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Is Healthcare Too Big to Fix?

Now that the health care bill has been soundly defeated by the election of a single individual to the Senate, the Democratic party is fleeing the House and Senate health care overhaul bills like rats from a burning ship. Sadly Republicans, too, are staying silent with (so far) few rushing forth with their alternative solution to counteract the impasse:

Senator Dianne Feinstein, Democrat of California, said Democrats were assessing their options on health care. “It’s a timeout,” she said. “The leadership is re-evaluating. They asked us to keep our powder dry.”

Mrs. Feinstein said Congressional leaders should simplify the gigantic health care bill and try to pass parts of it that would be understandable to the public. But she also acknowledged that the odds were long for a far-reaching measure. “I think big, comprehensive bills are very difficult to do in this environment,” she said.

The Senate Republican leader, Mitch McConnell of Kentucky, said White House comments on health care suggested Mr. Obama was not listening to the American people.

In Elyria, Ohio, on Friday, Mr. Obama said he was not going to “walk away” from the fight for major health legislation. If the bill becomes law, White House officials said, Americans will see its benefits and will embrace it.

But Mr. McConnell said, “This a clear sign that the administration has not gotten the message, that it’s become too attached to its own pet goals, that it’s stuck in neutral when the American people are asking it to change direction.” He said Mr. Obama should “put the 2,700-page Democrat health care plan on the shelf” and “move toward the kind of step-by-step approach Americans really want.”

Republicans, however, have not come forward with any new proposals, and Mr. McConnell has said he hopes the health care bill is now dead.

Which leads to an ominous question: is health care really too big to reform? With all the special interests at play, all it takes is one well-respected 93 year-old surgeon general to come out and ask some pointed questions to Congress and the President about their actions, and people take notice.

No matter how you cut it, overt rationing of health care benefits is political cyanide. What both parties now understand is the deeply personal nature of health care paired with the special interest affilitations they must nurture have mixed to create an undrinkable potion to assure relection.

So don’t look for massive health care overhaul anytime soon. Instead, it will be peacemeal – bit by not-so-tiny bit. Like doctors taking a five percent cut rather than 21%, medical device companies taking a $20 billion tax instead of $40 billion, pharmaceutical companies having to accept competition from overseas, insurers forced to cover more of the populace or face extinction, hospital payments continually reduced, and patients having to pay more and getting less. It’s our only way forward.

And while these changes will not be very popular to most, the current debate has not been without its benefits. People now understand what’s at stake. Health care and its associated costs aren’t going away. As the Congressional Budget Office has reminded us:

“…fiscal policy is on an unsustainable path to an extent that cannot be solved by minor tinkering. The country faces a fundamental disconnect between the services the people expect the government to provide, particularly in the form of benefits for older Americans, and the tax revenues that people are willing to send to the government to finance those services. That fundamental disconnect will have to be addressed in some way if the budget is to be placed on a sustainable course.”

For now, the people have spoken clearly. We’ll have to settle for a slower step-by-step approach. But this issue will not be so easily tabled.

Thanks in part to the internet, we’ve seen that health care reform has become deeply divisive issue, separating socioeconomic and generational interests. The reality of funding such a massive overhaul without affecting health care benefits and taxes remains a huge challenge. But this division has also made it clear that a one-fix-does-all approach that replicates similar entitlement programs that are already fiscally unsustainable isn’t going to work with Americans.

Perhaps we should survey the other countries with viable health care plans and make a case for using the best ideas of the best models out there. Perhaps in this way, we should use a hybrid approach to reform based on data, rather than a special interest path to reform based on scare tactics. Oh, we might have to settle for more than one option for care delivery, like every other successful country in the world with health care for their populace has done, but would that be so bad?

Of course not.

But then, looking to others besides special interests for help at constructing such a model hasn’t ever been our modus operandi, has it?

*This blog post was originally published at Dr. Wes*

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3 Responses to “Is Healthcare Too Big to Fix?”

  1. The health care behemoth may be too big to fix; it is certainly too big to fail. The public, who have the most at stake, expressed its opinion on the issue when it rejected Democrat Martha Coakley in liberal Massachusetts. At this point, even the Democrats are walking away from their ambitious and unaffordable plan. Within and around the system are layers of stakeholders, with lots of influence and competing agendas. Do we expect one stakeholder to sacrifice their industry for the greater good? I don’t. Everyone is willing for someone else to give something up. There is sharp conflict even within the medical community, and we are only one player in the game. Get ready for nano-reform.

  2. drval says:

    I hadn’t heard that term before. Nano-reform… how appropriate. 🙂

  3. Art says:

    Of course it is too big to fix, until it soon fails at which point it will be found to be so essential it will morph into a single payer system.

    If you count government employees, veterans, Medicare and Medicaid recipients, and those without coverage whose care the government pays for, the grand total is the majority of the population and costs; so it can be argued effectively that the majority are on a one payer system [the government] today.

    Recent reports show that these programs along with commercial healthcare insurance cannot detect nor resolve the huge waste, fraud and abuse issues that cause our system to be a 33% higher in costs and provides among the poorest health results in the World. We pay over $800 billion for Medicaid and Medicare, out of the $2.3 trillion healthcare costs, of which up to an equal amount [$800 billion]is lost to waste, fraud and abuse each year. [see WASTE IN THE U.S. HEALTHCARE SYSTEM PEGGED AT $700 BILLION IN REPORT FROM THOMSON REUTERS, Oct. 26, 2009]

    At a Justice/ HHS meeting last Thursday these “culprits” were described as being “out of control” by commercial insurers while the AG placed Medicare fraud at $60 billion, which fraud experts call conservative compared to the 24% to 33% they find.

    Since all the “Kings” horses and all the “Kings” men can’t find any of the broken pieces let alone put any of them together again, we soon will have to “build” another system, or “roll” all citizens into Medicare or medicaid! Imagine that, “backing into the system everyone else uses that produces better results!

    Won’t that be fun?

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