Health insurance and sausage making

It was Bismark who said there were two things we didn't want to see being made; sausage and laws. This summer we are really lucky- we can watch the manufacturing process in living color for both simultaneously! At summers' end, the challenge will no doubt be to make the distinction in the finished products. For without real leadership, the best we may get is a health care plan that passes for sausage.


It began with health care reform initially focusing on the uninsured and medical cost reduction. Then the plot sickened with CBO estimates in the trillions, concern for cut backs in Medicare/Medicaid, tax increases and fears about a public option. It didn't help that the Mayo Clinic has panned the pending house bill. The areas for decreasing costs in our lifetime appeared limited to less paper work via computerization of records, and amorphous administrative savings. Not much about tort reform, or otherwise moderating malpractice insurance. Not much about breaking the geographic health insurance oligopolies in much of the country. Nothing about equalizing the tax treatment for employer provided and individually owned health insurance plans. Little about making costs transparent. In hindsight, we shouldn't be surprised at the lack of specific cost control substance coming from this congress; look at the battle over 7 F22s', Nancy's airplane upgrade. You really cannot expect the foxes to mind the chicken coop - can you?


With the growing public unease about costs, the public option, and the lack of definition on the likely program, our politicians took the low road; health care reform morphed into health insurance reform and finally as an attack on insurance companies. We are now treated to senior congressional leaders going on about "rapacious", "villainous" insurance companies. Of course we do have the equally inane coming from the other side including ignorant comments about "death panels".

So what's next? Nancy Air will fly our august representatives home for the August recess. Some how the senators will get home also ... again at our expense . The WH will go on the town meeting tour to try and gain public support for reform. There is public support for reform; the problem is the lack of specifics; not very many people are against apple pie and motherhood. People want to know how a new plan will help them; can they keep their existing plan? What is the public plan? How does all this get paid for? Who is going to pay for the plan? Is there any "other peoples' money left? Fair questions that deserve direct answers...not the DC shuffle.

When congress returns, the various sub committees will no doubt finish their versions and begin a reconciliation of the different versions into one for the House and another from the Senate and eventually into one proposed law. The downside of leaving essentially everything to congress is we will wind up with sausage.