Nobody seems to know what’s going to happen next or what the actual chances of getting reform legislation passed might be. I don’t know about you, but considering all the pimples, warts and wrinkles in HR 3962 and 3590, there is an impulse to breathe a sigh of relief over the opportunity to push the reset button and get this more effectively. On the other hand, the real potential of a complete derailment is really worrisome.

Here’s the reason to keep the champagne corked about the prospects of a prolonged logjam in getting health reform passed: The access to care problems are growing and cost a lot of money in EMTALA and uncompensated care costs; despite the fact that at its best, U.S. health care is the best, quality is uneven and coordination of care is seriously messed up; and most disturbingly, costs are rising more than twice as fast as GDP and our ability to pay for health care. Allowing the status quo to drift forward will mean draconian measures for rationing and tiering of care for most Americans sometime in the near future; and it will most certainly mean ongoing reductions in physician practice revenues and practice and hospital viability. Medicare is moving rapidly toward overt bankruptcy.

Senate Minority Leader McConnell said the Massachusetts election made clear that the voters didn’t want government taking over health care. Whaaaat? The Massachusetts universal coverage law is in many ways not too different from what the Senate proposes -- and Sen. Scott Brown (D-Mass.) voted for it and doesn’t want it repealed. Maybe the voters were fed up with back room deals like giving unions a free ride exemption from the ‘Cadillac plan’ tax (when they are the only ones with such plans), and with stinky deals like Ben Nelson’s and Chris Dodd’s state bonanzas. Maybe we didn’t need 2000 page bills with so much complexity they created distrust. Whatever, they’re all running around crazily bumping into each other here in the Capitol. It’s absolute chaos. 

Pelosi is right that she has nowhere near the votes in the House to simply pass the Senate bill. That ain’t happening. And using the “reconciliation” process to jam something through with 50 votes to avoid a filibuster is not a likely strategy now, because the public won’t like it. One can only hope that Congress can muster a smidgeon of bipartisanship to create a much simpler solution than what is proposed for reform that addresses the access problem, improves coordination and quality with the participation of the profession, and slows the cost curve toward sustainability. We should all be committed to that as a nonpartisan, necessary thing to protect both the economic and social viability of this country.

So, this is not a time for either chest-pounding or antidepressants. Rather, we have another window of opportunity during this whole congressional season to shame both parties in Congress into acting more responsibly. We can do better than this.

 

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