Truth or con­se­quences

Col­lab­o­ra­tion, com­pro­mise still in short sup­ply, but it’s what the pub­lic wants

Modern Healthcare - - Opinions Editorials - DAVID MAY As­sis­tant Man­ag­ing Edi­tor/Fea­tures

“ Elec­tions have con­se­quences.”

That was a fa­mil­iar quote heard in news cov­er­age of last week’s noisy show­down in Madi­son, Wis., be­tween the Repub­li­can gov­er­nor, Demo­cratic lawmakers and union mem­bers over leg­is­la­tion that would ban some col­lec­tive bar­gain­ing by state em­ploy­ees and in­crease cost-shar­ing for their pen­sions and health in­surance ben­e­fits.

They’re also words that have been chanted fre­quently since last Novem­ber’s midterm elec­tions brought sweep­ing changes in state leg­is­la­tures and in Wash­ing­ton. One such elec­toral con­se­quence is sup­posed to be the un­rav­el­ing and even­tual demise of the health­care re­form law.

In Wis­con­sin, one man spout­ing that quote was a state tea party rep­re­sen­ta­tive, mak­ing the point that Wis­con­sin Gov. Scott Walker was elected to slash spend­ing and close a grow­ing hole in the state’s bud­get, so he was only do­ing the will of the peo­ple in de­mand­ing pas­sage of the leg­is­la­tion. What about the tens of thou­sands of pro­test­ers op­pos­ing the gov­er­nor’s bill and seek­ing ne­go­ti­a­tion? “We won, they lost,” was the re­tort, re­fer­ring to the tea party’s achieve­ments in Novem­ber. I guess the mes­sage was that it was time for ev­ery­one to shut up and go home.

By the time you’re read­ing this, it’s quite pos­si­ble that the Badger State fi­nally found a way to move be­yond the stale­mate. But the shrill­ness of the spec­ta­cle will linger. And the same bat­tles are play­ing out in other states across the coun­try as lawmakers con­front the wide­spread dam­age from the Great Re­ces­sion as well as years of fis­cal mal­prac­tice. Health­care spend­ing will con­tinue to be a big tar­get.

So maybe it’s time to look a lit­tle closer at these con­se­quences ev­ery­one likes to talk about. From much of the polling fol­low­ing last year’s elec­tions, it’s pretty clear that one key con­se­quence vot­ers ex­pected to see was a more col­lab­o­ra­tive ef­fort to strengthen the econ­omy and — yes—re­duce gov­ern­ment spend­ing at the state and na­tional lev­els. How- ever, those push­ing for a full re­peal of the health re­form law are mis­read­ing pub­lic opin­ion. A more ap­pro­pri­ate con­se­quence would be an­other “C” word: com­pro­mise.

No­body dis­putes the fact that ac­tions at the bal­lot box equate to some type of change. But is it only this most re­cent elec­tion that has con­se­quences? Are the re­sults of pre­vi­ous elec­tions in­val­i­dated at some level? Of course not. We still have a man named Obama who will re­side at 1600 Penn­syl­va­nia Ave. in Wash­ing­ton for at least two more years. And I be­lieve the sen­a­tors who weren’t up for re­elec­tion in 2010 still have their in­cum­bency in­tact. Their con­tin­ued pres­ence, a con­se­quence of pre­vi­ous elec­tions, is prob­a­bly an an­noy­ance to many fresh­man Repub­li­cans.

Let’s also take a closer look at the man­date to rein in gov­ern­men­tal spend­ing. Ac­cord­ing to a re­cent CBS News poll, nearly 80% of those sur­veyed would in­deed rather cut spend­ing than raise taxes (fa­vored by only 9% of re­spon­dents) to tackle bud­get deficits. But what should be cut?

While spe­cific num­bers var­ied by po­lit­i­cal lean­ings or af­fil­i­a­tion, 67% of those polled said they were “un­will­ing” to cut health­care and ed­u­ca­tion spend­ing, while more than half, or 52%, said they were “will­ing” to trim the de­fense bud­get. Those aren’t ex­actly the con­se­quences that con­ser­va­tives in Wash­ing­ton are tout­ing. And a new USA To­day/ Gallup sur­vey shows that by 2-1 mar­gins Amer­i­cans want Congress to reach a com­pro­mise in the bud­get battle to avoid a gov­ern­ment shut­down.

Still, look for more fire­works very shortly as Congress gets down to busi­ness con­fronting spend­ing bills for the re­main­der of this fis­cal year, the Obama ad­min­is­tra­tion’s fis­cal 2012 bud­get pro­posal, and the pub­lic’s de­mand for de­ci­sive ac­tion to ad­dress the nation’s mon­strous debt. If there are any egre­gious mis­steps, the next elec­tion will in­deed have some harsh con­se­quences.

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