For­get it, sweet­heart

Con­sider re­form bills on mer­its, not the pork they carry for in­di­vid­ual states

Modern Healthcare - - Opinions Editorials -

Over the past few tu­mul­tuous weeks, both the U.S. House of Rep­re­sen­ta­tives and the U.S. Se­nate passed ma­jor pieces of leg­is­la­tion de­signed to fun­da­men­tally change the na­tion’s health­care de­liv­ery sys­tem. But as we and many other news out­lets have re­ported, fed­eral law­mak­ers may not have voted for health­care re­form per se as much as they may have voted for sweet­heart pro­vi­sions con­tained in the re­form leg­is­la­tion.

With so much at stake not just for the health­care in­dus­try but also for the fu­ture eco­nomic health of the coun­try, we urge the law­mak­ers charged with rec­on­cil­ing the House and Se­nate bills to strip out all the pork and force each mem­ber of Congress to vote solely on the mer­its of the merged bill. That’s the right thing to do, and that’s the only way the Amer­i­can pub­lic will be con­vinced that their elected of­fi­cials acted in their col­lec­tive best in­ter­est, not in the in­ter­est of vot­ers in a hand­ful of states rep­re­sented by savvy politi­cians.

Would Sens. Ben Nel­son (D-Neb.) and Mary Lan­drieu (D-La.) have voted for the Se­nate bill ab­sent their sweet­heart Med­i­caid deals?

Would Sen. Bernie San­ders (I-Vt.) have voted for the bill ab­sent his sweet­heart com­mu­nity health cen­ters deal?

Would Sen. Christo­pher Dodd (D-Conn.) have voted for the bill ab­sent his sweet­heart aca­demic med­i­cal cen­ter deal?

Those ex­am­ples are just the ones that have gar­nered na­tional at­ten­tion. But we’re sure that there are dozens if not hun­dreds more in the fine print of the two mas­sive re­form bills as well as other wink-and-anod deals that were never writ­ten down. Leaders in both the House and Se­nate have brushed aside crit­i­cism of horse-trad­ing as busi­ness as usual in Wash­ing­ton. They say that’s how things get done and how things al­ways have got­ten done. So it’s no big deal.

Maybe that’s true. But with leg­is­la­tion that holds the po­ten­tial of for- ever chang­ing the course of health­care and the na­tion’s econ­omy, we need to hold Congress to a higher stan­dard. The feed­back from our read­ers in­di­cates that most of them feel the same way (See Let­ters, p. 21). Re­gard­less of where they come down on health­care re­form, they’re not happy about how the re­spec­tive bills got passed out of both cham­bers.

So, the ques­tion be­comes, who will step up and de­mand that each rep­re­sen­ta­tive and se­na­tor come clean and dis­avow spe­cial-in­ter­est pro­vi­sions and vote for or against the merged re­form bill solely on the mer­its of the leg­is­la­tion? Does the fi­nal bill head­ing to Pres­i­dent Barack Obama’s desk ex­pand ac­cess, con­trol costs and im­prove qual­ity? Yes or no, se­na­tor? Yes or no, con­gress­man?

It likely won’t be con­gres­sional leaders, as they’re the ones who cut the sweet­heart deals. It likely won’t be Obama be­cause his pri­or­ity is the pas­sage of a health­care re­form bill. He’s not sweat­ing the de­tails on how it gets passed. It likely won’t be the Amer­i­can peo­ple be­cause they don’t seem to have any say in the re­form process. Pub­lic opin­ion ei­ther way is quickly dis­missed as ex­trem­ism that shouldn’t be taken se­ri­ously. It won’t be the me­dia. The me­dia are in the same boat as the pub­lic. Opin­ions ei­ther way are jet­ti­soned as lib­eral or con­ser­va­tive bias.

So that leaves health­care ex­ec­u­tives and in­dus­try leaders. Who knows bet­ter than the peo­ple who run and lead the health­care de­liv­ery sys­tem whether the pro­posed re­forms in a merged bill will ex­pand ac­cess, con­trol costs and im­prove qual­ity? They should step up and de­mand that all 535 rep­re­sen­ta­tives and se­na­tors push their gravy­filled plates away from the ta­ble and take a stand on the mer­its of the merged bill. They need to do so de­spite the fact that many of the sweet­heart deals will ben­e­fit their or­ga­ni­za­tions fi­nan­cially. They need to look be­yond their own in­ter­ests and call Congress on what it’s do­ing. It’s what their pa­tients—the sick and in­jured who rely on them for care—need them to do.



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