Obama Health Reform Rope-a-Dope

In legal circles , they call it “waivering,” i.e. giving up a claim or right. In partisan legislative circles, they call it “flexibility” or “compromise.” In health policy circles, they call it a “swing to the center.”

In boxing, they call it “rope-a-dope,” a defensive stance against the ropes, absorbing punches, to tire your opponent while conserving your energy for a counterattack when you return to the center of the ring. In the conservative media, they call it a “mirage of flexibility.”

In health reform , I call it “Anything but Markets,” or ABM for short.

It may also be good political poker, not showing your hand until absolutely necessary.

In health reform, President Obama is a master of all these tactics.
His strategy? Avoid a knockout blow. Go the distance until 2012.

Here is how the Obama strategy works. Don't knock it. Polls indicate he remains the favorite for 2012, even though his health care law remains unpopular, even by margins of 67% to 32% among seniors, the most reliable voting bloc.

• Appear to give ground at the margins, but stick to your command-and-control entitlement agenda.

• Ask for cuts in your annual budget, but do not give an inch on Medicare or Medicaid or Social Security.

• Tell the state governors they can design their own Medicaid packages, but only if they offer the same expensive benefits as the government, and only if they supinely ask for permission.

• Give your political allies $2 billion dollars. i.e. unions, worth of waivers to escape health reform costs, but turn down similar requests from Big Business or other perceived political enemies.

• Never, never, never, let the market have any role in health reform.

. Give lip service to “innovation,” by setting up “Innovation “Centers for Medicare and Medicaid , but only on government terms while stifling innovation in the private section with thousands of new regulations and $500 billion of new taxes on health care corporations.

• Outlaw physician investors who seek to create doctor-owned hospitals that offer quicker, faster, better services with greater amenities and, Gasp!, a profit.

• Do not stoop to market-based tactics such as offering health plans across state lines, tort reform to bring down malpractice rates, letting doctors repackage or reprice services outside of Medicare or Medicare guidelines, permitting doctors to set their fees outside the Medicare coding system dominated by RUC (Reimbursement Update Committee).

• Or, Heaven Forbid!, allowing all citizens , corporate or self-employed tax deductions across the board for health care costs, or encouraging ordinary citizens and individuals to become members of health plans with high deductible or Health Savings Accounts (HSAs).

“The reality is, “ as a Wall Street Journal editorial today, puts it, ” that the liberals who wrote this bill really do think they have a monopoly on good ideas, and they do not include markets. Democrats are more than happy to give the states more freedom, as long as the states use it to impose comparable government control.”

Or, as the poet in me, explains,

Government may think it knoweth,
What is the best for most of us,
But the market tends to bestoweth,
What is best for the rest of us.