The cram-down of health care reform bills continues this week from the White House and senior Democratic officials despite the CBO's analysis of the negative impact on the budget and total failure of the bills as written to address costs.
The idea that the two bills could pass and then undergo a massive transformation during the reconciliation process boggles the mind.
We are talking about health care quality and yet the authors of these huge bills seem not to care about quality in presenting them as long as the President is appeased and the mess sweep under the rug.
Last night on Meet the Press, Secretary of HHS Sibelius said that coverage of the uninsured was a major objective along with several others not necessarily the most important one. Supposedly, the quality of care and reduction of expenses are the top objectives.
Now, that has merit. But the election may have been won on the coverage issue among the unemployed in key electoral college states.
Worse, the issue of quality cannot be married with the idea of a competing public plan being the savior to all. To be sure, a public plan would result in numerous contracts limiting costs and/or benefits to numerous procedures at below "market costs". As it stands now, most health plans pay far less than the uninsured to do just about everything beyond Doctor visits themselves. It seems doubtful that costs would decrease more than a few per cent. And it would likely cause a number of
Corporations to reconsider what benefits they will allow (or the cost shared with the employee) as a required duty to shareholders to obtain the maximum return for capital.
The number one concern in the CBO review is how to pay for it all. The analysis shows that nothing is being proposed to actually keep health costs down: these things would include research into effectiveness of care and the excessive use of technology.
Clearly, the Democrats figure that most of the rich are either Independent or Republican and hence should be hosed down for as much money as possible. The labor unions and education lobby among others would not be taxed much if at all. Now, most people would be willing to give a little more to help get people insured if they could be assured that the tax or fee was fair and that those with the ability to pay some of the cost themselves actually did so.
Massachusetts rides to the rescue by forcing everyone to pay for coverage or pay a penalty. But in doing so the design they chose did not reduce costs, it increased them. I suggest that taking a bit longer in planning and writing the National bills would be of tremendous long term benefit.
Obama has the bully pulpit. But the credibility of the President comes into play here. If he is such a great leader, he and of course the Democratically controlled Congress, must have confidence that they are doing the right thing even if the poll numbers are at risk. Otherwise, the charges later of Socialism when things need a serious overhaul again in a year or two will ring much truer. Doing something in haste with a poorly written and analysis bill just makes no sense unless the truth is that ideology not practicality has taken hold of them.
Republicans do want change and want to make sure everyone (including those with existing conditions) can get covered and afford the care they need. But we don't want to throw the baby out with the bathwater. The President has said that the United States leads the world only in cost for health care.
He may be right on statistics. But the overall assessment must include such things as research and innovation as well as the per cent of people getting timely care.
We must increase the capability of the existing health care system while we are making these changes. We must regulate health plans to insure they do not cancel and mistreat their subscribers. We must penalize them for excess profits when they refuse to treat for economical reasons alone.
And we must empower Physicians to run the system and provide the care they know is needed, not just what some bureaucracy imposes.
We must, as a society, change our view on long term treatments at the end of life. We must revise how care is delivered and our attitudes towards the terminally ill to avoid spending resources futilely because only the best and most will do.
These are not now or never events. We must work as a nation to turn the tide against the current health care crises.
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