I heard a part of a speech by Mike Huckabee, with whom I was certain I would find very little in common, and was stunned to hear a compelling and cogent argument about the core problem with healthcare in the U.S.
It comes down to an MBA-style incentives analysis: why do insurance companies prefer paying for major healthcare interventions when prevention would be cheaper, in the long run? Because, from a strictly actuarial standpoint, they have almost zero interest in the long run, since the average person is covered by a single given healthcare provider only for a short or medium run (i.e. a person keeps a given job at a given company for, say, 5 years, when prevention-oriented healthcare requires much wider windows of 8 or 10 years, at the least). Thus, to pay for prevention-oriented healthcare for covered workers is only to subsidize a competitor, who would be the next insurance provider down the line in a given worker's career track.
One can question the accuracy of the individual bits of fact or statistic in the above analysis, and I didn't get a chance to hear what he thought the solution might be, but I was nevertheless pleased by the argument's underlying clarity and logic – it had an almost marxist-dialectic appeal.
No doubt, someone's been writing Huckabee's policies and speeches, but that he would sign on to such an assumption-challenging exposition speaks well of his intellectual integrity. I'm not saying I would vote for him – he is, after all, the current favorite of a fundamentally intolerant Christian right – the all-American Jihad, made-in-Arkansas. But, he's been condemned more than once as a new example of something that might be called an "evangelical liberal," and this example may provide some support to that categorization.
