HEALTH MATTERS: Can We Talk? By Richard DavisGUILFORD- Political solutions to social problems generally require finding the answer to two basic questions: “How much will it cost?” and, “Is there enough money already available without raising taxes?” Sometimes we cut to the chase and try to answer those questions too early in the problem solving process. When that happens we run the risk of having the wrong answers to the wrong questions.Our citizens have never had a meaningful public discussion about the role of government. If we did, we would have to thoughtfully listen to the widest possible range of political philosophies. We know that some people believe less government is better and we know that some believe government should do it all. Many others believe that the world is composed of an infinite variety of shades of grey.Unfortunately, government has become the servant of the rich and powerful and that has come to mean that those with the deepest pockets get what they want. A lot of hot air will be generated over the next year nationally and in Vermont as the election season heats up, but it is doubtful you will hear any candidates call for a public debate about the nature and role of government. Yet that is exactly what needs to happen.Our tax dollars support the behemoths of bureaucracy, national and state governments, yet we rarely sit down and develop a vision and a long term game plan for how these monsters should operate. It is a national disgrace.Rather than have the public weigh in on issues such as health care, energy, education and the environment or even national defense, we have allowed a few powerful people to determine public policy. (Of course, we have elected most of these people.)Having the kind of public discussion I am calling for will not be easy. Making it happen would require a new (hopefully temporary) bureaucracy and a lot of meetings, but it would be worthwhile because it would transform not only government, but our entire society. After the first round of discussions, the country could decide that it needs to repeat the process at regular intervals, perhaps every 20 years.I have my bias about the direction in which we should head, but I am willing to have a discussion that is all inclusive and that allows us to understand what Americans and Vermonters really think. Let the chips fall where they may.  If the process is truly open then I am confident we can fix a lot of what is wrong with this country. Make no mistake. This would be a beginning, not an end. The hard work of restructuring government and society would begin after the great dialogue. If we can pull this off it would mean that we could revive the hope for a true democracy, something we have never realized since the founding of this country.Based on polls and surveys over the years, I have to believe that such a national dialogue on health care would result in a commitment to have government insure a basic level of health care service for all Americans. Everyone would pay according to their ability. The government would not run the health care system. It would remain a free enterprise quasi-public/private partnership as it now is. But the government would become the insurer of health and that would mean redefining the role of health insurance companies. Those companies would be reduced from the current roughly 1200 with all of their own rules, to a handful with rules created by government. The insurers would contract with the government to administer government health insurance, not government run health care.This week begins the second year of Vermont’s legislative biennium. You will hear the Governor and lawmakers say that we cannot do anything new this year because we can’t afford it. We need to tell them they are looking at the wrong end of the horse. First all of us, not just politicians, have to figure out what we want government to do.Vermont politicians just might find that the average Vermonter is not afraid to hear that it is a fair tradeoff to pay higher taxes if they can actually stop living in fear of going to the doctor because of the prospect of bankruptcy. We might also learn that Vermont business owners would be willing to pay a dedicated health care payroll tax to be more productive and competitive by buying into Vermont’s new health insurance program. Politicians might also learn that Vermonters would spend a little more in taxes now to create better energy efficiency for the next 40 years.We can let it be business as usual or demand that our elected leaders take a deep breath and first figure out why they are doing what they are doing. Vermont could become a model to propel this country into a national dialogue. Someone has to lead.