A Pledge to America- Good Political Move; Not the Solution We Need for Health Care

I can’t remember when politics in this country has been so polarizing. It seems like we’re all pulling in different directions. Thomas Friedman hit it on the head last week when he wrote, “For democracy to be effective and deliver the policies and infrastructure our societies need requires the political center to be focused, united, and energized. That means electing candidates who will do what is right for the country not just for their ideological wing or whoever comes with the biggest bag of money. For democracies to address big problems- and that’s all we have these days- requires a lot of people pulling in the same direction, and that is precisely what we’re lacking.”

All of the name calling, finger pointing, and blaming is not going to solve the big issues we face today. It’s time to pull together and figure out how to pull ourselves out of this mess.

The Republican side came out with their Pledge to America last week. Obviously trying to replicate the success of the Contract with America that was launched by Newt Gingrich in the 90s, the Pledge basically continued the name calling, finger pointing, and blaming that is the standard operating procedure of politics today.

You can't disagree with some of the facts presented in The Pledge. Our government has grown too much and is involved in too many things. The deficit is a huge concern and needs to be addressed. However, the free market (however you want to define it) has also proven that it runs into problems when left on its own. There needs to be a balance. Health care is a prime example.

The Pledge calls for repealing the legislation that is in place today. We do not disagree that the PPACA is confusing, complex, and went too far in some areas. But, that’s what you get when you can’t work together and operate in a partisan manner. That’s how our government operates today. The most recent Kaiser Tracking Poll found over half of the population is confused by the law. Most have not read it and can’t begin to put it into context. Most Americans can only determine their perception of the law by personal experience and by emotions. And remember, most Americans receive the majority of their information about health care reform through cable news- not the most unbiased source in the world.

The Pledge believes PPACA should be repealed and replaced with enacting malpractice reform, allowing consumers to purchase health insurance across state lines, and emphasizing the use of Health Savings Accounts. We’ve heard all of these before. We’re sorry, these will not solve the mess we have with a shortage of primary care physicians, increasing medical technology and pharmaceutical costs, and the tremendous inefficiency in health care delivery we have today. The Pledge does not even address what it would do with Medicare and Social Security- the largest components of the budget and the deficit challenge we are facing.

Repealing PPACA is a nice political talking point as long as American’s remain confused with the broader problems we face in health care. Both sides have done a terrible job of objectively communicating a complex issue to the American people.

If PPACA does end up getting repealed (which it won’t) I hope those who wrote The Pledge can come up with better and appropriate ideas than they have included in this draft. A better idea is to take what we have and work together to make it better- but that ain’t going to happen with the political culture we have today; and that is sad for America.

Our Governor Is Not Going To Play Nice With Health Care

On August 31, 2010 our Minnesota Governor, Tim Pawlenty signed Health Care Executive Order 10-12; Directing State Departments and Agencies Regarding Discretionary participation in the Federal Health Care Law. This was our governor’s attempt to essentially tell the Patient Protection and Affordable Care Act to take a hike.

Now, our governor is probably running for President and he’s made his views very clear concerning any government involvement in health care- and anything else for that matter. This Executive Order was a political statement more than anything else. You can’t object to legally directing those in our government to use some discretion in requesting and using federal funds- if we don’t need it, don’t take it. That’s not the way government works. The only way to filter spending is to hold someone accountable- Pawlenty is assuming that role and I can’t object to that.

It’s the way he did it that bothers me. Instead of a directive focusing on federal and state fiscal responsibility- he used it as a political statement. Here’s a “fact-check” of the reasons supporting his Executive Order:

1. PPACA was signed on March 23, 2010:

True

2. PPACA is a dramatic attempt to assert federal command and control over this country’s health care system and reduces individual freedom for health care decisions.

PPACA establishes the framework at the federal level, and allows the states to implement as they see fit. Pawlenty is free to participate or not. However, the reason the government set some framework is because the private sector could not or would not do it on its own. Somebody needs to take control of health care spending before it breaks the bank.

3. PPACA is unprecedented federal intrusion into the individual liberty including the mandate to purchase health insurance.

This one would be easy to fix- have the health insurance companies eliminate pre-existing conditions for those who can’t receive coverage today and not require everyone to participate. They won’t do it- and we can’t have it both ways.

4. PPACA is funded by taxes and fees coupled with unrealistic assumptions purported for future cost savings.

This is true, to an extent. The only reason the cost assumptions are "unrealistic" to some is because nobody is willing to give. Hospitals, health plans, consumers, and employers will need to realize the old way is not sustainable. The days of $0 co pays are over, fee schedules will be determined by value, and the technology will be dispersed efficiently instead of on every street corner. If everyone embraces the broader need and sucks it up a little the assumptions may not be all that far off.

5. PPACA increases federal spending at a time when the government debt threatens private sector economic growth.

Yes it does- but if we don’t do something, the unfunded liability of our health care debt could bring our entire economic picture down in the not so distant future. Just advocating for more HSAs, competition across state lines, and malpractice reform is not going to cut it. The problems we have created are much deeper.

6. PPACA includes many demonstration projects intended to speed the transition to federally-controlled health care.

This is just silly. The intent of all of this is to organize care better than it is organized today. Once again, if the private market wanted to do it- it should have by now.

Pawlenty’s Executive order would have been much more palatable if he had just stated that since health care represents over 1/6 of our national economy- and since fiscal responsibility is of paramount importance- all requests for funds will need to be directed and approved by his office.

But, he’s running for President, so I guess he felt he needed to create a buzz. That’s the way we do it nowadays.