The amount of dislocation and disruption required to reduce health care spending by half would be enormous.

Yes, it would.

But that doesn't excuse our local, state, and federal governments from doing nothing to improve the situation. And that's all we have accomplished towards spending less on medical care and improving the health of our residents.

Can we get there in one massive overhaul piece of legislation? Perhaps. But not likely. It will take a series of actions up and down government, from legislation and executive orders and agency rule-making, to states willing to work alongside the federal government to make lives better. And those actions will need to be taken over a long period of time. Perhaps a decade or more.

The issue to me is not whether some big changes should be made. The real issue is asking if the country - politicians and citizens alike - has the will to do something big. Can those big changes be made?

We certainly have had that will in the past. We chose to rebel against the king of England and break away as an independent nation. That took a bunch of political will. We chose to end slavery, causing economic disruption in a sizeable portion of the country that still has echoes a century and a half later. We've chosen to engage in scientific advances that had unknown benefits at the time (the Manhattan project and the race to the Moon, to name just two).

Can we do that again in the area of medical care? I don't know.

But I will opine that if we can't undertake such a venture simply because it is hard, that will be a sorry commentary on the state of our nation.

--Peter