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Stones & Bones / health care / volume 11 number 6, June 2009 DOSE OF REALITY As we watch the Senate Committee on Finance grapple with the task of how to reduce the cost of health care in the United States it is easy to get the impression that we are watching a remake of the old movie, Abbott and Costello Meet the Invisible Man, a comedy horror film from 1951. The plot in the new version is thin; centering on the old-timey burlesque gag in which the players have a problem that they stumble around trying solve, not realizing that the solution—which as the watching audience is well aware—is obvious. That solution is virtually staring the Abbott and Costello company in the face, but of course these comics cannot see it, and they take humorously extreme measures to avoid looking in the right direction. Replacing Abbott and Costello as lead comics in this modern-day version of that film are Senate Finance Committee chairman Max Baucus (D-Montana) and his strait man Chuck Grassley (R-Iowa). The part of The Invisible Man is played by the proposal for single-payer health care, best embodied at the moment by HR 676, introduced into Congress last year and gaining increasing public support. The remainder of the cast is comprised of the other twenty-one members of the Senate committee and their staffs. Experts all, the cast excellently parodies how we in the public think our elected officials should represent our interests. The show is not all comedy. The actors try hard to portray that they are seriously looking at ways to reduce health care costs and expand access to health care. The problem of course is serious, and getting worse with time, the average cost of health care now rising to above $7,000 per person. The entire cast emphasizes that it believes that change is needed and that each member is working hard toward that end, trying to look at all options. Yet this group has steadfastly refused even to talk about the one best option available: a system of single-payer health care that would cut health care costs by hundreds of billions of dollars, perhaps as much as one-third of current costs. Like Abbott and Costello’s Invisible Man, this option has to remain unseen by the actors in this movie. One scene in this modern movie demonstrates how far the Senate Finance has gone to avoid the obvious best option to health care reform. It takes place at a meeting on health care held several weeks ago by the Senate Finance Committee where the Invisible Man showed up in the form of several activists promoting the establishment of single-payer health care. It seems hard to believe that people providing the committee with another option to consider would not be welcomed. Not only were the single-payer activists refused an audience, they were arrested! Then a week later, twenty uninvited nurses promoting single-payer showed up at another committee hearing. They were asked to leave, and they did. That’s our democratic representative government in action, Abbott and Costello style. Makes a person proud to live here in America, doesn’t it? Ignoring poll results indicating that 60 percent of Americans and doctors are in favor of single-payer health care, and after getting rid of all those unruly promoters, the Senate committee went into closed session to consider a forty-one-page list of policy options for financing health care reform. This list contains some real doozies, fitting of the comedic horror of the situation. A choice one is a proposal to tax sugar-containing soda pop. The idea is that the whole problem with health care in this country is that Americans are too fat. They are too fat because their sugar intake is too high. Therefore we can kill two birds with one tax. The result will be skinnier, healthier Americans and maybe up to a piddling $24 billion in new taxes derived only from the pop-drinking citizenry. Nice thing about this option is that it doesn’t reduce the profits of our important private industries like the private insurance and pharmaceutical companies, so certainly they won’t object. Whoops, we forgot about the Coca-Cola Company and Pepsi Inc.! Best not offend them either, so let’s forget this one. A number of the options being considered don’t generate any new money to pay for health care or reduce its actual cost. They are merely cost-shifting tricks involving reduction of health insurance payouts by forcing increased direct payments by consumers for their health care. The idea here is to make health care look cheaper by hiding some of the accountable costs. Specific actions would be to reduce direct payments to hospitals and other Medicare and Medicaid providers, despite the fact that they are already suffering underpayment in many instances. If adopted, two of the cost-shifting tricks will hit Alaska particularly hard. One is the proposal to make more geographically uniform the Medicare payouts to providers. At the moment, Alaska receives the highest level of Medicare payout in the nation, 135 percent of the average. Alaska Medicare beneficiaries are already having a difficult time finding doctors to serve them, and so if this option is incorporated in a health reform bill older Alaskans will be in even deeper trouble. The other damaging option involves cutting payments to hospitals operating in areas designated as having many residents with low incomes (disproportionate care hospitals), and most Alaska hospitals fit in this category. It’s for reasons like these that the Senate Finance Committee machinations make the whole operation look like it was scripted by Abbott and Costello writers. It would be funny if it were not so sad. Sad because this comic production sends the strong message that many senators are more interested in serving the interests of the health insurance and pharmaceutical industries than those of the public. Neil Davis is a retired geophysicist and author of several fiction and nonfiction books. His most recent book is Mired in the Health Care Morass. More on health care issues can be found at his blog, http://healthcaremorass.blogspot.com. Neil can be contacted at neildavs@mosquitonet.com. | ||
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