PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

Even as many of us reckon with the U.S. House of Representatives’ action to replace parts of ObamaCare and pending action in the U.S. Senate, it is important to recognize that health care is like a number of other public policy issues these days:

• If you make policy decisions on the facts and statistics from a dispassionate point of view, you might get one result – or, more accurately, a series of results.
• If you make policy decisions based on anecdotes, you might get far different results.

It’s easy to say that my view is that public policy decisions should be made on the basis of facts, not anecdotes. But, based on my 40 years of work on public policy, not to mention my observation of the current health care debate in Congress, that is not the way the world works. And, in the spirit of full disclosure in my long tenure as a state lobbyist, I often turned to anecdotes to make a client’s point.

Anecdotes often carry the day.

Here’s the way the Wall Street Journal put it in relation to House passage of what is coming to be called TrumpCare, even as the Senate began debating how to respond:

“The Trump Administration and the GOP have to be prepared for the communication strategy their opponents are already employing, with the media’s help: The bombardment of emotionally laden anecdotes. Already Republicans are making the same mistake they always do, which is to rest their case on impersonal facts and figures.

“Facts are the background noise of debate and analysis; anecdotes are a message’s most powerful anchors. In the battle for public opinion, personal stories win. So what if ObamaCare is woefully undersubscribed because it’s a bad deal for young, healthy people, or if millions have watched their deductibles skyrocket and choices narrow? Do you really want Paula, Namir, Cameron and Jason to die (a reference to specific case studies involving names)?”

Consider the issue of pre-existing conditions. From an insurance standpoint, those who have such conditions should pay more to be insured than those with lower risks. Otherwise, a portion of the burden for pre-existing condition care falls on the rest of us.

A key tenet of insurance is to assess the level of risk and establish premiums in response to the risk. The higher the risk the higher the payment.

But, mark my words, Congress and the Administration, if they finally, pass a new health care plan, will decide pre-existing condition policy on the basis of anecdotes, not neutral facts.

Look no farther what comedian, Jimmy Kimmel, said on TV the other day, which almost immediately went viral via the Internet:

“If you were born with congenital heart disease like my son was, there was a good chance you’d never be able to get health insurance because you had a pre-existing condition. If your parents didn’t have medical insurance, you might not live long enough to even get denied because of a pre-existing condition.”

Using neutral facts, one way to deal with pre-existing conditions is to create high-risk pools, which more than 30 states have done and which are included in the House-passed version of TrumpCare. It is true that some of these high-risk pools have not worked well, or at least have encountered very high costs which threaten their financial viability. But they also represent a worthy option to deal with a tough issue.

For me, the fact that anecdotes are driving health care policy underlines an important prediction: Before long, we’ll have a single payer system and government will be that payer.

One of favorite columnists, Charles Krauthammer, has reached the same conclusion and says in regard to U.S. House action on TrumpCare: “Ironically, ObamaCare won the day. I think what conservatives and Republicans are beginning to understand is how the fundamental view of health care among the American people has changed.

“ObamaCare is a disaster on the ground, and, politically, it ruined the Democrats. However, there’s an irony and a hidden victory here: Over these past seven years, people’s expectations have changed. You watched the debate over the last three months. What are the grounds? The grounds are all liberal grounds: How many people are going to lose their coverage? How can you leave people out in the cold? The Jimmy Kimmel thing. It’s showing that the country is at a point where I think it believes in universal coverage.”

So, I say, bring on the anecdote-driven single payer system and, then, we’ll have to decide how to pay for it.