Obamacare, Football and Prizefights, The Battles Continue

http://www.washingtonpost.com/wp-dyn/content/article/2011/02/06/AR2011020603109.html

Divide et Impera

Divide and Conquer

Julius Caesar

The passage of Obamcare was not the superbowl of healthcare reform. It was more like the first round in a prizefight. As the article today discusses, there is still a substantial amount of lobbying money going to Congress in anticipation of the next few rounds of legislative pugilism. The first round was won by the unions and large businesses, who made certain Obamacare remedied their specific ailments, with little thought for the country as a whole(see posts from 6/29/10, 9/11/10, 11/25/10).

Although a poorly conceived framework for increasing coverage was hammered out, other big issues were deferred. How costs will be cut, and who will suffer from those cuts remain to be determined.

Obamacare was passed using budget projections that at best could be described as fanciful, and at worst as blatant fraud. Within a few years, Congress will be presented with a huge bill they cannot pay, and enormous, truly painful choices will need to be made.

What percentage of money will go to hospitals, drug companies, and doctors? What services will be covered, and what will not? Will care be rationed by the government, or left up to the healthcare plans? Will doctor reimbursement cuts curtail care? How will drug costs be contained? Will hospitals be allowed to continue to receive their cost/plus payments without complaint?

In our country, these decisions are not made by reasoned people attempting to balance the best interests of the many groups involved. Instead our country has an adversarial, money driven system, manipulated by pressure groups wielding votes and money to influence elections. As Obamacare demonstrated, the spoils go to the best organized and funded. If form holds true, the drug companies and hospitals will win the next round. Their well financed, professional and unified messages will play well to our botoxed and tanned Congress.

Doctors lost the first the healthcare battle due to their inability to mount a coherent and understandable message. Rather than taking up the mantle of quality care, doctor groups are busy fighting among themselves over how to split the pie. Instead of banding together to represent the profession, they has splintered their resources into a myriad of ineffective and contradictory lobbying groups presenting an incoherent and contradictory message that is easy to ignore. The vestiges of “rugged individualism” combined with jealousy and greed have rendered physicians incapable of winning this battle. I don't bet much on sports, but I know who I would have my money on in this fight.