Thursday, July 23, 2009

Health care

I tried to hear the President say something of substance in his news conference last night, but to no avail -- unless you count the minor point that he's okay with taxing millionaires. Whoop de doo.

Obama is not nearly so fluent when speaking off the cuff as he is when delivering a prepared speech, but still adroitly ducked a question about whether he would insist on a public option being part of the final bill. He also managed to avoid making any concrete suggestions regarding how cost containment could be accomplished. Both of those must be present in a final bill if we are to have any hope of a successful outcome.

The harder task, by the way, is the cost containment -- and the problem lies not with the "moderates" of both parties who insist on fiscal responsibility, but with the "business as usual" Democrats catering to health industry lobbyists working to preserve the cash cows of their particular employers. It seems to be clear to everybody but doctors and hospitals that the "fee for service" model has to be jettisoned and replaced with outcome based compensation. It seems to be clear to everybody but Big Pharma that insurance plans should not pay for high priced drugs under patent protection when older, generic substitutes will work just as well, or better.

I needn't go through all the examples of industry players fighting hard to maintain the status quo because it's more profitable than change -- everybody who's been paying attention gets it -- but the resistance to researching which treatments for different medical conditions achieve the most positive outcomes is not just mind boggling -- it is immoral. Don't blame the lobbyists, though -- they're just doing their jobs. Blame Congress.

The CBO's recent report, which projects a trillion dollar cost over ten years for the plans currently knocking around the House committees, should not be ignored. It's not often I find myself in agreement with Ben Nelson and Mike Ross, but their criticisms of the plans that currently are in play are valid criticisms.

It's time for the rest of the Democratic Party to deal with cost containment -- and it's time for Barack Obama to take the lead.

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