The Healthcare Mess

Take it from someone who has managed many big projects, the reason why the healthcare reform debate has sunk to its current low point is relatively simple....no leadership. President Obama stated that healthcare reform would be the signature issue of his administration. No sooner did he make that pronouncement then he walked away from the issue and stood idly by as Pelosi, Reid & Company made an utter hash of it.

Right at the beginning, the President should have clearly stated the basic principles that he wanted to see in a finished bill. He should have worked on building the bi-partisan consensus that is clearly required for change of this magnitude. He should have explained that this reform had to be done in incremental steps.You can't build a pyramid from the top down, so the President should have tried to fix the problems of the current system first, before adding millions of new people to it. He should have had the courage to insist that serious tort reform be included as fear of malpractice lawsuits drives doctors to perform unnecessary and expensive tests. He should have insisted that we examine if fee for service is the best way to go. He should have insisted that work be done to establish a secure centralized medical records database to help reduce costs. (for goodness sakes Taiwan has a terrific one) But he did none of these things.

We all know that the President proposes and Congress disposes, but Obama really dropped the ball when he proposed nothing and sent Congress on their merry way while he tried to stay above the fray. That's not leadership.

Over the August recess as public opinion of the plan soured (due in no small part to some mis-information and scare tactics), Obama found himself backed into a corner, hence the speech for before the joint session of Congress. The strategy, such as it was, also made a radical turn. The insurance companies, whose representatives were all smiles with the President during a March rose garden photo op, now became the bad guys who were subjected to daily poundings. All the problems were their fault.

The result has been thousands of pages of incomprehensible legislation (I'm not kidding, just try reading the bills) that fails to address the real problems of our healthcare system. Every day we see a new compromise that further dilutes the bill in order for the Senate to get to sixty votes. They just want to pass something, anything, to get this behind them. But that is not good enough. Not when you are dealing with one sixth of the U.S. economy, and the personal relationships between doctors and patients. And the advice of former President Clinton to pass something just to get the ball rolling was not helpful either, because history tell us that Congress is not particularly adept at fixing things once they've been put into motion.

So much of this could have been avoided had President Obama taken control of the process from the very beginning. He probably would not have gotten everything he wanted, but I bet he would have gotten something with bi-partisan support that sixty percent of the American people would be for rather than against.

What is sad is that like lemmings walking in lockstep off of a cliff, the Democrats will simply continue with this process until it reaches a pointless conclusion. They will then congratulate themselves on this "major accomplishment". If they had any common sense ("if" being the operative word), they would pullback from the brink, and restart the process. But alas, I dream.