Dr. Rich explains the difference between the healthcare reform being pushed in Congress and real healthcare reform.
Here’s Congress’s idea of healthcare reform:
Now that five reform plans have been advanced by five Democrat-controlled Congressional committees, a few prominent Democrats – Pelosi, Reid, and Baucus to name a few, along with numerous staffers and sundry czars of this and that – will gather in secrecy to put together a “compromise” bill aimed at being acceptable to enough Democrat legislators to pass both houses of Congress.
In concept this sounds easy, but we have seen that it won’t be. They will have to assemble a bill that holds together both the radical left-wing of the party and the conservative (so-called Blue Dog) Democrats. The bill will have to be written so that both the progressives and the conservatives can be convinced that the bill honors their views (or, at least, gives them sufficient political cover, if not sufficient pork, to assure reelection).
Obviously, creating such a bill will be difficult if not impossible. So most likely, when the Democratic leaders write that final bill, they will have to obfuscate.
The bill will have to be written in such a way as to be fundamentally obscure, so that everyone can see what they want in it, and can assure their constituents that their wishes are being honored. Each faction of the Democratic party will be assured in private meetings that the bill actually accedes to their demands – but that this result cannot be spelled out in so many words, because the bill still needs to be sold to the opposite faction. (To see how this can be accomplished, simply read HR 3200, a masterful work that actually says whatever you want it to say.)
Obviously, this same obscurity will also allow critics of the bill to find in it whatever they want – from death panels to puppy mills – then to stir up the great unwashed masses, so it will be important to keep critics from seeing the bill before the final vote. Thus it will be necessary for the Democratic leadership, once the bill is written, to invoke once again the now-standard “dire emergency,” which of course makes time of the essence, in order to force a vote before anyone has a chance to read it. This procedure has now become commonplace in the tradition of our American Congress, and should not produce too much heartburn. It has also become standard practice to rely on the American press not to notice that a few days or weeks delay would not really make much difference in a bill whose implementation will likely not take place until at least 2013. (Implementing it any earlier will put the election of 2012 in grave jeopardy.)
And here’s real healthcare reform:
Real reform would require us to:
A) Minimize the necessity of imposed rationing by having patients themselves make as many of the spending decisions as possible, using their own money. (Subsidies could be provided to people who don’t have enough of their own money to pay for routine healthcare.)
B) Provide everyone with a high-deductable, catastrophic insurance product to cover non-routine medical expenses. This is where the necessary rationing would take place, but the rationing would be open, transparent, and determined through a public process.
C) Create a private market for “extra” health insurance for those who choose to supplement the universal catastrophic plan with their own funds.
But of course, any plan that relies on both personal responsibility and open rationing is a non-starter. Which is why we are going to get what we are going to get.
There’s much more of this in Dr. Rich’s terrific blog post.