Health Care--Backing Into The Future

Pundits are beginning to suggest that one reason Obama doesn’t have a lot of achievement to show for his first year in office is that he spent so much time on health care reform. Yeah … . All I can say is that if he spent a lot of time and energy on health care it wasn’t easy to notice.
He certainly didn’t spend EFFECTIVE time and energy. LBJ got all kinds of Republican votes for Civil Rights, Medicare and Medicaid. Obama hasn’t gotten one Red senator to go with him. LBJ was a master at the art of compromise and trade-off—but the finished bills that came to his desk were pretty much what he wanted in their essentials.
What Obama has, so far, is a thousand or more pages that no one fully understands (it would be interesting to find out if ANYONE in Congress has actually read either of the whole bills through). He has allowed Congress to create a big target that any disaffected soul can shoot verbal arrows at—whether Republican or Democrat.
I don’t pretend to understand either the Senate or the House bill and I’m sure I won’t understand the reconciled bill that finally emerges from closed door sessions. (So much for Obama’s promise of open deliberations—back to Chicago style politics?) It’s unlikely that most of the members who eventually vote for or against the final bill will understand it any better than I.
One thing I do know, as do most people who have any kind of a handle on the situation, the cart has been firmly positioned in front of the horse.
Going in, there were two major problems with American health care—too many millions had no health care at all (incidentally the new bill will NOT include all of these). Second, health care cost too much, and costs were rising without any attempt at restraint.
It was as if every health care provider were allowed to act like a defense contractor in an emergency situation—what’s a few billion here or there in cost overruns? My grandfather worked as a receiving clerk in a major Grand Rapids hospital fifty years ago. He used to regale us with stories of how much sheer waste and misuse he saw from his small vantage point.
It truly offended his Dutch soul to see all the goods that hospital ordered and either never used or tossed out. He could see lots of ways in which the system could be changed—to deliver the same care for considerably less cost. This was fifty and sixty years ago.
So, it is obvious that before you can overload a crashing system with millions of more patients (like piling more debt on Chrysler), you have to figure out ways to effectively cut costs. (No, boys and girls, this does not mean more health care rationing than exists now—very possibly LESS. Just better use of what is there.)
Get rid of the waste that my grandpa saw—after all many of these institutions are “non-profit”, which means they have little motivation to beef up a bottom line by cutting costs. Consolidate the dozens of health care providers who order this or that test without talking to each other—I shouldn’t have to walk into a specialist’s office and find out that his computer knows nothing about me or my condition. He should immediately know everything my GP and any other specialist knows, what tests I had, what medicines have been tried, et cetera.
And, above all, above all, there should be a single payer. If we went our medical system to survive, private insurance companies—except as supplements to Medicare for the wealthy, if they want them—should be obsolete. They are a luxury we cannot afford.
Correcting a glitch in my health insurance shouldn’t require five hours on the phone, as it did me. It should be like a single or call to Social Security. Bingo! The problem is fixed. Not with private insurance. Having one payer will allow it to force cost savings on the whole industry.
We won’t have that. There will be no real means of controlling rising—and potentially bankrupting—costs. The Republicans are right—as it stands, costs will just go up more. And we won’t even cover everybody who needs it.
If Obama does as good a job in Afghanistan as he’s done on health, we may as well surrender now. Nothing he promised has come to pass. Should we vote for this mess? If you truly believe that nothing else is possible, I guess you hold your nose and say, Yes. But after all these decades, it’s a pity to think that this mess is all we’ve accompolished.