While the hawker in chief chilled on Martha's Vineyard and in Camp David, we enjoyed a week of
peace and quiet, but now President Barack Obama
has accelerated back to full voice as he speaks to America's
schoolchildren Tuesday and to a joint session of Congress Wednesday.
the supposedly non-partisan speech to children is controversial enough,
the speech to Congress should be a doozy. In it, opponents of Obama's
health-care vision will finally find out what his health-care vision
is. Despite the president having given nearly 30 speeches on
health-care reform, Americans still don't know exactly what he wants.
Truth is, Obama set up Congress for a fall by letting House Speaker
Nancy Pelosi and her liberal allies front his radical re-creation of
America's health-care system in the form of the proposed America's
Affordable Health Choices Act. As Americans have come to better
understand the legislation, its popularity has dropped, along with the
public approval rating of Pelosi and her congressional allies.
no longer will let Obama sit comfortably on the sidelines. He'll have
to come up with something, and considering the political opportunism
that permeates the Obama White House,
it will be no surprise if the president scuttles the Pelosi vision and
proposes something that the Obama/Emanuel/Axelrod trinity thinks is
No matter how good it first
sounds, if it contains a Health Choices Administration or something
like it, Obama's "compromise" will just be a wolf in sheep's clothing.
If you don't know what a Health Choices Administration is, you haven't
studied the legislation. It would be an "independent" (oh, sure) agency
created in the executive branch, headed by a "Health Choices
commissioner." Its job would be the "establishment of qualified health
benefits plan standards ..." Even if Obama drops the controversial
"public option" that puts government in the insurance business. And
retention of an HCA-style agency still would represent a
nationalization of health care.
The agency wouldn't be some kind
of advisory panel; it effectively would define what falls within
"generally accepted standards of medical or other appropriate clinical
or professional practice" worthy of being insured (or not insured).
What amounts to a health czar backed by a big, new bureaucracy would
set national health standards, root out "non-compliance" and enforce
its own codes with the power to impose fines and boot out insurers that
don't meet those standards. If this is not an overly broad grant of
power to a brawny new federal agency, then nothing is. No wonder people
are scared into thinking the Health Choices Act provides for "death
Dr. James Rosenberg, a north suburban
gastroenterologist, told me he was especially troubled by the
combination of such powers with the mandated creation of a national
electronic health record database under federal auspices. He showed me
how my complete health record already can be called up on a computer
screen by participating health-care providers. It's a wonderfully
comprehensive system that clearly gives me better health care than can
be provided by the old pen-and-paper system.
But what happens
when this information is fed into a nationalized data bank under the
control of a new federal agency that sets and enforces standards of
care? Rosenberg said he envisions a federal system that will monitor
and regulate procedures he deems necessary for his patients. Enter the
patient's name and the procedure into the computer, and the course of
care could then be theoretically bumped against what the Health Choices
Administration has defined as appropriate for a patient of that age,
state of health and other demographics. To put it bluntly, a patient
could possibly be denied a colonoscopy because she is too old to meet
the cost-benefit standards or whatever tests the new agency sets for
"standards of medical practice."
Here it should become
apparent that the use of the word "choices" in naming the new law and
the new federal agency is a public relations sham. The choices wouldn't
be in the hands of the patient and her doctor, but (as the cliche goes,
as true as it is) of a distant bureaucrat.
Yes, such decisions
now can be made by bureaucrats sitting in distant offices of large
health insurance companies. When disagreements arise over what should
or shouldn't be covered, the patient and the physician squabble with
the insurance company for the best outcome. But I'd rather take my
chances with Rosenberg going after my insurance company than taking on
the federal government.
This column also appeared in the Chicago Tribune.