TUCSON, Ariz., Dec. 10 The incoming administration and Democratic Congress are determined to complete the job started around 1900 and last attempted by Clinton in 1993: the nationalization of American medicine. They plan to move fast, seize momentum, and not let go.
"We need to be on the offense," said former South Dakota Senator Tom Daschle, presumptive new Secretary of Health and Human Services.
The bill might well be S. 1, and Senator Ted Kennedy (D-MA) may seek support for this as his final Act before he departs the Senate. Obama is expected to go along with it, despite some initial differences, and might sign it shortly after Inauguration.
This bill will favor the insurance industry even more than Clinton Care did, perhaps because Kennedy and Obama fear a repeat of the Harry and Louise television ads that helped sink the Clinton plan. Insurance companies are getting a gold mine this time in return for their support: everyone will be forced to buy a government-approved plan, however overpriced and undesirable it is. Subsidies to select groups will buy off opposition.
Because insurers will be forced to take all comers and charge them all the same, younger and healthier people will be greatly overcharged to subsidize those who are older and sicker. Since the charge will not be based on risk, it may be called a "premium," but it will actually be a privatized tax: a neat way to circumvent resistance to tax increases, while pouring more money into the system. Long waiting lists for seeing your doctor will develop because healthy people seeking their money's worth will crowd out those who really need the care.
From Clinton's failure in 1994, Obama has learned not to propose a 1,500-page bill, full of details that can be targeted. Instead, he wants broad principles, with details to be filled in later, possibly by Daschle's "Health Care Fed."
Instead of having a task force with appointed members meeting for months, Obama will invite anybody and everybody to convey concerns and experiences--in "house parties" between Dec 15 and Dec 31. These will be posted on www.change.gov. Then a bill can roll right through Congress while falsely claiming public support.
Although the misleading number of uninsured is a frequent talking point, the main goal is not just to provide coverage, but to dramatically change the way medicine is practiced. Most uninsured choose not to buy overpriced insurance products that they do not need, and simply pay out-of-out pocket for medical care they do need. But by using the scary term "uninsured," a few political insiders hope to sell the public what the insurance companies really want: more customers and more profits.
As Senate Finance Committee Chairman Max Baucus (D-MT) wrote in his Call to Action: Health Reform 2009: "The nation's healthcare stakeholdersare signaling that they are ready and willing to engage in serious and comprehensive reform of the health system in crisis."
A key element of Obama/Kennedy/Baucus proposals is the interoperable electronic medical record. This is needed for controlling and monitoring doctors, and rationing their care. Demand will inevitably soar if care seems to be "free" or nearly so to millions of newly insured. Increasingly severe rationing of sickness care will be unavoidable. Electronic surveillance is an essential tool in the arsenal, to cloak care denial in the guise of monitoring "quality" measures, prescribing practices, "disparities," and compliance with coding/billing rules.
The inner circle of stakeholders meeting with Obama, Kennedy, Daschle, and Baucus includes the AARP, which collects about half a billion dollars a year from its endorsement of insurance products, and the AMA, which makes tens of millions from its exclusive contract to provide medical procedure codes.
"The reformers have co-opted much of the opposition that protected us from the Clinton Plan," stated Jane Orient, M.D., Executive Director of AAPS, which represents private physicians nationwide. "The resistance will have to come from physicians defending their profession, and patients defending their right to make their own medical decisions."
ANALYSIS OF BAUCUS CALL TO ACTION AVAILABLE. See http://www.aapsonline.org/health-care-reform-baucus.php.
NOTE: AAPS is a non-profit, professional association of physicians in all specialties, dedicated since 1943 to protection of the patient-physician relationship. It accepts no corporate or government funding, and its board members and officers serve without compensation.
SOURCE Association of American Physicians and Surgeons (AAPS)