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Self-interest and health care reform
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The federal government is moving closer to some sort of major health care reform for the United States as the nation's hospitals agree to cut $155 billion from their health care charges to the government over the next decade, namely in the form of reduce billings to Medicare and Medicaid.
Two weeks ago, drug makers committed $80 billion in drug discounts for seniors saddled with staggering costs not covered by their Medicare plan --this, too, would be shelled out over the next 10 years.
Gee, I wonder where that money came from. If they need money to run the hospitals or their drug companies, how can they cut $155 billion, or $80 billion? Doesn't that mean they didn't need the money in the first place? Makes you wonder who's been getting it all this time. We know where they get it from, of course --us. But why these conciliatory concessions all of a sudden?
It's all about self-interest. It's easy to track in the health care debate. Of course the insurance companies want the private sector to provide the coverage because that's how insurance companies make money.
Of course, pharmaceutical companies want to keep generics off the shelves and medications from Canada or England out of the country because it would cut into their profits to do the research and development to find new drugs and Lord knows we need new drugs, right?
And the hospitals say we're doing every bit as good a job as we can. We're taking care of people who can't afford to be taken care of. We don't even charge them. They come to our emergency rooms, we take them in no questions asked and absorb all the cost. Don't punish us. Let the system work.
So when the Vice President Joe Biden announced that an historic agreement has been reached between the White House and the nation's hospitals to the tune of $155 billion that they'll suddenly "contribute," the vice president said, you have to ask the inconvenient question: If the hospitals of the United States can pledge to the Obama administration a saving of $155 billion in the next 10 years in reduced charges to Medicare and Medicaid, and if the pharmaceutical industry of the United States can pledge to the Obama administration an $80 billion-dollar discount in the cost of prescription medication for the elderly, what prevented them from doing this 10 years ago?
Why not five years ago?
Why didn't they take the lead and come to the government and say, "Ya know, we think we can reduce hospital costs by $150 billion in the next 10 years."
That'd be a good thing, right?
Or how about, "Ya know what? We think we can reduce the cost of drugs to elderly patients in the Medicare system by several billion dollars in the next 10 years."
That'd be a good thing, wouldn't it?
But they didn't do that, did they? And why didn't they do that?
They didn't do that because they didn't have to. They had no reason to. Nobody was putting pressure on them to do it.
But now they see the writing on the wall, and they believe it when the Obama administration and members of Congress say we're going to change the health care delivery system of the United States. We're not exactly sure how we're going to change it, but we're going to change it. We're going to make it more efficient and more effective and it will cover more people. And that may lead to the government having a health plan that will compete with private enterprise, but it's going to change.
So what happened? Well, hospitals, which are making money hand over fist in this country, and pharmaceuticals, which are among the most profitable enterprises on earth, suddenly said, "Uh oh. We better get on board or we're gonna get shoved out of the way." So they quickly figured out ways to look like they were helping so they could get on the inside and hold the damage to their respective industries to a minimum.
All of a sudden, the hospital industry which told us for years they were doing the best they could, suddenly could do "$150 billion over 10 years" better.
And the pharmaceutical companies, which told us they were delivering the finest medicine on earth to the American people at the most competitive price, consistent with having the research and development money necessary to find new medicines for diseases, following the great American free enterprise model, with modest profits, were doing the best they could.
All of a sudden they found they can do better.
You bet, because there's a gun pointed at their heads now, because the new president wasn't bluffing, and they understand while there's going to be a spirited debate in Congress, it is a certitude, as the vice president said, that by the end of summer or early fall, there's going to be some kind of health care bill out of the United States Congress that is going to change the health care delivery system of this country.
And the hospital and insurance industries and Big Pharma are finally powerless to stop it. They stopped it in the Clinton administration and at every other turn by invoking the "isms," by saying it's socialized medicine, by using cute slogans like "Do you really want the government to run your health care system?"
It just is passing strange that suddenly the nation's hospitals and the nation's pharmaceuticals can collectively find $235 billion in savings that last week didn't exist.
So when someone asks where the money came from, it turns out it's been there all along. They never really had any impetus to try to save money because they've always been able to blackmails us by threatening that we'd have socialized medicine if we didn't keep feeding their gravy train.
Fascinating when they're facing the prospect of real health care reform, the people who'd been resisting it because it would cut into their profits suddenly are able to bring their prices down fearing they won't be able to control those prices like they used to.
Self-interest is a fascinating thing, and every now and then it works in our favor. Don't ya think?
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