Su­per­com­mit­tee’s fail­ure shows what politi­cos are for­get­ting

Politi­cos fail on the econ­omy while for­get­ting what hap­pened in the past

Modern Healthcare - - MODERN HEALTHCARE -

Notes on the news:

Ven­dors nowa­days of­fer their cus­tomers ser­vices that they in­vari­ably la­bel “so­lu­tions.” The Amer­i­can po­lit­i­cal es­tab­lish­ment, es­pe­cially Congress, ped­dles so­lu­tions that are in re­al­ity, prob­lems—huge ones.

That be­came painfully ev­i­dent to health­care pro­fes­sion­als and just about ev­ery­one else with the fail­ure of the wildly mis­named su­per­com­mit­tee to reach a deficit-re­duc­tion deal. Now providers are left fac­ing Medi­care cuts, in­clud­ing a 27% whack to physi­cian pay­ments, as well as a raft of painful re­duc­tions in dis­cre­tionary health spend­ing. They and the rest of the coun­try face an­other year of po­lit­i­cal bick­er­ing and fis­cal uncer­tainty.

What brought us to this point was the hi­jack­ing of the national agenda by a de­ter­mined mi­nor­ity of ide­o­log­i­cal zealots. While the rest of the coun­try thought the im­me­di­ate prob­lem was a mori­bund econ­omy, our law­mak­ers set up a fis­cal booby trap fo­cused os­ten­si­bly on the long-term deficit prob­lem. This is de­spite the fact that the govern­ment has been pay­ing record low in­ter­est rates for bor­row­ing. At a time when the econ­omy needed a trans­fu­sion, the solons pre­scribed bleed­ing the pa­tient.

Af­ter the deficit deal col­lapsed, the Premier health­care al­liance is­sued a state­ment say­ing in part: “Rather than move to­ward blunt, across­the-board cuts to Medi­care, Premier be­lieves there are bet­ter so­lu­tions to con­trol­ling health­care spend­ing, in­clud­ing mea­sures that will ac­cel­er­ate sav­ings through de­liv­ery sys­tem re­forms.”

Pend­ing a so­lu­tion to the gov­ern­ing prob­lems of this coun­try, such a view is too rea­son­able.

Our politi­cians can es­cape ac­count­abil­ity be­cause so many Amer­i­cans have the at­ten­tion span of a gnat and his­tory is their least fa­vorite sub­ject.

That was brought to mind by a Nov. 17 Washington Post story on GOP pres­i­den­tial can­di­date Newt Gin­grich. The ar­ti­cle noted that a think tank founded by Gin­grich—the Cen­ter for Health Trans­for­ma­tion—had col­lected at least $37 mil­lion over the past eight years from ma­jor health­care com­pa­nies and in­dus­try groups. The pa­per said the cen­ter, which opened in 2003, brought in dues of as much as $200,000 an­nu­ally from in­sur­ers and health­care firms, of­fer­ing them ac­cess to Gin­grich.

An in­ter­est­ing as­pect of the story was that the cen­ter had ad­vo­cated for a re­quire­ment that peo­ple earn­ing more than $50,000 a year buy health in­sur­ance or post a bond. The man­date was part of an “In­sure All Amer­i­cans” plan that had been posted on its web­site.

Such a stance is at odds with Gin­grich’s cur­rent cam­paign dec­la­ra­tions. He says he is “com­pletely op­posed to the Obama care man­date on in­di­vid­u­als.”

The Post quoted Gin­grich as char­ac­ter­iz­ing his pre­vi­ous sup­port for an in­di­vid­ual man­date as a re­sponse to Pres­i­dent Bill Clin­ton’s health re­form plan, which was more govern­ment-fo­cused. He has since turned against the man­date.

The former speaker is hardly alone in this re­gard. Lots of his col­leagues seem to have for­got­ten, per­haps con­ve­niently, that in the late 1980s and 1990s they backed re­form schemes based on pri­vate in­sur­ance ex­changes and in­di­vid­ual man­dates. That was the Repub­li­can and con­ser­va­tive al­ter­na­tive to Demo­cratic pro­pos­als. Many big name GOP law­mak­ers co-spon­sored such leg­is­la­tion, in­clud­ing some who are still in Congress and in­veigh­ing against “Obama care.”

Gin­grich is a his­to­rian and re­tains enough mem­ory to re­call his ear­lier po­si­tions. Per­haps he can tu­tor his cam­paign coun­ter­parts on the his­tory lead­ing up to the Pa­tient Pro­tec­tion and Af­ford­able Care Act. Or maybe—if they read up on the sub­ject—the vot­ers can pro­vide a so­lu­tion.

NEIL MCLAUGH­LIN Man­ag­ing Editor

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