Tuesday, January 24, 2006

Healthcare, Federal Budget, Lobbying, and Corruption. “$22 Billion is a lot of money.”

“$22 Billion is a lot of money.” That’s the quote that caught my eye from an anonymous Republican healthcare lobbyist in today’s Washington Post. The complete article from the January 24, 2006 Washington Post appears here:

Closed-Door Deal Makes $22 Billion Difference

If I am reading this article correctly, and if the events and details are presented accurately, I must confess that I’m a bit flabbergasted. Where do I even start to rant?

The entire body of elected officials has voted as a whole and chosen to reduce the federal budget by removing payments deemed excessive that are made to Health Management Organizations (HMOs), progressively through 2010. This makes sense – we vote for folks, and then they go and make laws and manage budgets for us. If I don’t like the way I’m being represented or the policies that come from my representatives, I vote differently in the next election to try to get somebody else to represent me. And the diversity of that elected group as a whole, in theory, represents the diverse opinions and wishes of the constituency of the United States as a whole. It’s not a perfect system, but I think I can live with it.

And then, after the elected bodies have voted, members of only one party meet – behind closed doors, without a recorded vote – and make $22 billion dollars worth of changes that benefit a group which has been lobbying heavily to ensure that its pockets will be well-lined with federal dollars in the years to come.

Gosh, why does that seem wrong to me somehow?

I’d like to be happy that more of my tax dollars will be going to “health care” – but there’s more that’s wrong here. Because the dollars in question are not being spent to give health care to anybody – instead, these dollars (22 billion of them) are the estimated amount that the federal government is overpaying to HMOs, above and beyond the cost of the care provided by the HMOs to patients.

Are you friggin’ kidding me? And this is LEGAL?

Well, yes – unfortunately, it is. And conference committee decisions like this one are relatively commonplace, although the matter seems perhaps worse in light of the current administration’s demonstrated preference to avoid due process whenever possible.

I could go on and on about what I think is wrong, but I think I’m doing us all a disservice if I just whine without offering something better. But where can change come from? Our present system seems to have some tragic flaws, and some of those flaws seem to be absolutely necessary to the effective running of a government. Try to remove them, and we just trade one set of problems for another.

One hope I have in the near term is that public distaste will provide some pressure toward improvement – both in terms of legislation, and in simple terms of better behavior on the part of our elected officials. This may seem naively optimistic, but there are clearly at least some legislators, reporters, and even lobbyists who feel that these behaviors are wrong, and are willing to speak out against them. So, in my opinion that’s a start – those of us who feel that something is genuinely wrong with the way things happen, raise our voices, raise some awareness, and become agents of change in the short term. It won’t save us, but it is a start. My aims, however, reach much farther.

Have you ever noticed that there is no need for a law prohibiting something that nobody wants to or is willing to do? Even if such an activity is illegal, it doesn’t matter because nobody is willing to do it.

I don’t want better legislation and laws. I want better people. And better laws don’t make better people. How many times in my own life have I looked at the list of prohibited activities as a kind of challenge, a checklist basically, of things to do? I didn’t need more laws – I needed better decision-making skills.

I am not suggesting that we need to become angels. That’s absurd on several levels, and it’s a kind of naive optimism that even I am not willing to stoop to. There always has been and always will be a diversity of human beings, from the best of us to the worst of us. It’s a spectrum, and that’s the way it should be. Anything else would be inhuman.

And frankly it’s too late for us. You and me and all the people holding office in Washington and elsewhere, we grew up in this. And apparently, what we have right now for government is the best that we all collectively have come up with so far. So, what is it that I am hoping?

Raising a voice and raising awareness is a start – we have to do that, or we’ll never get anything better. Staying silent is like saying that this is okay. And it is not. We are foolish, ignorant, short-sighted, and lazy – unless we remember not to be. And I don’t know about you, but sometimes I need a little bit of reminding. And like I said, that’s a start.

But our real hope, our only hope, for better results lies with people who don’t exist yet. I believe that the only hope for humanity is to figure out how to raise a generation of children, who in turn are capable of raising another that’s better – until at last we raise a whole generation so saturated with people of conscience and decency, that any time I go to do something foolish, short-sighted, lazy, hurtful, or crooked, there will be so many people standing around me asking me what the heck I was thinking that I don’t often get to finish the thought.

And when I say children, I don’t just mean my own personal genetic material. They say it takes a village to raise a child. I think maybe it takes a nation to raise a legislator or a president. I’m not real pleased with the way my nation raised the president we have now. And it’s too late for him, just like it’s too late for you and me. But we can learn from this, and do better in the future.

“That’s sweet, Simon. But how do you suggest we pursue this utopian ideal? Didn’t you already say it’s too late for us?”

Yeah, I did. But I can start right now, building a better future for people I won’t live long enough to meet, and reaping a few benefits along the way. I can start by asking questions, out loud and in public, like, “Is this wasteful? Is this hurtful? Is this what I truly believe is decent?” and then encouraging others to ask themselves the same questions.

I don’t especially care if your answers have anything in common with mine, as long as we’re asking the questions, and thinking about the answers. If we do that, and we don’t let up, this planet may someday be full of humans who ask themselves these questions automatically, as part of the natural way of knocking around the world. I fantasize about a world where anybody who doesn’t ask those questions every day is considered a freak.

That’s what I want. And so, I’m doing it now, and I’m not going to quit, even though I know that I will not live long enough to see the end results. Why? Because it is not wasteful, and it is not hurtful, and it is what I believe is truly decent. And whatever you believe, I hope you’ll ask yourself the same questions.

That’s what Simon says.



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