From the January 4, 2010 Pajamas Media
January 4, 2010
by Ronald Radosh
Today’s TNR.com features an article by Jonathan Cohn, in which it is reported that the Democrats will not convene a formal a conference committee made up of both House and Senate members, to reconcile the versions of the health reform bills in both Houses. Instead, Cohn has learned from his sources, they will negotiate informally, thereby avoiding what he writes would be “a series of procedural steps–not least among them, a series of special motions in the Senate, each requiring a vote with full debate–that Republicans could use to stall deliberations, just as they did in November and December.”
To put it differently, the Democrats will bypass the procedures of democratic debate and process, in order to quickly put through what they know will be a slowing down of enactment, giving the public and opponents of the bill more time to mobilize and hopefully stop it from passing. It will be done in the name of democracy—since every small d democrat knows the current measure is good for the people—and hence undemocratic means must be used to protect the overall democratic good.
They will avoid “procedural hurdles” that would occur in a formal full tilt conference route in the Senate, thereby putting a stop to Mitch McConnell’s promise that “this fight isn’t over.” So while the first round failed to produce the promised open sessions televised on C-Span that Obama said would take place during the campaign; now the reconciliation process will also take place completely out of the Senate conference room. Once again the public is kept out of the process, only to find the results after a successful Senate vote.
Of course, reporter Cohn reflects the liberal view that now holds forth on domestic policy in the pages of TNR, and hence he thinks it is “a good thing.”
For the rest of us, there has been a good indication of what Obama Care will bring forth in the future in the news from The Mayo Clinic. Last week the organization, cited by Obama as well as others as a good model of a health institution that really works, announced that as of now, one of its clinic facilities in Arizona, will stop accepting Medicare payments! 3000 patients who now use that clinic in Glendale will be asked to pay cash at full price if they want to continue seeing their regular doctors at this family treatment center.
The Mayo group is doing this first at only one of its centers, to find out whether, as they obviously suspect will be the case, they have to follow suit as well at their other units in Arizona, Florida and Minnesota. President Obama had previously said that May offers “the highest quality care at costs well below the national norm.” But they have found that Medicare pays its doctors too little, and even this cost conscious health organization, run on an efficient business model in which doctors are paid a regular salary not dependent upon how many patients they treat, cannot keep up the program because the gap is too much to make up.
We know, of course, that the health reform will now even lower Medicare payments to doctors. What this means, as the Bloomberg article notes, is that Mayo’s decision “may be copied by family doctors, some of whom have stopped accepting new patients from the program.” The American Academy of Family Physicians notes this is already happening. With 30 million more added to the number of those insured, and with less doctors available to treat them, and with insurance paying them even less, we can look forward to thousands more doctors and medical groups making a similar announcement sooner rather than later.
This will happen because it is a simple matter of economics, something the proponents of Obama Care seem to know little about. Last year Mayo lost $840 million alone on Medicare! $840 million. Once the “reform” goes into effect, that number will undoubtedly double or triple, if health organizations do not begin to refuse to accept the insurance. What’s next? Another law making it a criminal offense for a health organization to do that? Doctors who now are paid 20 per cent less for treating Medicare patients than caring for those privately insured will not look kindly to keeping with Medicare when they end up being pay 30 to 40 per cent less in the future. To reassure doctors, Congress issued a two month postponement that would have introduced a 21.5 percent cut in Medicare reimbursements. Once Obama Care is passed, kiss goodbye to such temporary postponements.
Supporters of the program argue, as a fellow at a liberal think tank told Bloomberg news, that Medicare lacks providers because not enough new doctors are becoming family doctors, internists and pediatricians. But why should they, since they are being told in advance that with the new rules, they will most likely not have enough pay to cover expenses, pay off medical school bills, and of course, cover the exorbitant cost of medical insurance? What ever happened to tort reform? Oh yes—the trial lawyers that dominate the Democratic Party coffers are opposed, and somehow, any indication that it might be put into law disappeared. That alone, of course, could lower costs tremendously and help put into effect a meaningful new health reform. Bring it up, and you will be accused of being an anti-humane conservative or Republican.
I’ll take that insult, and lend my name to the efforts of others who want to defeat this abominable health reform bill.
Ronald Radosh is an adjunct fellow at the Hudson Institute; Prof. Emeritus of History at the City University of New York, and the author of many books, including "The Rosenberg File;" "Divided They Fell: The Demise of the Democratic Party, 1964-1996," and most recently, "Commies: A Journey Through the Old Left, the New Left and the Leftover Left."
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