For the next several weeks, political “journalism” will be filled with reports on President Obama’s first year performance. Principal in many of these treatments will be the poll numbers on his administration’s handling of various topics. Polls are especially poor methods to track job performance (imagine the “general public” evaluating your performance at work in a poll), and in this climate, they are worse than ever at capturing the facts. For this reason, I will ignore polling for both this post and that one that will come next (containing my grade for the Republican opposition).
The criteria for evaluation include five categories:
- Constitutional alignment
- Alignment with campaign promises
- Structural improvements versus cosmetic change
- Ethical foundation
- Execution of plan
Best wishes to Rush Limbaugh after his recent heart scare in Hawaii. I have been through the same thing and it is definitely not fun. I will always root for his good health, as I can identify with his weight struggles (and as someone who would wilt without the “inspiration” his material provides).
He made a point to note how good his care was whilst in Hawaii, and how it demonstrated that there was nothing wrong with the health care system in the United States. I was glad to hear that. Many like myself have long distinguished between the people (doctors, nurses, technical support) in the system, and the system itself. Mr. Limbaugh was very pleased with the nurses in Hawaii, and felt the system worked fine.
Over the next decade, this country will lose $7 trillion worth of productivity due to sick days and disability leave. The greatest country on the planet will continue to rank in the middle of industrialized nations in death rate, life expectancy, and infant mortality. Local public hospitals will continue to struggle to meet their obligations, and the states and counties that support them will continue to suffer under massive budget shortfalls due to medical costs.
Nowhere in the industrialized world do businesses have to deal with the costs and consequences of health care that businesses in the United States encounter. Like most of the real domestic issues in our nation today, health care is a matter of deferred maintenance; how long can we go without fixing an issue before it cripples our operations. The American people understand this, and they express it in polling every day.
Back in 2004, when Congress revisited Medicare and tried to deal with prescription drugs, they dealt with a related health care matter. The Schiavo debate was fresh in the public’s mind and there was wide agreement that a problem existed with a fairly straightforward fix; educate the nation so that people could make legally binding decisions in order to keep government out of their death. Among the responses to the issue was a clause in the Medicare bill that provided coverage to seniors for counselling on items like living wills, do not resuscitate orders, medical powers of attorney, and final wills. This clause facilitated conversations that would help seniors and their families decide and communicate to doctors their desires; whether they be DNR’s for terminally ill patients or an order to keep the tubes in and machines on indefinitely. You may not realize, but if these desires are not clearly illustrated and presented to medical and legal authorities, the state can and does step in to make the decision.
This important and well-stated legislation passed without comment in 2004; in 2009 it was included in the description of services for the public option in HR 3200. In that description (for insurance through the government that would not be mandatory), the steps were called “end of life planning”. Insurance company shills quickly dubbed it “granny killing”, and Sarah Palin jumped into the fray calling it “killing granny to save money”. The more people have actually read the bills moving through Congress, the more they have realized what a bunch of garbage this all was. That said, the time it took away from the issue, and the way that it shifted the focus of lawmakers was a terrible waste.
Just a few thoughts on the imminent demise of real action on health care…..
There should have been a real conversation in this country on several topics;
- Why should taxpayers who have coverage bear a burden for the uninsured?
- How can a government program help to spur the creation of a competitive marketplace in health care?
- Why do government run programs in the rest of the world outperform U.S. providers in health care outcomes while costing less of those nation’s GDP?
- Can we trust government committees with sensitive choices in regards to our family’s health care?
- Why do we trust big insurance bureaucrats with sensitive choices in regards to our family’s health care?
- How do the costs of action now relate to costs in the future?
We all know the players in the health care debate. The teams are well-defined; Republicans against, Democrats for. The American people, overwhelmingly, want something done. The AMA, insurance industry, big pharma, the AARP, and just about every other group or lobby remotely associated with the issue will openly acknowledge a problem.