I’ve
made some critical comments about the national health care reform
efforts. Nothing personal… my primary criticisms have mostly been
that I just don’t think any of it has been handled properly.
For
the most part, I understand that politics is politics… a different
beast that follows different rules.
Let’s
start out with this opinion from me. Health care needs to be reformed.
In
my mind, there’s no question about it. There are plenty of horror
stories, and it seems like more people are experiencing more problems
each year. That’s not just in getting coverage and treatment,
but it also applies as what I’ve heard from doctors and nurses
and other industry professionals that I know.
So
understand… as clearly as I can say it… my problem is not with
the idea of approaching the health care industry, asking questions,
gathering information, doing the work, and then even potentially
applying legislation to make things better.
As
I said last
summer, and continue to believe, one of my
biggest problems was the speed this was pushed along at. It seemed
at times like a breathtakingly quick pace, defined more by the
personal interests that seemed to be involved than the ultimate
goal of improving things for everyone. This thought includes political
stature associated with winning and losing the fight… not the
right and the wrong of the issue… and how it looks on a campaign
flyer of a paid-for-by-the re-election commercial.
At
times, it doesn’t even appear that they care about the facts.
For
instance… the cost. Let’s strip this down to basics. 32 million
people are going to get health care coverage they didn’t have
before, but the government is going to save money? That’s the
estimates?
How?
How
is that possible?
Did
you hear about the give a day, get a day Disney volunteer program?
The fundamental idea was that if you gave a day of work to an
accepted charity, in turn you would get a one-day admission ticket
to a Disney theme park. It was stated that giving back to the
communities was the goal here.
And…
maybe that was part of it.
But
Disney is a business. And once they get you to those park gates…
Many
people will tell you that theme parks don’t make vast revenues
from you paying for admission. Sure… there’s profit there, especially
at the rates they charge. But it’s the food and shirts and everything
else you buy while visiting that really adds up.
You
would think Disney had nothing to lose here. Give away tons of
days. After all… they look great for the offer, and if people
do use the tickets they get people on their property. Heck, people
don’t just travel to Orlando for the day from New England. Maybe
they even get us into their hotels on top of it… and, if you traveled
there, you’d probably buy additional admission tickets on your
own).
Yeah…
well… Disney capped the offer at the first one
million people to qualify and has already ended the program
for additional requests. Took all of about 8 weeks to end what
was basically a year-long promotion.
So
even when there was money to be made, they capped the offer.
Back
to health care.
This
is 32 million… thirty-two million… 32,000,000… 32 million
people getting health care coverage. 32 million people that aren’t
traveling to Orlando and making winners of any company associated
at getting you through the Disney gates. These are people with
treatment costs attached to them. They’re not buying cheeseburgers
and sweatshirts to remind them of their hospital visits.
Somehow
though… our government tells us… we’re going to save a ton by
adding roughly ten percent of the population to coverage.
Let’s
pause here for a second. Basic math time.
If
you have “x” dollars to spend on “y” care for “w” people, seldom
do you get to spend “x” dollars for “y” care on “w + 32,000,000”
people.
With
me so far?
Ok.
What that means is, if we are saying the number of people cannot
be changed, we either have to increase the dollars spent or reduce
the care given.
Right?
Interesting
then that Massachusetts is talking about how universal
health coverage may be destroying their state budget. A
quote from the article: “‘It has been a fiscal train wreck,’ Cahill
wrote in yesterday’s Wall Street Journal. Without federal assistance,
‘Massachusetts would be broke.’”
A
simple, basic approach… without much digging or research… says
that the money has to come from some place. It could be door number
one… door number two… or door number three. The one thing that’s
certain in my mind though is that the government… in claiming
we’re going to save money doing this… simply hasn’t revealed which
door involves us reaching for our wallets.
Now
maybe the federal efforts are different than the Massachusetts
ones that are losing money. Maybe the government ones will work.
But don’t seriously tell me that you believe the budget estimates
will be close to accurate.
You
don’t… do you?
32
million people… and
we save $138 billion dollars?
(Not
a chance.)
Oh…
wait… see… maybe on paper it will look like we saved $138 billion.
But, ladies and gentlemen, that rabbit doesn’t just appear behind
door number four in this game. It has to come from a wallet at
some point. And that’s the kicker…
Because
we the unwilling, led by the unknowing, are going to be asked
to give more of what we don’t have.
Will
it be higher co-pays for office visits?
Will
it be reduced coverage percentages and more out of pocket expenses?
Will
it be denied care for certain procedures or tests?
I
don’t know.
What
I do know is that 32 million people are not going to suddenly
get health care and costs overall go down.
But
that’s not the worst part of this whole mess.
(It’s
not.)
Anyone
recall the presidential election? See… to my memory… I had the
television on one night and there was Senator Obama, during a
debate, telling me that Senator McCain wanted to tax my health
care benefits.
I
saw that. I remember that.
He
told me that if I had great health care from my employer, John
McCain was going to tax it.
Umm…
did I miss something? In one story, Consumer
Reports points out how some plans, ones that meet
certain conditions… will be taxed.
Someone
is going to claim that Obama meant apples when debating and this
current legislation is talking about oranges.
Apples…
oranges… sure sounds like he’s doing what he accused the other
guy of doing, while bending me over an exam table to perform a
medical procedure.
On
top of this… then we get the run around on Capitol Hill… with
the Democrats losing a vote one way, so they push for passage
of the bill another way.
There
is plenty I don’t know about this health care plan. There may
even be elements I like. And… heck… much of it may hit the wallets
of others, earning significantly more than me, and not change
my life all that much.
But
I doubt it.
For
every action, there is always a reaction. Simple physics. And
seldom do people consider the reactions. Very little about the
way this is being handled passes the sniff test to me. It’s not
simply the Democrats… not just the Republicans… and it certainly
isn’t a question of doing the right thing.
The
current result just smells… bad.
Maybe
this says it as well as anything: “(Congress… is) ‘stuck in an
endless cycle of recrimination and revenge. The minority seeks
to frustrate the majority, and when the majority is displaced
it returns the favor. Power is constantly sought through the use
of means which render its effective use, once acquired, impossible.’”
That
quote is from
this column, and is attributed to Evan Bayh.
I
say it again… welcome to the new Washington, same as the old Washington.
I
find myself agreeing with Ezra Kelin, so wonderfully summed up
with this passage: “What we have learned instead is that even
in those rare moments when bold action should be easy, little
can be done. Consider the position of the Democrats over the last
year: a popular new president, the largest majority either party
has held in the Senate since the post-Watergate wave, a 40-seat
majority in the House, and a financial crisis. Congress has managed
to pass a lot of legislation, and some of it has been historic.
But our financial system is not fixed and our health-care problems
are not solved. Indeed, when it comes to the toughest decisions
Congress must make, our representatives have passed them off to
some other body or some future generation.”
This
isn’t about individuals or political parties or my opinions about
issues. It’s about ineffective leadership that seems more concerned
about doing something than whether or not it should be done… the
hell with the consequences of doing it.
It’s
about hiding the costs by moving where the charges hit, and using
slight of hand to prevent votes from being taken. It’s about name-calling
and finger-pointing and chest-thumping.
Don’t
kid yourself for a second… because one thing this isn’t about
is health care.
Not
really.