Monday, April 5, 2010
The insurance companies won and the people lost - that's how I read it.
Should we be surprised? Imagine the megabucks flowing from the powerful players - Big Insurance, Big Pharma, Big Medical Associations, etc. As usual, we got the best legislation money can buy - unfortunately, those that write the checks got to write the legislation.
Obama put his presidency on the line to get some semblance of health care reform passed, and some progressives chose to see the glass as half full rather than empty. They reasoned better some reform than none, and hoped it would form the baseline that frames future incremental improvements. The intentions were good, but the results are worse than doing nothing.
In the midst of the curiously rancorous and divisive debate, Republicans pulled out all stops to oppose and obstruct, but failed. Some conservatives, such as Paul Ryan of Wisconsin, actually came up with reasonable-sounding alternatives, but for the most part, the Republican party is bankrupt of ideas. They represent those who either benefit from the present system, or are wealthy enough to not care. They fan the flames of fear and discord with loaded phrases such as "Socialism" and "Government Takeover of Health Care". It remains to be seen whether they will reap any electoral benefits from these tactics in November.
One thing Republicans are correct about: The legislation is a budget-buster and will cause a lot of economic damage. Although clearly in disagreement with their motives or agenda, I rooted for their efforts to stop the legislation. Hopefully the more heinous elements can be repealed by the next Congress.
Cutting Medicare to offset new spending makes no sense; one immediate effect will be more doctors and providers pulling out of Medicare practice, and reduced quality of service from those that remain.
Placing mandates and higher taxes on employers will likely backfire, particularly in an economy which is already teetering on a renewed downward dip.
Already insurance companies are arguing over and resisting some of the new mandates, and who knows what details are tucked away within the vast pages of legislation. Look for a series of unpleasant surprises to emerge.
As stated earlier in this blog, the basic concept of insurance is ill-suited for funding medical care. The "single payer public option" is the most reasonable solution that spreads costs among the widest possible base. Unfortunately for backers of true reform, this leaves insurance companies out of the equation, and they refuse to accept this outcome quietly.
Rationing is another monster in the closet that obstructs true reform. Is rationing a truly bad thing? This isn't about "pulling the plug on Grandma", although many feel as I do that being kept alive artificially is hardly a good thing. Rationing must be addressed because unlimited access to health care potentially means unlimited expense. We must decide what level of expenditure is appropriate, and allowing the percentage of wealth spent on health care to climb toward infinity is not appropriate.
There is an optimal point to be found in the cost/benefit curve, but the big money interests that benefit from unlimited funding of medical technology must be excluded from the debate. Of course, this touches on basic issues and questions regarding the practice of allopathic medicine in this country. Any debate on medical expenditures must take on the broad issues, with enormous amounts of money at stake. It's a battle that the big money is not likely to lose in a head-on fight.
A more likely outcome will be the gradual collapse of the present health care system as the overall economy continues to slide into depression, so most of this debate has been a moot point.
Believe it or not, there is a bright side to this, and that's what this blog is all about. Things are shifting! Something new is emerging. Stay tuned.