Memo to Members of Congress Who Have Promised to Deliver Health Care Reform: This Is The Time. No Excuses Accepted (Joe Rothstein's Commentary)

July 15, 2009

By Joe Rothstein
Editor, EINNEWS.COM

MEMO TO MEMBERS OF CONGRESS OBSESSING ABOUT THE COST OF HEALTH CARE REFORM AND HOW TO PAY FOR IT:

Forget about it. Instead...

Think back to all those campaign stops you made in 2008 (and probably in 2006, 2004, 2002, 2000, 1998 etc.). All those questions you took at town hall meetings from all those desperate people, People whose lives were being destroyed by high health costs. The mortgages that couldn't be paid. The fights with insurance companies reluctant to pay claims. All those who couldn't get insurance because of prior health problems, or lost jobs.

Think of all those promises you made to them at the time. “The system's broken. We're going to fix it. It's shocking. It's criminal. It's unfathomable that America---alone of all industrialized nations in the world---cannot figure out how to provide quality, affordable health care for its people.” Your words. Your speeches. Your TV commercials.

Remember all of that?

Did you mean it? Did you really mean it?

If you really meant it, a big (boy) (girl) like you should not be surprised by the avalanche of lobbyists now trying to talk you out of it, or the mainstream media's institutional inertia that resists nearly all major change.

Worried about costs?

Remember that when the Republicans wanted to push through the drug company-friendly prescription drug program for Medicare how to pay for it was never even considered. They just enacted the program without any offsetting cuts, taxes...anything. Not only that, for those members who might have worried about costs they conveniently hid the actual price tag until the bill was signed into law.

(The administrator of Medicare threatened to fire his chief actuary if he told Congress his cost estimates----which were $200 billion more than what Congress was being told. The Bush White House, and presumably the Republican congressional leadership, knew the actual costs all the time but suppressed them.)

Sure a trillion dollars is a lot of money. But we're talking an estimated cost over ten years. If Congress did nothing but stop funding the wars in Afghanistan and Iraq at peak levels the entire health program would be paid for.

And paying for it really shouldn't be the issue at all. The changes coming out of the House and Senate committees are designed to “bend the curve” and get the overall cost of U.S. health care moving lower through more efficiencies, better management, incentives for quality and cost containment and the like. Doing nothing is not an option. Continuing the current system as it is will bankrupt us.

Sure, you're hearing a lot about not letting “a government bureaucrat come between you and your doctor.” That, of course, is a red herring. And if you believe that you shouldn't be in Congress. If you take that argument seriously you never would have voted for an FDIC (putting “a government bureaucrat between you and your bank”) or an NLRB (“putting a government bureaucrat between you and your employer”) or a clean water or clean air act (“putting a government bureaucrat between you and your local utility company”). Etc.

Personally, I have Medicare and an additional private policy to take up the slack that Medicare doesn't pay for. I never hear from Medicare, except when I receive notices of bills the system's paid. They've never failed to pay a bill. Not one. They've never steered me to a doctor or hospital or away from a procedure. From my experience, the Medicare system runs like a Swiss watch.

Making the system accessible and affordable for all is the easy part. The hard part will be attitude adjustment about the role of health care in our society. It cannot be considered just another for-profit business. Where Medicare and a range of well-managed health providers find efficiencies are in places where the medical community works cooperatively to provide needed skills and tests, not where the entrepreneurial spirit is king and success is measured in balance sheet profits.

Getting back to costs, President Obama is insisting that any new health care model is paid for. That's a pretty restrictive policy to impose from the outset, but apparently he, and congressional leadership intend to stick to it. The House version of the bill pays for it through a combination of operational savings and small tax increases on high income individuals.

It's useful to point out that if that increase survives House and Senate votes and becomes the dollar source for health care reform, those with $1 million or more in incomes would be paying just about what they paid in taxes when Reagan was president. Since then, the top 1% of U.S. taxpayers has been about the only group that's made great strides in net worth. The bottom 99% have barely seen the needle move in their own household income. It's hard to make the case that taxing those who have reaped a bonanza during the past 30 years is now unfair or oppressive.

So, members of Congress who campaigned in 2008 (and years earlier) for health care reform:

All your political lives you've been promising to work for, and vote for, affordable, accessible health care. Now you have the chance to redeem that promise. This is the time. If you go wobbly now and it fails, expect no mercy from those you promised. Or from political allies who are counting on you, and won't give you another chance if you let them down when your vote really counts.

(Joe Rothstein can be contacted at joe@einnews.com)