Pick Two

Sunday night I was privileged to attend a function at Bet Shalom Synagogue where NPR's Scott Simon was the featured speaker. Listening to Mr. Simon wax poetic about his experiences as a journalist, the people he has met, the places he has covered, and the success he has humbly achieved as a story-teller made me feel a little nostalgic for the days 40 years ago when I considered a career in journalism.

The consideration never rose to the level of a definite plan. But I was a vociferous reader and loved to write. I had spent three years under the tutelage of Hattie Steinberg, St. Louis Park High School's legendary journalism teacher who Tom Friedman of the New York Times eulogized as the only journalism teacher he ever had, "she was that good." I won a National Council of Teachers of English award, thereby cementing my acceptance at Carleton College. While, ultimately, I pursued a career where writing skills are important, there are times when I cannot help but reflect on the life I would have led if I had stuck to answering the who, what, why, where and when mysteries Miss Steinberg trained us to solve.

Prairie Pondering is a release for my writing. Few days pass where I don't think about writing another installment. Unfortunately, few days end where thoughts are committed to my Mac's hard-drive. Typically, the disconnect results from being overwhelmed by the choice of subjects and the desire to say something meaningful and defensible. Fluff pieces are easy, but a little too self-centered. If readers are going to take the time to allow me to share my thoughts, the takeback ought to include some modicum of enlightenment or, at least, a thoughtful discussion of an issue that matters. Writer's block ensues and my blog guilt blossoms.

Tonight is no exception. It is now after midnight and I should be sleeping. In fact, I am sleeping, from time to time as I write this. But the inspiration of Scott Simon, the historic nature of the passage of health care reform Sunday night, the addresses of Secretary of State Clinton and Israeli Prime Minister Netanyahu to the American Israeli Political Action Committee, the passage of the jobs bill, yesterday's observation of a Facebook friend that Michele Bachmann is "a black eye for Minnesota", the flooding down the road, and the pending return of outdoor Major League Baseball to Minnesota leads me to force myself to generate another blog installment.

Since twenty minutes has passed since I started writing the last paragraph, I will be efficient with the remaining hours of consciousness this evening (morning) and offer some thoughts that apply to nearly every challenge facing us today. I offer the lesson of "Pick Two."

More than one business client, either engaged in manufacturing, in sales or in providing a service, has applied the lesson of Pick Two to their commercial practices. It is a rather straight forward concept. When shopping for a product or a service, consider (a) high quality, (b) low price and (c) quick delivery. Pick two.

Invariably, one of the three options suffers at the expense of the other two. Let's apply it to health care. If I want to see my highly qualified primary care physician for the low price of my c0-pay, I'll have to wait to get an appointment. If I merely need a quick flu shot, at a subsidized price, I can go to a clinic at the local Walmart and receive the services of a less experienced medical practitioner who will, hopefully, have some knowledge in the use of a syringe. Finally, if I need an immediate consult with a physician specializing in what ails me, I may have to go outside my insurer's network and pay retail.

On a broader scale, we ALL want high quality, affordable health care. Under the rule of Pick Two, and as a matter of common sense, we cannot expect everyone to have instant gratification in their health care needs if quality and reasonable pricing are to be maintained. If our society continues to insist that every major hospital make the latest high quality technology available for every conceivable medical contingency (e.g., burn units and brain injuries) in order to facilitate quicker treatments and notwithstanding the competition operating similar facilities at 50% of capacity, it is going to be expensive. Hopefully, newly passed reform legislation will address such wastefulness. If so it will not be a "government takeover of health care" as much as a reallocation of limited resources and imposing brakes on the medical equivalent of an arms race.

The lesson of Pick Two applies to government services as well. When my barn starts on fire, I want a fire truck and personnel capable of handling the emergency at Meadow Breeze Farm as quickly as possible. That being said, it is going to be expensive. Someone has to pay for the purchase and maintenance of the latest equipment. Someone has to pay to support emergency service personnel. We can save money by scrimping on replacing equipment and/or cutting back on the size of the fire and police departments. That will reduce costs and leave me with either a prompt inadequate response (and a smoldering barn) or a slow comprehensive response (and a smoldering barn).

In the days, weeks and months ahead, when friends who do not share my admiration for the president and his administration challenge me on the wisdom of his policies, I will fall back on the lesson of Pick Two. This country voted for a new direction in 20008. Loudly. We were promised a change in the way government serves its citizens. Absent the political vitriol, we should be smart enough to realize that quick fixes are the antithesis of well-reasoned, high quality approaches to problem solving.

We should remember that difficulties that have developed over decades cannot be quickly and magically made to disappear. That means, under the lesson of Pick Two, we are going to have to spend some money. Not coincidentally, Republicans have been focusing exclusively on the cost of health care reform and the cost of the economic stimulus and the cost of repairing our infrastructure and the cost of converting to renewable energy sources. What they forget, and what I will remind my more conservative friends, is that if you take your time and purchase a high quality solution, you save money over the long run. And, most importantly, there can be a long run.