It is good to be back from hiatus (even my children grew tired of seeing Mr. Krabs at the top of the page). A lot (or nothing - depending on how one counts) has happened since my last post, which is part of the reason I needed a break.
Being an analytical and policy person by nature as well as an optimist, I tend to look for solutions to real problems and try to move the ball forward, so to speak. But the whole health reform effort crossed a line with me and started tugging at my emotions as opposed to my intellect.
It all got me thinking back to the video below, which I originally saw on the show Planet Earth (one of the reasons I got an HD television). In the video, the male bird does the most amazing dance with the most amazing plumage I have ever seen (look for the smiley face). I kept having that video pop in my head every time a congressional or health industry leader pointed to why they should be treated differently. Or every time a state senator talked about sedition or stood by at check signings for things they did not support. Since when did we become a country of whiners and posers? How can Congress expect providers to work together in interdisciplinary teams and accountable care organizations if it is unwilling to do the same?
Yes, I know I am beating my head against a wall because this is the way things work in DC and state capitals, but that does not make it right. And I believe this feeling permeates the country, albeit from different angles.
Personally, I support many of the provisions in the various health reform bills. Truth is, 75 to 80% of the bills are not really debatable and have been supported by both sides of the aisle at one time or another. But leaders and the media flubbed on communicating what was actually in the bills and how they would affect normal people (kudos to other bloggers, KFF, NPR, and Health News Florida for trying to fill this void). Add that to the fact that for every good provision, there seemed to be a cockamamey proposal that sucked all the oxygen out of the room. For example, the anti-fraud provisions added in the recent manager’s amendment are a major move forward to streamline and solidify the government’s efforts to deter fraud. Nobody every heard about them. What they did hear about was the other item Senator Leahy worked on, abolishing the anti-trust exemption for health insurers. Problem is, repealing the anti-trust exemption for health insurers will do nothing to improve care and will probably increase costs. It is one of those things that everyone hears about because it makes intuitive sense but healthcare is not intuitive because it not a marketplace.
Same goes for the Republican proposal to sell insurance across state lines. Sounds great right? Problem is, we’ve seen this before with credit cards and corporations where companies flock to the state with the most lax standards. Is that what we really want? I don’t think so. Oh, and did anybody even mention that the Bill passed by the Democratic Senate will allow insurance to be sold across state lines, either in regional compacts or based on meeting a nationwide standard? Nope.
But it is comforting to know that Congressional leaders are considering a method of paying for reform first proposed by Merrill Goozner and myself on the same day last August that actually improves the fairness of the current tax system. But that is cold comfort given the current state of affairs.
Will health reform survive? I do not know. Should it? Yes, but I have to admit there are many times I wish we had started from the center with a bipartisan proposal like the Wyden-Bennett bill but that is a post for another day this week. I have always tried to be true to the saying, he/she governs best who governs from the middle. Maybe it is time for Congress to do the same. ~BAA
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