Theater disguised as policy not even good theater

Healthcare Purchasing News, April, 2008 by Rick Dana Barlow

Congress engineered yet another shameless spectacle last month by parading the "guileless" and guiltless but generously compensated CEOs of the leading lending companies to get to the bottom of the bottoming-out and bottom-feeding mortgage crisis, allegedly contributing to the artist formerly known as recession.

You may laugh at these elected officials lobbing pithy, nonsensical questions to a group of feckless guys armed with preordained talking points and basic training on "managing the message." But you also have to cry that these elected officials are wasting taxpayer dollars when they should be concentrating on how to fix all the messes they've created that's wasting many more taxpayer dollars.

When the crisis du jour seemed ripe enough (based on what the fashionable media decided, as well as the late-night comedy shows and cable television fake news programs), they've grilled--more accurately, flambeed--professional sports executives, oil company executives, airline executives, banking executives and if they ever get inspired, "professional ministry" executives, too. However, the initial skewering of GPO executives nearly six years ago (and still the best of its category for the easy-to-miss revelations) represented fairly entertaining theater at the time--at least for industry insiders.

Yet with all the lingering--and festering--policybabble by the current presidential candidates on reforming healthcare--long unfinished business left in the fridge by the Clinton Administration and Gingrich Ersatz Revolution of the 1990s--we have yet to see the feckless, guileless and guiltless but royally affluent CEOs of managed care companies and payers behind the microphones. They, too, need to be inconveniently and unceremoniously plucked from their palatial offices to blather about their ballooning personal income as millions and more can't afford or are denied health insurance.

Granted, any bloviating by multimillion-dollar-earning suits would be mildly entertaining at best because they'd be snatched out of their Wall Street comfort zone and slapped with some negative publicity. But it probably wouldn't accomplish anything--except motivate Michael Moore to make "Sicko 2: Electrosurgical Fire Boogaloo."

In fact, last year Healthcare Economist author Jason Shafrin postulated that if the government were to reduce and limit health insurance company CEOs handsome compensation to, say, a hypothetically determined $5-million ceiling, and if (stretching credulity to its limits here) those companies magnanimously decided to pass that savings on to the consumers the estimated benefits to enrollees would top out at $3 per person. That's not to say the government should, would, or even could do this anyway--legally or morally.

What's more troubling is Congress contains several influential members sporting medical degrees--including the Senate Minority Leader who, like his doctoral colleagues, accomplished little to improve healthcare even when he served as Senate Majority Leader and flirted with his own race for the White House.

Meanwhile, perennial presidential aspirant Newt Gingrich has been trying to fan the flames of his fleeting post-Speaker of the House popularity by forging himself as Captain Healthcare with his Blue Shield of Technology to save the day and the future. Too bad he, along with his party's current beleaguered standard-bearer and the opposing party's presidential wannabe Wonder Twins can't figure out the concrete and explicit details on how to pay for any of it.

So what's the point? All of this talk is just that: Talk. Discussion is fine but it's reached a point where the debaters, politicos and pundits are driving on bald tires and going nowhere. It's time to change the tires ... or drivers and passengers in the car. Someone has to step up and 'fess up about the real reasons why the healthcare system in the United States resembles more of a Luddhite contraption than the finely tuned bureaucratic machine everyone envisions. They're painful. And no one wants to make those decisions or even be held accountable and responsible, which is one of the reasons why we're where we are.