Friday, June 24, 2011

Obamacare on the Defensive

I am in earnest – I will not equivocate- I will not excuse – I will not retreat a single inch; and I will be heard!

William Lloyd Garrison (1805-1879), The Liberator, 1831

June 24, 2011- As I gaze across the health reform terrain, I see proponents of Obamacare retreating on multiple fronts:

• the constitutionality of the health reform law now being considered in Atlanta Appeals court,

• the McKinsey report indicating 30% of employers will drop coverage in 2014,

• CMS announcing no new waivers from the law come September,

. polls indicating unprecedented resistance to a national entitlement program,

• uproars over restrictions to imaging utilization and Presidential appointment of an Independent Payment Advisory Board,

• rejection of rules proposed for setting up Accountable Care Organizations.

It’s enough to make an ordinary president blanch, or even blush, but not this president or spokespersons for his administration.

Their strategies seem to be: The best defense is a good offense. Use the bully pulpit to discredit your opponents. Never retreat, attack.

In the case of Republicans suggesting how to save Medicare through a voucher plan to save it from imminent bankruptcy, these tactics worked in New York state district 26. There a Democrat upset a Republican by, among other things, showing a television ad featuring a Paul Ryan-look-alike pushing Grandma off a cliff. In some circles, this is known as demogogic chutzpa, accusing your opponent of insensitivity while you are cutting $575 billion out of Medicare.

The Democratic tactic seems to be: Don’t challenge the facts, change the language or shift the blame.

Using the impact of the universal health plan in Massachusetts as an example, in his Heath Care Blog, “Rationing by Waiting, “ John Goodman pointed out how this is done in Massachusetts in a recent blog. Massachusetts’ 5 year old plan has produced the nation’s longest waiting times, the highest health plan premiums, and runaway state budget costs.

Goodman says: If your health reform policy causes patients’ care to be rationed by forcing them to wait longer for care, don’t call it “rationing,” call it “universal coverage.” If your plan forces physicians to close their practices to new patients, don’t call it “rationing,” call it an “access to care” problem and blame it on the private sector. If your top-down policies create higher premiums and higher taxes, don’t call it bureaucratic bungling, call it lack of “cost-effective care” or lack of “coordinated care.”

If an independent consulting firm, McKinsey & Co, reports its impartial survey of 1300 companies indicates 30% of companies say they will drop employee coverage in 2014, shut the company up by questioning its “methodology”or “impartiality.”

If WellPoint and Humana and the Blues withdraw from markets or raise rates to cope with expenses of new regulations, to protect its profit margins, or to satisfy its stockholders, accuse them of “unconscionable behavior.”

If accountants of ATT, Verizon, John Deere and other Fortune 500 companies truthfully say Obamacare will lead to huge write-downs, question their veracity.

Sneer at critics who call the new health care law “Obamacare” instead of the Patient Protection and Affordability Act (PPACA), or the Affordable Care Act (ACA), even if the PPACA or ACA so far at least, neither protects most patients from keeping their present plans or physicians or makes most of their care more affordable.

Never back off an inch from Obamacare. Deny its unforeseen consequences on patients and the general economy.