Monday, November 30, 2009

Healthcare Reform-Now With 100 New Opinions!

Here we go again with healthcare reform. Recently the House of Representatives muscled through a healthcare reform bill by a narrow margin using the advantage of a Democratic majority presence. Now the Senate has also used a Democratic majority to narrowly vote to entertain a healthcare bill in coming Senate sessions. Let us be very clear about this. The Senate needed to vote on whether or not to debate the healthcare reform bill. After they debate it they can vote on it. I suppose we should be glad they did not need to vote on whether to vote to debate the bill. We are already a year into the Democrats rule and are still stalled on healthcare reform, though it’s not hard to see why.

First, the Senate only narrowly voted to allow the bill to be debated. Even with a majority of Democrats, they could barely get all the Democrats to agree that healthcare reform was needed. And as with the House, there are some Democrats that behave more like Republicans. Heck, they call themselves the Blue Dogs in the House! Why not just call yourselves Republicans? This tells you that everyone’s vision of healthcare reform is different. This also means that healthcare in its current state was no one’s vision. It should then follow that whatever form healthcare policy takes will also match no one’s vision. It makes sense that it should not be one person’s vision, but it would be tantamount to trying to create a lion and ending up with a chimera. It should be expected that the Senate will modify the bill to a mindboggling degree, so that everyone’s personal vision can also be inserted. So why waste a week of Senate sessions to only decide to debate the bill? Obviously because not everyone actually wants healthcare reform. That tells you a lot right there.

Second, the Senate healthcare reform bill is different from the House healthcare reform bill that passed a few weeks ago. Why is it different? If the Senate actually passes a bill it will have to go to House to be debated on as well. Which makes you wonder why the House even bothered to develop a healthcare bill in the first place. And all this time the Obama administration has its own plan for healthcare reform but must wait for the Legislative branch to finish its job first. It is quite a wonder that anything is actually accomplished in government.

Third, the House just passed a bill removing the twenty percent Medicare physician reimbursement cuts that were proposed this year. Will the new healthcare policy reinstate it? Has it been compensated for in the new budget? Granted, Medicare is only a part of the overall healthcare bill, but it can be a deal breaking part. Just as the public health insurance option seems to be a deal breaker for many Congressmen. The thing that the government is failing to recognize is that while it can force people to get health insurance and set its own reimbursement rates however it pleases, it cannot ever force people to provide medical care and products. Nor can it force companies to stay in business to provide health insurance. It is a dangerous bluff that will likely be called. If you pass a bill for healthcare reform that saves over a trillion dollars in the next decade you should be happy that it will likely save even more than that because healthcare providers will opt out of government insurances like Medicare, hospitals will close down from poorly reimbursed services, and insurers will close their doors rather than be told how to run their businesses. That means the government will be paying less to fewer healthcare providers, fewer hospitals, and will be the insurer for most Americans. That will save a ton of money. Too bad the actual healthcare will become nonexistent.

The problem with trying to insure everyone is that in order to reduce costs you will need to cut services—office visit time, testing, drugs, and procedures. And no one likes being told what they can or cannot do for their health, especially if it is so important that we need a law for it. In fact, the reverse may actually work better—making people purchase their own insurance and literally letting that drive the market. That means no money, no healthcare. Is that fair you say? Is it any fairer than the disparity in access to food or shelter? We have federal subsidies for that. There could be healthcare stamps. Just as you would not buy filet mignon with food stamps, you would not get a full body CT because you wanted it. But you could still get antibiotics for that pneumonia. Is health insurance that important? Most people care more about their cars than their health. And healthcare is not in the rule of twos—two hours without shelter, two days without water, and two weeks without food. What would it be—two decades without health insurance?