So the Obama administration has kinda sorta given up on healthcare reform. As the President said in his State of the Union address, “By now it should be fairly obvious that I didn’t take on health care because it was good politics.” Nobody’s going to argue with that assessment--certainly not Senate Majority Leader Harry Reid, who volunteered last week, “We’re not on health care now. We’ve talked a lot about it in the past. . . . There is no rush.”
Thus Obamacare exists as a political zombie--not alive, but not dead yet. In the words of The Washington Post this morning:
And while Obama's budget assumes that health-care legislation eventually will pass, reducing deficits over the next decade by about $150 billion, neither the White House nor congressional Democrats have outlined a plan to push the measure through a reluctant Congress.
But in avoiding a real decision on healthcare policy, the Obamans are giving themselves the worst of both worlds. They are still, theoretically, pushing a 70s-style healthcare plan that nobody except a few Beltway wonks really wants, and yet they are now moving down a path toward cutting healthcare expenditures, because they think they need the money elsewhere. In other words, they are ditching their own vision of “reform,” however cockeyed it was, and are picking up the more familiar refrain of budgetary bean-counting.
Indeed, the Obamans, and the Democrats, are getting themselves on the wrong side of what anthropologists call a “taboo trade-off”--that is, the idea that healthcare, possessed as it is with all sorts of mythic and primal resonances, can be reduced to a Gradgrindian exercise in shaving and paring costs. The American people, as we have seen, recoil at this sort of blood-for-money calculus. If the Obamans think they need to make spending cuts, they should stop talking about healthcare altogether, focusing only on deficits and debt. Yet by using “healthcare reform” as just another label for spending cuts, they are increasing public cynicism--cue up “death panels”--and poisoning the well of future medical progress.
The Obamans think they need to do this--a “pivot,” they call it, from healthcare to jobs--in order to win re-election. But what they don’t seem to realize is that healthcare could be a positive for them--if they could bring themselves to see healthcare as a source of growth and jobs. And oh yes, better health. Think about it: Is there any lack of enthusiasm for better health and medicine? Are fewer people worried about their aches and pains--or the illness that killed their grandparents? Are fewer people watching Sally Field’s Boniva commercials?
The demand for healthcare--defined as what actually makes your health better, as opposed to healthcare financing schemes of one kind or another--is as strong as ever.
Just yesterday, in the middle of a deep recession, St. Jude’s Children’s Research Hospital and Washington University School of Medicine announced a joint $65 million project, privately financed, to help develop new treatments for pediatric cancer. The effort, which will create jobs and growth in both St. Louis and Memphis, builds upon the efforts of the Cancer Genome Atlas, a project of the National Institutes of Health. In the words of NIH director Francis Collins, “The long term dream is that this will uncover a list of powerful new drug strategies that we don’t know about.” In highlighting new treatments and drugs, Dr. Collins was thus offering hope to the 10,000 children a year who are stricken with pediatric cancer. Does anyone remember “hope”?
Such announcements of new medical efforts, as well as new medical breakthroughs, are routine, of course--along with a permanent buzz of news reports and advertisements about medical matters, proof of steady public interest--but for the most part, our politicians have lost interest in medical topics. And so on the same day as the St. Jude’s announcement, President Obama was announcing his retrenchment budget, and Republicans, for their part, were denouncing it as not retrenching enough. None of them, that I could see, paused from their partisan spitballing to take note of the good work that St. Jude’s and Wash U. are undertaking. That’s good work that will not only make children healthier, but that also holds out the promise of a better economy--as people grow up to be productive, as new industries sprout to make popular new medicines.
Yet as noted, national politicians are ignoring such news, because the Zeitgeistial story line is that we are spending too much, and that healthcare, too, needs to take a haircut. In other words, we must provoke a recession in healthcare, as part of an overall austerity package.
A recession within the biggest sector of the economy--in the name of promoting economic recovery? Does that sound like a good plan? It’s not a good plan for health, to be sure. And it’s not a good plan for the economy, either. The only person who might think of it as a good plan is Herbert Hoover, wherever he is. And he, of course, did not win re-election. In fact, he got beat in a landslide.