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update to date posts

Health Care reform: shifting sands

Health Care reform: shifting sands

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Watch the bouncing ball.  In an earlier post I cautioned my gentle readers to keep your eye on the ball.  A difficult task.

What is the goal?

The goal started with a political strategy and calculation based on a lofty ideal.  Cover everybody.  It is becoming clearer to more people that coverage alone does not guarantee access nor quality.   Does universal coverage remain the goal?  Or universal access?  At what cost?

Now the debate shifts even more subtly  to insurance reform.  That is probably where the debate should have started.   Remember, I cautioned in some previous posts that the insurance giants and Big Pharma will not lose.  They are the Titans that no one wanted to challenge.

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CNBC Meeting of the Minds (Health Care)

CNBC Meeting of the Minds (Health Care)

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Billed as the Meeting of the Minds, a roundtable discussion hosted by Maria Bartiromo.  Attended by Dr. J. James Rohack, MD, President of the AMA;  Angela F. Braly, CEO of Wellpoint (Blue Cross); Dr. Steven Nissen of the Cleveland Clinic; ex-Senator Bill Frist, M.D.; Michael Milken; Jennifer M. Granholm, Governor of Michegan; and John C. Lechleiter, Ph.D., CEO of Eli Lilly. You can see the range and diversity of opinions and philosophies.  There was no one unifying concept.  Enlist this panel to draft special legislation and you would be hard-pressed to see a consensus statement.   Let’s discuss this further in the next thread.

America’s health care system is on the verge of a massive transformation, fueling a debate that has pitted neighbor against neighbor, patients against insurers, and the haves against the have-nots. We’ve demanded reform, but now that reform is raising more questions than answers.

In “Meeting of the Minds: The Future of Health Care” hosted by CNBC’s Maria Bartiromo, CNBC assembles some of the biggest names in the industry and government to advance the conversation and propose solutions to America’s health care crisis. Will universal access lead to lower quality of care? Will our efforts to health care for all stifle business and put America at a disadvantage in the global arena? And what will American health care look like for the next generation?

What is the goal?  A healthier nation? More coverage? Better Access? Cost containment?  How about improved quality of care?  A new paradigm …

Health care reform weekly wrap-up

Health care reform weekly wrap-up

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This is worth studying – from the Wall Street Journal.  This is not new.  It is not driven by the current economic crisis.  Keep your eye on the ball and watch the money. This dynamic duo will not lose — large insurance companies and  big Pharma.  That’s why Harry and Louise now favor a new plan.

Also required viewing is Marcia Angell interviewed on this weeks Bill Moyer’s Journal.  She fears a bad plan is worse than no plan at all.  Reference her past accomplishments as Editor of the prestigious New England Journal of Medicine (NEJM) and author of The Truth about the Drug Companies: How they deceive us and what to do about it.

Hillary Clinton was interviewed on Meet the Press.    David Axelrod on Face the Nation.   Not very convincing as he trys to answer the unanswerable.  How to fund the grand plan.  Watch Jim Cooper, who follows.  He may be the weatherman.   [unless you remember Dylan’s most favorite line … from Subterranean Homesick Blues]

end game or round 2

end game or round 2

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It has come to this.  This deadline will come and pass.  It will not be met.  What happened?

Strategically, to frame health care reform as the defining and pivotal achievement of this administration was a setup.  The new administration entered under a wave of jubilation and hope.  I shared these sentiments.

In 1964, Lyndon Johnson entered the office of the presidency with a mandate for change.  A mandate to finish what had been started in the three previous years under an inspiring but a feckless young president.  Johnson was the consummate politician.  He knew how to twist arms.  He knew the Senate intimately.  As so aptly put by Linton Weeks of NPR:

President Johnson was famous for staring down, shaming, cajoling, strong-arming, coaxing, sweet-talking legislators into doing his bidding. Johnson spoke directly to lawmakers. Sometimes very directly. Through manhandling and manipulation, Johnson was able to push through legislation affecting public health for the elderly, fair housing, voting rights and other programs that brought sweeping social change.

Obama came in with a new agenda.  This was to be the reincarnation of Martin Luther King or Mahatma Gandhi.  Leading by example.  Without rancor.  But Washington is a shark tank.

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Unsustained costs — temperature rising

Unsustained costs — temperature rising

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Now it’s heating up.   This should be a sensibility and economic reality issue.  It should not be a partisan issue.  Over the last few weeks I have developed a rationale for slowing this process based simply on the math and the daunting economic and financial  limits that we must honestly confront. This must not be framed as a political football game.  It is not about winning points, or vanquishing the opponent.

The goal should be truly charting a new course — finding new paradigms.

We are now coming into the closing moves.  More frantic charges.  More  heated and vapid rhetoric.  Aspire to something higher.   That is not what we will see.    This is how it degenerates.  We are back to jousting and shouting and invectives.  Can we avoid George Orwell’s admonition?

Political language — and with variations this is true of all political parties, from Conservatives to Anarchist — is designed to make lies sound truthful and murder respectable and to give an appearance of solidity to pure wind.

Talk about personal responsibility.   Moving to optimal health and wealth being for each and all.   The Phoenix rising.

This is a glimmer of the end game … more Roman Circus …

unsustainable costs (cont)

unsustainable costs (cont)

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Our thread seems to be gaining traction.    Moderator David Gregory of Meet the Press was  was questioning Kathleen Sibelius this morning on the economics of health care reform.  She was not very convincing in her answers.  Why?  They still do not know how these “reforms” will be funded.

The Wall Street Journal has an opinion article tomorrow, July 20, on the politics of passing health care reform.  I am not endorsing the Wall Street Journal and its editorials.  But the formulation of the strategy bears scrutiny. In the last six months too much legislation has been passed “because the crisis demands an immediate answer.”  Shock Doctrine evolves.

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unsustainable costs (cont)

unsustainable costs (cont)

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We were talking about unsustainable costs.  I and many others have asked the question — how is this to be funded?  Both the House and Senate have been struggling with this Herculean task.  And now we have new headlines.

House formulating plans for a surtax on the wealthiest of Americans.  Well it’s only 2.5% of the population.  And it does hold true to the President’s pledge not to tax the middle class.  And one could argue that the wealthiest of Americans have already benefited mightily from the Bush tax cut years.  Whatever that was.

But … this is an unwise long term solution.  It has a nice ring to it.  A Robin Hood approach.  Let’s all sharpen our pitchforks.

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