The Health Care Reform Bill has passed . . . finally. The question is what does it mean and the answer one gets depends whom you ask. In an effort to clear my own thinking, I accepted a luncheon invitation from Congressman Bob Goodlatte. It was well-attended by the party faithful (of which I am not one) but I was appreciative of being included.
Bob Goodlatte, whom I have known since his days as an aide to then Congressman Caldwell Butler, conducted himself impressively. He has a command of the facts, a presentation manner that is authoritative without being professorial, and a sense of humor that has survived his long tenure in Washington.
In his remarks he pointed out a number of serious problems, as well as some good points, in the bill as it was passed. We need not dwell on those here, since they have been bandied about, ad nauseam, for months. Two things impressed me about his talk: First, he knows why he thinks it a bad bill; second, he had almost nothing to say about what better alternative would be.
The questions from the floor he handled with aplomb but many dealt with further explanations of the problems rather than pushing him for better solutions. As I listened to the discussion I thought back to the history of political controversy about health policy.
In 1964 President Johnson proposed sweeping changes in healthcare. Out of this came Medicare and then Medicaid. Although both are contributing to the financial precipice toward which we are being swept, that was not viewed as a problem when the bill became law in 1965. What upset everyone was the socialistic flavor that was rolling across the land; it was not about the cost.
We have heard the same thing about the current legislation but those who have received the benefits from Medicare and Medicaid are, by and large, satisfied with how the programs have worked. Although there was no oversight agency such as the Congressional Budget Office in 1965, government economists predicted that in 1990 the cost of the programs would be 12 billion dollars; in actual fact, in 1990 the cost was 107 billion. Now the unfunded mandated entitlements of Social Security, Medicare and Medicaid to are in excess of 50 trillion dollars. Congressman Goodlatte said, and everyone agrees, that the current rate of debt accumulation is unsustainable.
Then comes the conversation about getting rid of abuse, fraud, and waste in healthcare. These are laudable goals to be sure but will fall dismally short of curtailing the cost. The administration and the Democrats are equally disingenuous in saying there will be a debt reduction of one trillion dollars as a result of the new bill. The CBO has to define the cost of a bill according to the rules set by Congress, the most onerous of which is that the bill must be considered in a vacuum; other programs and their needs cannot be factored into what the government can afford. It is exactly analogous to an individual buying a million dollar house without considering that there are 6 children to send to college while a huge mortgage has to be paid. For the supporters of the healthcare reform to suggest that it is a cost-saving measure disregards not only past history, but present and future needs beyond health issues.
I am often asked how I feel about the legislation. I am confused; I am frightened; I am concerned that both sides are playing fast and loose with the facts. Of even more concern is the public’s opposition, sometimes violent, to anything that will increase taxes, decrease services, or both. The ugly backlash against some Congressman who voted for the bill will give pause to many candidates in the coming election cycle.
I left the meeting feeling somewhat better. Had the issue failed entirely, as it appeared a few months ago it surely would, then we would have faced another 40 years before it could again be approached. That would be too late . . . we cannot survive if changes aren’t made. But we, the people, hate change particularly when it reaches our wallets.
There are only three ways to deal with the debt of which healthcare is a huge part: Raise revenue, cut expenditures, or print money. If you think the latter works, remember hyperinflation of Argentina.
The whole thing reminds me of having to give my children nasty tasting medicine. It had to be done. We held them down, squeezed their wee noses and made it happen. Our bad medicine will be increased taxes, decreased services and
Congress needs to make us take our medicine, even if it costs them their jobs. To ignore the truth is to place the entire system at risk for our grandchildren.
We have survived huge crises in the past and not been found wanting. I hope that will be true this time, too. It will take more than high flown rhetoric and an appetite for self-interest. That applies to ordinary people just as much as it does to Congress.
By Hayden Hollingsworth [email protected]