Health Care Babbaloney
January 27, 2010
The savage battle for healthcare reform, waged so valiantly in the "bloody" halls of the Congress, but carefully crafted in the cowardly confines of the lobbies, is about to hit a watershed moment. Something must be done. The manufacturing base of an entire nation is at stake. The undeniable fact is that this country's already failing industrial infrastructure is in serious danger of total collapse without some sort of reasonable national health care. To many people's utter amazement, many of our automobile factories were lost, not to third world countries where wages were cheaper, but to Canada, where wages, taxes,and currency were all more expensive! Canada, however, has national health care and companies can save fifteen hundred to two thousand dollars per vehicle produced!
Yes, forty eight million uninsured Americans, daunting as the figure seems, is not as shocking as the impending collapse of the entire economy and eventual establishment of a single payer system, desirable as it may be, is not as important as immediate reform of private insurance. Nine years ago, I watched an arrogant and largely incompetent president and Republican Congress proclaim that they possessed a "mandate," allowing them to dictate to the lowly minority what legislation "mandated" passage. Eight years later, equally shocked and dismayed, I witnessed Ms. Pelosi and an incompetent Democratic Congress turn, condescendingly, to the minority party with their mandate. The result, although not as blatantly psychotic, was still, very clearly, dysfunctional. The Democrats, unable to convince their own party members that the country was ready for a single payer system, were willing to compromise with the lowly Republicans and substitute a "public option," knowing that it was almost as odious to legitimate conservatives as "socialized medicine." In this way, they could placate President Obama's plea for "bipartisanship" without risk of such a "repugnant" gesture succeeding.
Understand that I am and have always been a strong proponent of a single payer system for health care delivery. Eventually, despite the best efforts of the insurance industry, of legitimate as well as "convenient" conservatives, of lobbyists and other special interest groups, virtually every free society will choose "socialized medicine." In fact, virtually every free society will become ever more socialistic as it progresses. It is the nature of a free society, with a responsive government, to ask that government to be its agent, to negotiate for its people, for their health, for their security, for fair prices and, yes, even fair taxes. The operative word, of course, is "ask." It is not the way of a democratic government to decide, for their people, that it is time to turn to a single payer or initiate a public option or arbitrarily attack a foreign country or loot their Social Security/Retirement fund to pay for such a pointless attack. All represent an inappropriate presumption of power, usually reserved for dictatorships.
There is, I feel, only one practical approach to "health care reform," one issue, and "national health care," a second, related issue. First, observing a long neglected, but previously time honored tradition, try to pass legislation that both parties are forced to agree upon. The most obvious bill, of course, is "portability of insurance" from state to state. The Republicans, despite millions of insurance dollars to the contrary, were forced to offer up the concept, blessed by both Bernie Sanders and Howard Dean, but it was rejected by the Democratic leadership. In fact, most of the Republican platform, sparse as it may be, is dedicated to saving money and will not hurt anything. The minority party can be easily embarrassed into various reforms in insurance practices, including easing of "preexisting illness" policies and "cancellation" policies. Why not pass such "bipartisan" reforms immediately? Or, are House leaders much more comfortable maintaining the opposition as "The Party of No?"
Second, since 2003, the Republicans have been trying to introduce competitve bidding in Medicare, for durable goods, oxygen products and laboratory testing. Obviously, the associated lobbies for these entities "own" various Democratic Congresspeople. The Democrats, ever since Tom Delay and Billy Tauzin asked Pharma to author Medicare Part D in exchange for thousands of dollars in campaign contributions and added millions in direct bribes, have tried to establish competitive bidding in that area of Medicare. What would it really take to "force" both parties to acquiesce to each others quite reasonble requests? I mean, why not agree to save a total of at least one hundred billion dollars a year between the two parties, for a program that is almost bankrupt, especially without sacrificing any member benefits? Perhaps, more than one trillion real dollars, saved in a decade, might give citizens some palpable faith in their government's ability to actually "clean up its act."
The election of Mr. Brown, an "anti-health care reform" Republican, in a state in which a Republican Governor had established a "universal" healthcare program, must be considered as a "wakeup call" to progessives. Most of the dissatisfaction in Massachusetts regarding their health care program can be traced to the inability of the state bureaucracy to manage the program. The federal bureaucracy, with the help of a truly bipartisan effort by Congress, has nearly bankrupted Medicare, Medicaid, Social Security,the United States' and the entire world's economies. Somehow, I don't think the federal bureaucracy has proven itself ready for a brisk public option (as much as I love the idea) let alone a single payer system involving three hundred thirty million members!
As usual, there is an added pest, constantly interfering with obvious facts and figures. The Congressional Budget Office was established in 1974. Its job, ostensibly, is to estimate government revenue and effects of various programs on the national debt. In the past, the agency has had "good" years and "bad" years. In recent years, apparently under serious pressure from various "educational equality" groups, hiring has been restricted only to those students who have failed college math courses. As a consequence, the Democratic plans in House and Senate are predicted to save enormous amounts of money over the next decade, despite their propensity for bankrupting every mismanaged agency they involve. The Republican proposal to allow portability across state lines, involving individual policy savings as great as fifty percent and forcing competition in all fifty states, is predicted to save six percent for employer sponsored policies and only three percent for individual policies. What did you say? You were born at night, but not last night?
Allen Finkelstein, D.O.