Congress Slows Down Health Care Reform, As It Should

by Pejman Yousefzadeh on July 22, 2009

Since the Obama Administration has not yet gotten the message, and since it has not revised its expectations when it comes to achieving health care reform, more and more members of Congress are announcing on their own that health care reform will not be achieved by the time Congress goes on its August recess:

After more than a week of tirelessly pressuring Congress to move his top domestic priority, President Barack Obama may have to settle for a fallback strategy on health care overhaul.

Instead of votes in the House and Senate by August, the best Democrats may be able to hope for this summer is action by the full House by the end of the month and some sort of agreement on a bipartisan plan in the Senate before lawmakers head home for vacation.

Not only are Republicans honing their opposition, but some Democrats in both chambers are voicing doubts about moving such complex and costly legislation too quickly.

“No one wants to tell the speaker (Nancy Pelosi) that she’s moving too fast and they damn sure don’t want to tell the president,” Rep. Charles Rangel, D-N.Y., a key committee chairman, told a fellow lawmaker as the two walked into a closed-door meeting Tuesday. The remark was overheard by reporters.

That had to make for a lovely gaffe. More frustration with the President’s methods is recorded here, and do bear in mind that these are fellow Democrats griping. And Steny Hoyer sounds like he is packing his bags, and that health care reform will neither be part of the checked-in luggage, nor part of a carry-on item.

Of course, since the Administration hasn’t gotten the message regarding the unrealistic nature of its health care timetable, the President will go on television tonight to push for health care legislation to come to his desk when he wants it, irrespective of whether the legislation is actually good or understandable. Apparently, he will also inform us that he “rescued” the economy, despite the fact that unemployment is likely to exceed 10% soon, and we still run the risk of a double-dip recession, with the recent stimulus package having done nothing to assist the economy. Call it The Audacity of Audacity.

How wound up is the Administration over meeting its health care deadline? Very, if one believes Charles Grassley:

A telling episode recounted by Senate Finance ranking member Charles Grassley reveals the Obama administration might be more worried than they are letting on that a Republican senator’s comparison of the healthcare overhaul to Waterloo might be dangerously close to the truth.

Grassley said he spoke with a Democratic House member last week who shared Obama’s bleak reaction during a private meeting to reports that some factions of House Democrats were lining up to stall or even take down the overhaul unless leaders made major changes.

“Let’s just lay everything on the table,” Grassley said. “A Democrat congressman last week told me after a conversation with the president that the president had trouble in the House of Representatives, and it wasn’t going to pass if there weren’t some changes made … and the president says, ‘You’re going to destroy my presidency.’ ”

The White House did not respond to requests for comment.

I can certainly understand how President wrap up their political fortunes with the passage of certain legislative items. But again (I don’t believe we keep having to emphasize this), at the end of the day, it remains more important to get legislation right, than it does to get legislation passed quickly. The Obama Administration does not seem to recognize or appreciate this. And if you believe the Mayo Clinic, one of the providers of quality health care the President most admires, this mad rush to passing any health care reform bill before the August recess is just not going to bring about quality health care. Indeed, it is worth looking at this editorial, penned by two doctors at Mayo, which eviscerates the Obama Administration’s premises for health care reform:

Over the past several weeks, President Barack Obama and some congressional leaders have cited Mayo Clinic and other medical group practices as “a great value” for your health care dollar: high-quality care at costs that are significantly less than other parts of the country.

While we appreciate this recognition, we question whether our political leaders realize that many doctors and hospitals that offer this high-value care are reaching the point where we cannot afford to provide it to patients with government-sponsored insurance such as Medicare and Medicaid. We worry that the same could hold true for patients in a new government-run public insurance plan.

Despite the fact that we strive to give patients the right level of care — everything they need, no more and no less — we consistently suffer huge financial losses due to the government price-controlled Medicare payment system, which financially punishes providers who offer higher quality care at a lower cost.

Last year alone, Mayo Clinic lost hundreds of millions of dollars caring for Medicare beneficiaries — the very patients with complex, complicated illnesses that we want to see and can serve well. Because of this shortfall, our other patients pay more to make up the difference. Someday soon, neither Mayo Clinic nor those other payers will be able to afford this situation.

Meanwhile, overall Medicare spending is ballooning because many providers have responded to price controls by increasing the number of services they offer . . . spending less and less time with patients but having them return for more frequent office visits, tests and procedures, driving up the volume of billable services. An example: From 2001 to 2005, Medicare cut payments to physicians yet spending-per-beneficiary rose because volumes increased. Research from the Dartmouth Atlas of Health Care shows that many of these “extra” services add nothing but cost to the patient’s care.

(Via Mayo’s Health Policy Blog.) I imagine that within short order, the Mayo Clinic will be denounced as being part of Rush Limbaugh’s media empire, the President’s previous (and entirely justified) praise for the Clinic notwithstanding.

With all of this renewed opposition, one can understand why the Obama Administration wants to rush health care through. As I have written previously, the Administration doesn’t want the public to learn more about the details of the plans at issue, and fears that the longer it waits to pass a bill, the more opposition will generate against the bill. We are seeing the generation of that opposition now, and given that it is coming from esteemed sources like the Mayo Clinic, we can readily understand why the Administration is suddenly getting nervous about the political prospects of passing a bill.

That very nervousness is, and should be a dead giveaway to the fact that the various health care reform bills being considered are seriously deficient. On substantive policy grounds, delaying the health care reform process is entirely justified. Indeed, delay is now essential to getting a good bill at the end of the process. If the Administration and Congress don’t understand that, then there is no reason to treat them as friendly and honest interlocutors in the effort to enact quality health care reform.

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