, one bit at a time.

“And so, if you ever have spots, now and then, I will be very happy to come here again.”

By Evan Falchuk

That thoughtful debate on health care continues.

Today, Senate Majority Leader Harry Reid had this to say on the floor of the U.S. Senate:

Senate Majority Leader Harry Reid . . .compar[ed] Republicans who oppose health care reform to lawmakers who clung to the institution of slavery more than a century ago. . . “Instead of joining us on the right side of history, all the Republicans can come up with is, ‘slow down, stop everything, let’s start over.’ If you think you’ve heard these same excuses before, you’re right,” Reid said. “When this country belatedly recognized the wrongs of slavery, there were those who dug in their heels and said ‘slow down, it’s too early, things aren’t bad enough.’”

He continued: “When women spoke up for the right to speak up, they wanted to vote, some insisted they simply, slow down, there will be a better day to do that, today isn’t quite right.

“When this body was on the verge of guaranteeing equal civil rights to everyone regardless of the color of their skin, some senators resorted to the same filibuster threats that we hear today.”

Seriously, Senator? Slavery? Suffrage? Civil rights?

Reid must know that there are valid reasons to question the legislation in the Senate and House. And he certainly knows that there are politics in the Senate. But shouldn’t we expect the Senate Majority Leader to be experienced enough at this game to handle it without resorting to such bizarre comparisons? (UPDATE 7:16am 12/9/09: Harry Reid confirms that he meant what he said).

So in the spirit of rational discussion, let me offer a reasonable rebuttal to a reasonable critique of the legislation in Congress.

Many reform opponents deride the bills in Congress as a “government takeover” of health care. Today, for example, Philip Klein of the American Spectator said that as Governor, Mitt Romney engineered the “state takover” of the Massachusetts health care system. Klein says the Senate bill represents a similar “takeover” at the federal level. What’s more, according to Klein, the Massachusetts experiment has worked out so badly that “the only people left defending the Massachusetts health care reform are liberals who want to see Obamacare passed … and Mitt Romney.”

It’s a curious comment.

The Massachusetts reforms of 2006 were dramatic, but fairly simple. The state made it mandatory, with some exceptions, for individuals to own health insurance, and for businesses to provide it. There was no government takeover of anything – the government didn’t even focus on a “public option.” Instead, it set up programs to make it easier for people without insurance to find affordable private insurance options, or to help them get on existing government programs for which they were eligible.

Some aspects of the program has been a great success.

Less than 3% of people in Massachusetts are uninsured. Doctors overwhelmingly support it. In fact, many worry that the current national reform efforts will undermine what has been accomplished in Massachusetts.

On the other hand, the public at large is skeptical.

Only 26% of Massachusetts voters think the program has been a success. Thirty seven percent think it’s been a failure, and another 37% aren’t sure. It’s probably because Massachusetts has some of the highest health insurance costs in the country. Not coincidentally, it also has one of the most concentrated insurance markets in the country, too. Meanwhile, the increase in costs to the state budget because of an underestimate of the cost of subsidies and other expenses is hitting hard in this difficult recession. It’s not a recipe for good polling.

Still, if the reforms solved the problem of the uninsured without having the government take over the health care system, why isn’t that a success? Yes, the cost problem hasn’t gone away. But isn’t this a lesson we should all learn? Cost is not caused by a lack of coverage.

And this is the larger point.

Does anyone debating health care really know what they are talking about, or is this all politics?