WHERE's THE BEEF?

Several years ago, Wendy's ran a very successful and memorable ad campaign with an old woman screaming, "Where's the Beef?" This ad's theme, for those who may have forgotten it or never seen it was that Wendy's competitor's hamburgers were very, very small, while Wendy's burgers were substantial. This same slogan can be used when talking about and/ or evaluating the main two programs that the President and the Congress have been spending so much time on - - health care, and joblessness.
Yesterday, President Obama gave a speech (it is beginning to seem like the "Speech of the Day" club) about how he would like to have Congress address the extremely high unemployment situation (What took so long?). Some of the President's suggestions included help for small businesses, transportation, energy- efficient homes, etc. Mr. Obama stated that the U.S. has to "spend our way out of this recession." Since more than 7 million Americans have lost their jobs since the recession began about two years ago, and the unemployment rate is 10% (that's the statistic although the reality is far higher), Mr. Obama called the rate "staggering" and made several proposals (cost estimates of about $150 billion +) he said would stimulate hiring and put Americans back to work again. Those proposals included: bridge and highway construction (MY NOTE- short-term and long-term, infrastructure programs usually add value and provide something eventually needed); for small business tax cuts (including elimination of capital gains if expenditure was accompanied by adding jobs); and credits for making homes more energy efficient. In addition, the President recommended more protections re health insurance for laid off workers, and suggested additional spending for seniors and veterans, and additional aid to states and municipalities so they won't have to lay off workers. This plan, of course, would have to go through and be approved by a splintered Congress, which is extremely time consuming and the result is unsure. All of this is being proposed while the President continues to talk about the need to address the growing Federal deficit. Many Republican leaders have already scoffed at this proposal, and if any program finally passes, I fear it may be another case of "too little, too late," and contain as much "pork" as effective program. It is always easy to criticize and point out the weaknesses in a plan, but isn't it about time for politicians to actually work FOR their constituency, instead of constantly playing politics (SEE YESTERDAY'S BLOG ABOUT POLITICIANS VS STATESMEN)?
In the meantime, the health plan debate goes on. Last night, an announcement was made that a compromise was reached where the "public option" would be replaced by a different alternative. There was another announcement that a vote was taken regarding language about abortion, and the more severe exclusionary language would not be included. Since the House bill that was passed last month will differ substantially from this Senate bill, a joint compromise bill will have to be arrived at, after which both the House and the Senate will have to approve. Further complicating the matter is certain language in each version appears to be distasteful to a large number of the supporters of the other version. The truly sad thing is, that after all this time and expense, if and when a final bill is approved, there is no assurance that it will be better, less expensive, or provide any better quality medical care. In fact, many independent (?) studies have indicated that the likelihood is that insurance will be more expensive for many, and provide lesser coverage for those fortunate enough to presently enjoy good medical insurance coverage. The costs, medical liability issues, unnecessary testing, expense of drugs, malpractice grants, etc. do NOT appear to have "made the cut" in either plan, but, of course, we do not really know what the final plan might look for. However, I have a hunch, that when all is said and done, that little voice in my head will hear the old lady chiming in, "Where's the Beef?"

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America's Health Plan

Everyone, whether Republican or Democrat, conservative or liberal, would agree to a couple of things about our health care in the U.S.: (1) The costs have escalated dramatically, and continue to rise at an alarming rate even during a recession; (2) All Americans should receive adequate health care. From that point on, the politicians, "spinners," pundents, advocates, etc. take over, and create opposing plans, none of which address both of the things that they originally agreed upon.
The plan passed by the House, and what appears to be the plan being proposed in the Senate, differ in many major ways. Yet, neither of them addresses the two basic issues listed above! The House plan passed was approximately 2,000 pages of verbal legal jargon, that few representatives read in its entirety. Most representatives assign that "heavy lifing" to their aides, who then summarize the plan to the Congressman. The very fact that the plan was passed almost entirely by one party and opposed by the other, indicates that politics, rather trying to create the best plan, is the rule! The Senate is now bringing up a plan that all the details have NOT been disclosed, and needs 60 votes to even get to the Senate floor to be discussed.
The American public hears the health proposals via the "spin-meisters" and politicians and advocates, who only state part of the issue. The Republicans discuss the malpractice issue (and its related costs) and the Democrats avoid that issue because politically they don't want to offend the trial lawyers. The Democrats discuss mandating coverage, and the Republicans object to mandates and the related costs. The Democrats speak of taxing big earners in one version or large companies in another, without discussing the ramifications. The Republicans avoid discussing how to address adequate health care for all, and instead object to the costs of the Democrats plans. An objective observer would say that BOTH sides are "spinning" both the numbers and the plans to make their ideas seem better.
In other countries, there are public health programs. A dentist friend of mine from London recently developed an illness, which was taken care of expeditiously and effectively, because, as he put it, he had "private insurance." In the Bahamas, there are both public and private plans. Canada has had universal health care for many years. However, these countries have far smaller populations that in the U.S., and plans that work in one country may not work in all.
We need to develop a different frame of mind regarding many issues related to health care if we are to accomplish the important task of achieving the two worthy goals stated at the beginning of this blog. (1) Health insurance must be able to be sold across state lines. That would increase competition, offer more alternatives, and somewhat lower costs. (2) We have to cap non-medical malpractice liability payouts, so as to reduce overall health care costs, (3) We have to be much smarter in terms of forcing unfunded mandates on employers, hospitals, local governments, etc ., (4) We have to have a more efficient drug creation and review policy, to reduce both the costs of bringing drugs to market, and increase usage of generics, (5) We have to curb the use of the huge amount of unnecessary testing done, much of which is done by doctors to protect themselves from medical malpractice liability, (6) We need to reduce government waste, by the continuous use by governments of multiple, off duplicative layers of beaurocracy, (7) We must permit whatever economies of scale can be effectively used to reduce costs, (8) We must create a better electronic system where x-rays, tests, etc., taken in one locale, are easily available to licensed professionals elsewhere, (9) A greater emphasis on prevention is essential, (10) A fair evaluation as to when alternative methodologies might be an important part of the medical puzzle, and most importantly, (11) WE MUST "THINK OUTSIDE THE BOX."
The American public cannot let the politicians do "their thing" with an issue such as this, where any plan approved will most likely be a hodge-podge, mish-mosh, expensive and eventually dysfunctional and unworkable program, that we must simply reform again in a few years. This is too important - - - let's get it right the first time!!!

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