Saturday, January 30, 2010

Satire - The State of the Union and the Arrival of the Lilliputians - A Fable

As President Obama was lecturing the Republican summit meeting about the merits of his health care program and the deficits of theirs, I thought of the story of the Lilliputians, who now loom large after the Scott Brown victory in Massachusetts. If you will recall, the Lilliputians, the small people of the nation of Lilliput, in Jonathon Swift’s Gulliver’s Travels, brought down the giant Gulliver by tying him down in countless places while he slept.

The Fable

Imagine an entity exists called the Government –Reactionary Union (GRU). The GRU president is an intellectual called Obama. He has an amiable vice-president named Biden. His intimate inner circle consists of Rahm Emanuel, a former Chicago Congressman , a human hammer who runs the show; Dr. Ezekiel Emanuel, an NIH- based earnest ethicist who consults on medical affairs; David Axelrod, a soulful and skillful Chicago policy guru; Robert Gibbs, a smiling unflappable native of Alabama who briefs the media; and Peter Orszag, an accountant dandy and a dandy accountant from Texas decked out in cowboy boots who explains and justifies the budget.

GRU, The Biggest and Fastest Growing Game in Town

GRU, pronounced “Grew,” is the biggest and fastest-growing game in town. GRU has grown the federal budget from $2.9 trillion in 2008 to $3.8 trillion in 2010, a 30 percent increase and the highest percent of GDP since 1945. When President Obama took office on January 20, 2009, the National Debt stood at just under $10.627 trillion. On his one-year anniversary of January 20, 2010, the National Debt totaled just over $12.327 trillion. That means the National Debt has increased by a whopping $1.7 trillion during his first year in office. That is the largest single year increase of any President in the history of the United States. Based on the 2010 U.S. budget, total national debt will nearly double in dollar terms between 2008 and 2015 and will grow to nearly 100% of GDP, versus a level of 80% in early 2009 and less than 25 percent over the last two decades. By statute, GRU is obligated to care for anybody 24 hours a day entering hospital doors. GRU cares for all of the elderly, and many of the poor. GRU is the caretaker of last resort. The disenfranchised represent a heavy and growing financial burden for GRU.

GRU, A Misnomer

The word “Union” is a misnomer. GRU is in a clash all by itself. GRU is American partisan politics at work. The G part consists of the CEO’s fellow followers. They are loyal to the President. The R portion is made up of reactionary renegades. The renegades resent and resist Obama. They seek to pin down the President. Obama’s job, as he sees it, is to grow GRU in perpetuity and care for all of the people all of the time. Some critics, tongue-in-cheek, call GRU gruesome and far too growsome.

Major Medical Programs

President Obama inherited two major medical programs , Govcare for 45 millon elderly, and Govcaid for 60 million more. Obama has yet to name a head of Govcare, a job originally intended for a powerful lobbyist and former Senator, Tom Daschle. Daschle withdrew for tax violations. Govcare has been headless for a year. But Obama‘s vision still guides it. Eventually Obama would like to grow Govcare and Govcaid into a single, an all-embracing, integrated entity, tentatively called Omnicare,. Omnicare will have Govcare at its core. Govcaid care will be farmed out to 50 states.

The Reactionaries

Unfortunately, reactionary Lilliputians, backed by big and small businesses. private health plans, the medical industrial complex, the America’s middle class, and Tea Party upstarts are not cooperating. Public polls show sixty five percent do not approve of Obamacare. They have made up their minds on their own. They persist in developing innovative, and effective life-saving and lifestyle-saving technologies sought after by the public. They claim outside. bottom-up market forces, rather than inside top-down bureaucracies, can do the job –cheaper and better. But because of third parties – Govcare, Govcaid, and Privicare plans – the public has no idea what things really cost and cries for more care.

Obama argues: if only me and my team could take over administrative functions of Privicare, the U.S. could offer a cheaper Govcare -backed option, and all would be well. We could reach our long sought goal of affordable care for all of the people all of the time . But, alas, through their incessant criticisms, says Obama. the Lilliputians have tainted and distorted my message. All that is needed now is more explanation of its benefits.

The Independents

Meanwhile, say Obamanites, independents in the lower middle class have gone berserk. They have elected a reactionary over a progressive in a deep blue state. They claim to be independents,, rather than fellow followers or reactionary renegades, but Obama followers say they are uniformed, small-minded red-necked, rabble-rousing Lilliputians. The Lilliputians seem to think they collectively ought to have a voice in running GRU, which affects all of them sometime in their lives.

They resent being forced to buy insurance and paying higher taxes and shouldering the growing debt necessary to carry out the mission of caring for all of the people all of the time. They also say that those operating outside of the GRU could provide cheaper more effective care in closer proximity to premium-payers, who, if they were spending more of their own money, would take better care of themselves and know what care to buy.

But Obama Knows

Obama knows these market based Lilliputians may bring down his vision. That would be tragic. Only he and his inner circle have the intelligence, wisdom, data, and good intentions to do what is cost-effective, operationally efficient, and morally right. But the R side insists, because they receive and pay for the care, they ought to be able to enter the inner G circle and to have a say in G decision making.

So the stand-off continues within GRU. Obama has suggested the solution lies in bundling and integrating the services of G and R , putting partisanship aside, and having the two sides cooperate and agree.

But so far, no go.

No comments: