Monday, July 27, 2009

A convenient failure

In his latest blog post Robert Reich makes the case for enacting at least the House healthcare bill prior to the August recess, lest our attention-deficient legislators lose their focus over the break, or worse yet have the opportunity to hide behind even more egregious lies about how universal healthcare will infringe on our civil liberties. But the bill will be a self-fulfilling prophecy if it does not contain real provisions to rein in costs.

Here is what I mean. From the beginning I was suspicious about the motivation behind AMA's support for the bill as proposed, and, of course, there turned out to be some favorable language on the Sustainable Growth Rate (SGR) that promised physicians much smaller cuts in reimbursements than previously feared. And although I do not begrudge the overworked and underpaid docs a stable income, there has to be some adjustment for the abuse and overuse. Furthermore, yes, I was encouraged by the inclusive discussions between the White House and the industry stake holders -- Pharma, hospitals, insurance providers. And though it was heartening to see them sing Kumbaya and drink wheat grass juice with the staffers, my feeling has always been that cost-containment has to be regulated, so that our collective amnesia does not prevail and forgive inaction.

So, what will happen if the bills that come out of Congress make a mockery of cost-containment? Well, I think it will be a very nice political smoke-screen for the opponents of universal healthcare. Here is how it will play out. First, there will be some rhetorical wrestling about whether it is OK to tax the ultra-rich to pay for the reform. Then, although the conservative elements will make some noise about how it is un-American to redistribute the wealth this way, they will quickly acquiesce. This way they can cover themselves on both sides of the fence: by briefly disagreeing they will have shown those who fill their coffers that they are willing to stand up for their interests, and then by letting go they will be supporting the course popular among 99% of their constituents suffering through the recession.

Thus, my guess is that a toothless bill will pass that will start covering a few of those who do not now have access to care... and will soon run out of revenue only to appear as a gigantic Democratic failure, playing conveniently into the hands of those in whose interest it is to maintain the status quo. This will be a painful "I told you so" for the American public, the majority of whom desires universal coverage. In my opinion this is a dangerous game played by a devastated political party to gain a political advantage. This game is played at the expense of our health and welfare, and we would be foolish to allow ourselves to be manipulated by this double-speak.

Back in the 1950s Harry Truman' attempt at reform failed because of the nation's willingness to believe the message of demagoguery delivered by a second-rate actor. This is the 21st century; we have a devastated economy, a healthcare system in ruins and an opportunity to provide what all other responsible nations provide: access to an equitable quality care. We must make sure that the Beltway follies do not ruin this chance for all of us.

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