Wednesday, August 12, 2009

Wayout from Squeeze Play

Jonathan Cohn has an excellent column about how two sided attack, but pulling in opposite direction, GOP is mounting on Health Care Reform. One, how costs are not controlled and when Democrats actually go for controlling costs by instituting independent panels to decide Medicare disbursement; by accusing Democrats to introduce Government in private medical decisions.

There are two answers to this attack:

A. One separate out these and other issues from one monolithic health reform umbrella bill into individual bills. White House has wisely, and by necessity of vastness of the topic, adopted an approach of dealing banks and finance in all separate bills. Such a piecemeal approach is needed here. This is expected to avoid all unnecessary compromises which are unfolding in Congress in order to get this one single monolithic bill passed. Things which otherwise have a broad bipartisan support are caught up in other controversial aspects of the bill and as a result nothing gets passed as well as political debate becomes needlessly hotter. At least 3 separate bills should be there:

1. one dealing with Insurance reforms and instituting national level health insurance exchange,

2. the other for an independent body to control Medicare Cost and

3. finally expansion of coverage for those who do not have coverage or afford coverage in the current system with the provision of adding new people as and how money is freed by cost control rather than upfront, deficit increasing coverage expansion. Even Public Option for expanded coverage can be brought in if in next few years private insurance companies do not show improvements in serving consumers.


B. The second thing is to say emphatically that health care reform indeed means adopting policies which decide when to end 'tax payer' paid treatment of Grandma in her last days of life. See, GOP is attacking Democrats with the implicit suggestion that Dems are pulling this plug because they want to extend this welfare to those who do not have any coverage at all. This is where separation of issues will help Dems to argue that regardless of whether coverage is increased or not; just to have the fiscal house in order we need to undertake an approach of triaging costs for end-of-life care. It is not a question of morality but simply responding to the need of being fiscally balanced and prudent. Today these questions are not asked nor answered because Medicare is footing the bill by other people's taxes with 'no questions asked' exorbitantly expensive policy. It is the duty of American Government to be accountable for taxes paid by people for Medicare and be vigilant.

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