Marty: What happened to reform?

We were out celebrating our 45th wedding anniversary during last
week’s town hall meeting on the healthcare and that, thankfully,
gave me the perfect excuse to stay away.
We were out celebrating our 45th wedding anniversary during last week’s town hall meeting on the healthcare and that, thankfully, gave me the perfect excuse to stay away. Except for forgetting to recite the Pledge of Allegiance, it appears the event went off about as expected; few opinions were changed. Those who came blindly supporting or blindly opposing the “reforms” left the same way. Our national politicians, who should know better when dealing with something this important, continue acting like – well – like politicians.  What’s the saying about the blind leading the blind?

America’s healthcare system needs reform – understanding that the word reform means improvement. Based on what has been left out, what’s been put in, what’s been given and traded away, I’m reluctant to call any of the current proposals reform.  Healthcare is certainly going to be changed, but it’s not going to be reformed and that’s the problem.

Opportunities abound, the things that need reform are obvious to any thinking critic, but we can’t seem to get our emotions and political philosophies out of the way long enough to do any thinking at all.  We need tort reform, economic end-of-life care policies, a thriving private insurance system and more free preventive care.  We need to give a bonus to people who stay healthy, tax gold-plated medical benefits and make insurance mandatory.

We need to provide affordable healthcare to the needy but they have to kick in and pay for some of what they get because free care does not work. Doctors and hospitals have to start policing themselves and their professions better and the public has to realize that you may get very good care and still have a bad outcome.

Some factions – the left or the right, the old and infirm, the young and healthy, the unions, business, the rich, the poor, the insurance industry, the government bureaucracy, healthcare professionals or ordinary patients, oppose a number of of these reforms out of selfish interest. As usual, everyone claims to be against waste, fraud and abuse, but no one is actually willing to do anything about it.

The funding equation sounds like your brother-in-law’s last get-rich-quick scheme; the enormous expenses are all immediate and real; meanwhile, the savings are all 10-years in the future and theoretical.  In 10-years the current crop of politicians will be gone and the new crop will be using the “Who me?” defense.  

The Democrats currently have the political clout so they have, naturally, put in what they like and they have left out the things their supporters oppose, but some old advice still holds true, “be careful what you wish for, you just may get it.” Nothing is forever and if the world’s biggest bait-and-switch scheme leaves a trail of resentful swing voters, political change will come double-time. 

Why not flip it and do real savings first?  Then use those savings to fund the expensive part in the future; in other words, why not phase it in instead of putting the huge bill on the national credit card – again?  That would make more sense and prevent the same kind of problems that cost us $100 billion to save Freddie and Fannie, expect that a healthcare bailout would cost about a trillion dollars.

It’s hard to believe that these smart politicians can’t design a bill that actually reforms the system instead of one that promotes a manifesto filled with panels and czars whose pronouncements are exempt from judicial review. That last part alone makes me nervous and it should make you nervous too.

Marty Richman is a Hollister resident. His column runs Tuesdays. Reach him at [email protected].