Making Sausage

The current health care debate is a forceful reminder of the truth of the old adage that the last things you would want to watch being made are sausages and laws.

President Obama wants to reform our dysfunctional health system. 

America doesn’t have a socialized system, like England, where doctors work for the government. We don’t have a single-payer system, like several European countries where medical care isn’t socialized, but health insurance is. And for better or worse, neither Congress nor the President is proposing that we emulate either approach. Instead, Obama wants to control costs, crack down on insurance company abuses, and create a public insurance option to compete with insurance companies—much as Medicare competes with private coverage for older Americans.

 Seems like a no-brainer. Thirty percent of Americans get their health insurance from government now, and government at all levels currently pays over 60% of all American medical costs. Curbing the waste and inefficiencies that characterize our current haphazard health delivery would save taxpayers a lot of money.

 But it has become clear that reform of any sort faces long odds; for one thing, there is too much money and power being deployed by those who are richly rewarded by the current system.

 A couple of weeks ago, my local newspaper ran an important investigative report about our own Senator, Evan Bayh, whose wife Susan raked in over two million dollars in two years for her “service” on the boards of several healthcare companies. The Senator seemed shocked—shocked!—that anyone might think this bonanza constituted a conflict of interest. (For those who believe it isn’t a conflict, or that this is an isolated case, I have some underwater land in Florida I’ll sell you…)

Public interest watchdogs report that insurance and pharmaceutical companies are spending huge sums to spread fear and disinformation about reform proposals. Since public understanding of these issues is thin, to put it mildly, they’re making progress; the New York Times recently told of a man who screamed at a public meeting “the government better keep its hands off my Medicare!” Others evidently believe that reforms will include “death panels” to expedite killing off old folks. 

 Meanwhile, ironically, insurers profess concern that “bureaucrats” will get between you and your doctor.  Those would be the same companies that list the doctors you can see, specialists you can consult and for what symptoms, and tests your doctors can or cannot perform for a given set of symptoms.

The lobbyists’ most recent tactic has been sending angry mobs to shut down discussion at public forums. This is faux populism, sometimes called “Astroturf” because it’s meant to look like a genuine grass-roots movement. Leaked memos confirm that the intent is not to argue the merits of particular provisions, which would be both useful and legitimate, but to drown out discourse and intimidate lawmakers.     

 It would be immensely productive to have an honest debate about what is actually proposed, how those proposals would work, and how they would affect our economy. Unfortunately, special interests from all parts of the political spectrum are determined to hijack that debate.

 We can give up eating sausage, but we have to live with the laws we pass. It would be so refreshing if at least some of those were based on a thoughtful consideration of actual evidence.


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