Sometimes Even the Winners Lose

October 2, 2009
Mike Hennessy

The spectacular rejection of the public option earlier this week should be a huge victory for the plan's opponents. So why do I feel like everybody somehow lost?

When bad political ideas are rejected by citizens, taxpayers, advocacy groups, and then, finally, by politicians, one would expect for opponents of the idea to enjoy the victory. Who could blame those of us who were vehemently opposed to a “public option” as part of healthcare reform for thinking, “Whew! Disaster averted.” Those of us who saw the public option for what it was—plainly and simply a Trojan horse designed to start us down the path toward single-payer healthcare—can take some comfort in the realization that informed people and politicians from disparate political leanings recognized and rejected a public plan.

Of course, the public option isn’t dead yet, and its proxies, such as state-level “co-ops,” will continue to appear in some form or another. But the spectacular rejection of the public option in the Senate earlier this week is big news. It should be good news for its opponents. So why do I feel like everybody somehow lost?

My gut tells me that the environment a few months ago was exactly right for changes that would have kept the things that work best about the U.S. model while addressing the areas most in need of a fix, namely:

  • Providing real incentives for healthcare providers and consumers to pursue wellness and prevention that would fundamentally change healthcare delivery
  • Eliminating the silly restrictions that prevent health insurers from competing across state lines
  • Overhauling the unfair and ineffective medical malpractice laws in way that would benefit not just physicians, but everyone who suffers when wasted and defensive medicine are the rule rather than the exception.

Any or all of those proposed reforms could have been the centerpiece of the President’s healthcare reform strategy, and any combination thereof would have meant a significant improvement in access to effective and lower-cost care. Instead, the big idea was a “public option,” and it’s now too late, and would be too politically damaging, for Obama and the Democratic leaders to dramatically shift gears and make one of the viable, popular policies outlined above the linchpin of the reform debate.

Ironically, the hidden purpose of this go-around of healthcare reform was to stop the runaway costs of the public programs Medicare and Medicaid. Neither program is run efficiently or fairly, and both programs are staring at bankruptcy. But overhauling the public side of care would involve correcting political mistakes. This Administration’s answer was to double-down on a losing hand, trying to make up for the difference through yet more tax-and-spend.

Fortunately, that solution was rejected. Now, we have the chance to refocus the debate. In a recent Wall Street Journal editorial titled, “Why Obama Bombed on Health Care,” Holman W. Jenkins, Jr., wrote, “The public is not as dumb as it’s made out to be, and Mr. Obama’s public option died a bipartisan death yesterday in the Senate Finance Committee. What’s left is a package of ‘reforms’ that are mere trite extensions of what we’ve been doing for decades. That is, piling up mandates on private insurers and then lying that this somehow isn’t driving up the cost of health insurance; piling up subsidies for health consumption and then lying that this somehow isn’t responsible for runaway health-care spending.”

Can the President press the reset button on healthcare reform? Can policymakers drop the charade of introducing “reform” as a stepping stone to a single-payer system? If not, everyone with a stake in the U.S. healthcare—which is to say, all of us—will have lost.

So, where do we go from here? On October 7th, Politics magazine, along with sister publications The American Journal of Managed Care and Pharmacy Times, will host a half-day event that will discuss these developments and the political, economic, and patient care ramifications of the reform plans still on the table. Governor Howard Dean, Senator John Barasso, and Congressman Michael Burgess will be joined by other influential politicians and industry leaders to discuss next steps. I encourage you to join the discussion.

Mike Hennessy is Chairman and CEO of MJH & Associates.Click here for more Hennessy's Highlights