FRED WOLFERMAN: It's All About Politics, Not Health Care
The Great Health Care Debate is turning out to be less about health care every day and more about the re-election of -- well, just about everybody who holds elective office in Washington.
The president has pretty clearly staked his future on it, and he has remained sufficiently vague about what he wants that he can claim anything that passes to be a success. This is probably smart politics if your objective is to remain The Chosen One, but it really isn't getting us very far in defining what he have, what we want, and what we can afford in the way of health care.
As Mr. Obama spouts platitudes above the fray, down in Congress various committees are coughing up 1,000-page legislative furballs that the congresspersons have not read, and which would be incomprehensible even if they had. For example:
Page 174 of the latest House version: "The tax imposed under this section shall not be treated as a tax imposed by this chapter for the purposes of determining any credit under this chapter"
Or, page 281: "The term 'base operating DRG payment amount' means, with respect to a hospital for a fiscal year, the payment amount that would otherwise be made under subsection (d) for a discharge if this subsection did not apply, reduced by any portion of such amount that is attributable to payments under subparagraphs (B) and (F) of paragraph 5"
This stuff gets written by lawyers and legislative staffers who pile on every idea they can think of and try to reconcile the gaps and inconsistencies with language like that above. Their bosses, the congresspersons who will vote on all this, glance at summaries of what it is intended to do and cast whatever vote they think will get them re-elected.
For the liberals, that is a "yes," for the conservatives, a "no," and for the Blue Dog Democrats, bless their hearts, a real dilemma.
Were it not for them, the House would probably have passed something like the mess above. The reason the Blue Dogs have not climbed aboard Co-President Pelosi's bandwagon is that they want to be re-elected. I would like to ascribe some higher motive, such as actual concern about health care, but that is too much of a stretch.
All these folks understand one thing: Heads will roll at the next election for those on the wrong side of this issue, and they are scrambling to figure out what people in their districts want. This is no mean feat, since hardly anybody understands the options or knows what he wants. Well, that's not strictly true; everybody wants excellent, cheap health care.
Since excellent, cheap health care is the one option absolutely guaranteed not to be available, this represents a real problem for the lawmakers. After all, if they're not re-elected, they will lose the excellent, cheap health care provided by their present congressional plan and have to live with whatever they unload on the proletariat.
The Democrats in charge appear to think, though they won't put it quite this way, that mediocre, cheap health care will keep them in office. The Republicans hope, though they won't say it either, that people would prefer excellent, expensive health care.
This presents an unsolvable problem, which is exactly why it has not been solved for the past 60 years. It is also why, in all likelihood, it will not be solved now either.
After taking flak on all sides from constituents and lobbyists during the recess, Congress will return to Washington and either do nothing or pass some watered-down, confusing piece of pandering designed to get Democrats re-elected because they can claim to have reformed health care, and Republicans re-elected because they at least fought the good fight. It's all just business as usual in our nation's capital.
Fred Wolferman lives in Southern Pines. Contact him by e-mail at email@example.com.
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