Well, the President is planning a summit with Republican and Democratic legislators to see if something can be done to salvage healthcare reform. And the legislative reform he is trying to salvage is a peach. Although the House and Senate bills have not yet been reconciled, it is certain that the landscape of health insurance would change under either version. But, at the end of the day, we are not really talking about healthcare reform but rather health insurance reform.
The practice of medicine is not likely to change one iota as a result of this legislation. Not one structural change to the delivery of health services has made it into either bill. And as with all sweeping social legislation, once the ink drys on a presidential signature, undoing what has been done is an absolute impossibility (see social security, Medicare or Medicaid). Lets consider what has and has not been accomplished.
The stated goal of the process when it first began was to provide for universal health coverage, affordable health coverage and health coverage that would cost the American taxpayer not one penny more. Admirable goals. What a pity that none of the above was achieved.
I’ll have a good deal more to say about this subject in the coming days and weeks. But for now there are several things to bring to the attention of our elected representatives as they prepare to sit with the president and break bread (and the national treasury).
This legislative train wreck is supposed to be revenue neutral as it relates to the national debt. Yet adding 41 million new souls to the roles of the insured, many of whom could not afford coverage at any price is going to cost a bundle…a bundle in the neighborhood of a trillion dollars. Now there are only two ways to cover increased costs…cut expenses elsewhere or raise taxes.
Our politicians have just realized that Medicare has some 300 billion dollars of waste that can be cut. Now that is interesting. Considering Medicare was established in 1966 and is now over 33 years old, I wonder why it took so long to realize that there is that much waste and fraud in a government run healthcare program. And it is even more puzzling why that waste and fraud has not been eliminated before now. And, for that matter, I thought that government was much more capable of managing healthcare than the private sector. After all, if the Democrats had their way we would be moving toward a single payer system managed by…you guessed it…the federal government.
Question: Does anyone really believe that our spineless windbags in Congress are going to cut anything out of Medicare? Get your head out of the sand (or where ever else you have stuck it) and get real. It’s a case of the Emperor’s new cloths…someone needs to shout “they ain’t going to do it.” So that leaves taxes. And guess who is going to get taxed? Well, I have some very bad news for you. It isn’t going to be the rich. They have very competent legal representation. They will do just fine. The politicians will begin moving down the food chain very quickly once the deficit really starts to sore.
For brevity’s sake I am going to stop here and catch my breath. I’ll leave for another day issues like the absence of tort reform, the absence of any answer to the growing cost of medical education, the critical shortage of primary care physicians, the absence of any incentive for personal responsibility, the absence of any reason why the cost of insurance isn’t going to go up even faster than before and an explanation of how doctors and hospitals are supposed to stay in business when we keep reducing reimbursement and mandating new coverage.
It will be interesting to watch all the players posturing before the camaras. An interesting prop would be to give each a fiddle.
As a very important source of strength and security, cherish public credit. One method of preserving it is, to use it as sparingly as possible; avoiding occasions of expense by cultivating peace, but remembering also that timely disbursements to prepare for danger frequently prevent much greater disbursements to repel it; avoiding likewise the accumulation of debt, not only by shunning occasions of expense, but by vigorous exertions in time of peace to discharge the debts, which unavoidable wars may have occasioned, not ungenerously throwing upon posterity the burthen, which we ourselves ought to bear. - GEORGE WASHINGTON, Farewell Address, Sep. 17, 1796
