onparkstreet

The Self-Reflecting Mirror of Good Intentions

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“The most interesting, under-discussed, and potentially revolutionary aspect of the law is that it doesn’t pretend to have the answers. Instead, through a new Center for Medicare and Medicaid Innovation, it offers to free communities and local health systems from existing payment rules, and let them experiment with ways to deliver better care at lower costs. In large part, it entrusts the task of devising cost-saving health-care innovation to communities like Boise and Boston and Buffalo, rather than to the drug and device companies and the public and private insurers that have failed to do so. This is the way costs will come down—or not.” – Atul Gawande, The New Yorker (via Real Clear Politics)

Or not? Or not? Or not?

Wait a minute. Proponents of Health Care Reform insisted that a crisis existed in American medicine – a crisis of steadily increasing costs and the uninsured. Forget for a moment the pages and pages and pages of regulation: the essential steel-frame structure at the heart of the bill consists – it seems to me! – of committees that have yet to write the myriad of rules that will govern the future of health care in this country. Isn’t that the case? Am I getting it wrong? And if I am, it’s not like the authors of the legislation took care to write something a layperson like me could understand. Do even the authors know what is in it?

I respect the good Dr. Gawande very much, but I cannot understand how any physician or scientist – who ought to pride him or herself on evidence-based medicine – would sign off on something like this? It’s all supposition. It’s all promises. It’s all the self-reflecting mirror of good intentions.* There’s no there there. Not really. Not if you look beyond the gimmicks.

Hey, if I’m being unfair, or misunderstanding, drop a line in the comments box, okay?

* I used the above phrase in this comment at zenpundit on an entirely different subject. I’m pretty sure I made it up on the spot, but somehow, I always have a subterranean fear that I am plagiarizing someone a lot more clever than I am. Not sure what that is about, but now, thanks to my penchant for TMI, you all know that about me!

Update: I am not saying the uninsured or costs are not a serious problem. What I am arguing is that the very legislation intended to solve the problem of cost is a roll of the dice in that regard. Why do we need an oxymoronic government “department of innovation” anyway? Why not break down government-set barriers and allow the experimentation to take place in the absence of said barriers? Honestly, I couldn’t understand a bit of the logic behind that article.

Another Update: “Two Views On Health Care From The New Yorker,” Peter Suderman (Reason – Hit and Run)

To be clear….

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“To be clear: it is not sufficient for those of us in the opposition to await a reversal of political fortune months or years from now before we advance action on health care reform. Costs will continue their ascent as the debt burden squeezes life out of our economy. We are unapologetic advocates for the repeal of this costly misstep. But Republicans must also make the case for a reform agenda to take its place, and get to work on that effort now.” – Paul Ryan in the New York Times

Is that “to be clear” intended as a little dig at the rhetorical style, or stylings, of our President? Gentle jokes aside, this is a very good Op-Ed.

*Because there’s more to life than Health Care Bills, here is a link about the William Eggleston photo exhibit at the Art Institute of Chicago. The exhibit is running until May 23.

But the evidence is right there – right there! – in front of you.

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(paraphrasing a conversation)

Me: Hi, I’m calling about my AMA dues notice?
AMA representative: Yes?
Me: I’m not a member currently. I’d like to be removed from your mailing list, please. I don’t plan on becoming a member any time soon, so I don’t need the dues notices.
AMA representative: Okay.

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From the AMA website a couple of days before the vote: “Washington, D.C. After careful review and consideration, the American Medical Association (AMA) today announced its qualified support for the current health reform bill as a step toward providing coverage to all Americans and improving our nation’s health system.”

Also from the AMA website (where they have a counter “counting down” to the 21% Medicare Physician cuts with the admonition to “take action now”:)

“Resolving the problem now is the fiscally responsible course to take. Relying on past methods of postponing the immediate crisis will only increase the cost of a permanent repeal. Congress can no longer afford to kick the can down the road.”

Does anyone want to explain the above statement to me? Seriously, I’m trying to understand what the organization might mean with that statement about fiscal responsibility – as they ask members to call and complain about cuts to physician medicare payments. What was that about CBO scoring again? I’m a dunce at all of this, so I ask for help from the readership! It’s a real question….

“It’s Now or Never”

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“If you want to make your voice heard on the health-care bill before the House votes on Sunday, you’d better do so quickly.” – Ed Whelan, NRO (via Instapundit)

Don’t stop calling even if the vote ends up passing the thing. I’m quite serious about this. Keep relaying your concerns, keep calling, keep at it. Actions should have consequences.

Update: Oh goodness, Instapundit is linking to this report of an incident in which serial phone calling to a Congressman’s office is interpreted as a form of harassment (Huh? How is that harassment? It’s about a specific bill that the Congressman is voting on ?)

Well, I certainly don’t want anyone harassed or treated in any way other than civilly and decently. I wonder, however, if such incidents are inevitable given that technology has empowered us “little people” (an Army of Davids!) to repeatedly call, or text, or fax our Congressman, while the low-tech Congressional side is nothing other than a person logging the calls or texts or faxes. I don’t think this dynamic is going to change any time soon, and in an odd way, highlights the problems with a central authority attempting to deal with such a complicated phenomenon as rapidly changing technology. It’s yet another illustration of why health care shouldn’t be managed by central authorities… .

“What people need to know is that Obama’s plan evades health care’s major problems and would worsen the budget outlook. It’s a big new spending program when government hasn’t paid for the spending programs it already has.”

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– From this Robert J. Samuelson article in the Washington Post (via Instapundit).

Many CB readers likely have read the above article, which does a nice job challenging certain aspects of the intellectual and policy “group-think” at the heart of ObamaCare. But never fear – I’m sure the same political class that sends its children to private schools in D.C. will cheerfully take its place in line with the rest of us should the “reform” fail to live up to expectation.

Update: Ezra Klein interviews Rep. Paul Ryan.