Here in Hate City, where the Potomac flows silently past an ever-babbling riverbank, the healthcare reform debate has degenerated into partisan sound-bite salvos. So far, all that is certain is that money is scarce and truth is scarcer.
Elephants and donkeys and blue-dogs are chasing each other’s tales. And the news media’s idea of balanced coverage is balancing each shovelful of distortion from the Right with a shovelful of distortion from the Left.
Today we are trying a new tack. We have conned leaders of the Left and Right into tossing back a few bar shots of truth serum. Finally, they are telling us the tough truths about how they got us into this healthcare mess, so we can figure out how to get out of it:
— From the Labor Union Leaders: For decades we got ourselves re-elected by getting wage increases for our rank-and-file. Finally we knew management couldn’t go higher — but we still had to deliver something. We found our new angle in an old Internal Revenue Service regulation exempting taxes on employer-paid health benefits. We got our members more money in the form of super health insurance and pensions — tax-free! For decades, employers passed the buck along to future CEOs and corporate boards. Of course, our workers now had no incentive to be frugal about spending on health care. Who cares what it costs if somebody else is paying? Here’s the truth: We were greedy.
— From the Doctors: We took advantage of a huge Medicare loophole that amounts to open-ended payments for us. When Medicare limited on what we could charge for each health problem, we got into a business sideline. We bought medical labs and equipment — and made more money by prescribing imaging tests, scans and you-name-it from our own labs. Congress tried to stop our obvious conflict of interest; Medicare wouldn’t pay for tests when a doctor referred patients to a lab the doctor owns. But our lobbyists got us a new loophole permitting payments when a doctor conducts in-office tests — and we doctors moved our labs into an office next-door and got that defined as being "in" our offices. So we continued ordering extra tests. The more we test, the more we make! All right, we were greedy.
— From the Hospitals: Medicare will only pay us a flat fee for each patient’s medical problem. So we rush patients in and rush them out. If they’re not really recovered and a complication sets in, hey, that’s a new case and a new fee for us. Preventative medicine isn’t in our financial interest. Greed is.
— From the Insurance Companies: We sold America on the idea that Health Maintenance Organizations would save healthcare by cutting costs. Then we made huge windfalls by denying many tests and coverage and delaying others. America got mad because we got greedy.
— From the Congress: Our guilt in the making of this mess begins by admitting we get our political money from all of the above special interests. And we enact the loopholes drafted by lobbyists for the unions, doctors, hospitals and insurance companies. Then we give populist speeches blaming the other party – but our opponents aren’t as bad as we say they are, and we aren’t as pure as we say we are. But we need lots of campaign money so we can keep saying it.
Today, experts on all sides have dueling proposals that have one thing in common: They are massive.
But there is a slimmer solution. Members of Congress and all federal employees have an outstanding plan by which they can buy excellent health insurance, with the government paying more than half the cost of premiums.
So perhaps all sides can agree on a slim and simple principle: All Americans deserve a plan that’s as fair and understandable as the one Congress and all federal workers enjoy. Perhaps the federal plan can be reshaped as the people’s plan. Open it to us all.
(Martin Schram writes political analysis for Scripps Howard News Service. E-mail him at martin.schram(at)gmail.com.)