Healthcare reform: It’s not only back on the table, but it gets a bipartisan fresh start.  At least that’s what President Obama told us.  The televised summit meeting, however, turned out to be a different story.  Instead, the President presented the 2700 page Democratic Senate bill which had been crafted entirely behind closed doors, while he challenged Republican Senators to convince him against it.  He alluded to otherwise continue with a process known as reconciliation, enabling him to block a Republican filibuster and force the legislation through the Senate.  No big surprises there.

There was clearly little in terms of agreeability with the Democrats on one side insisting on passing the entire overhaul at once and the Republicans on the other, insisting on a fresh start with small steps.  Hence, it’s fair to say President Obama may very well end up using political reconciliation for the entire 2700 page proposal.

The Congressional Budget Office estimates the total cost to be $1.5 trillion over the next ten years and the President still hasn’t told us from where this money is going to come.      It’s understandable he doesn’t want to admit he’ll have to at least partially recover it with heavy taxation on the middle and lower class.  Since a direct income tax would be too obvious and unpopular, it’s likely the source of revenue will come from higher taxes on  such things as property, public transportation, cell phone use, cable TV, liquor, tobacco, fuel, and increases in sales taxes, making the cost burden virtually inescapable.  The President does acknowledge he will cut $500 billion from Medicare to partially offset the cost at a time when the number of seniors is approaching it’s largest ever.  More so, we don’t clearly know what this money is going towards.  Initially, it was to subsidize public option plans.  Those public plans have since been removed from the legislation, yet the cost to finance the legislation hasn’t changed.

Despite the many suggestions offered by Republicans, the president remains steadfast his proposal is the superior choice.  One major plea from Republicans was for tort reform.   The President wants to address every aspect of healthcare at the federal level except lawsuit abuse, the cost of which inevitably gets translated to society.  He feels the inclusion of provisions to allow states to settle cases outside of court addresses the issue sufficiently.  Such provisions, quite frankly, seemingly make matters more convenient for people choosing to file frivolous law suits.

The President’s bottom line was that his plan would insure an additional 31 million people and none of the alternate suggestions were comparable in terms of results.   Since many of the suggestions which although might be effective may conflict with the President’s regulations, they were immediately discarded.  An example is the option for people to buy insurance across state lines because doing so would circumvent his Healthcare Exchange program.

But according to the CBO and even the President’s own admission, under the proposed plan only 14 million people will be considered financially able to buy private market insurance.  The other 17 million simply get put into an expansion of Medicaid, a program which offers meager healthcare coverage to the 20 million people it already has enrolled.  After all, it’s difficult to even find a doctor who participates with Medicaid.  Believe it or not, although the specialty reimbursement is poor, the Medicaid reimbursement to primary care physicians isn’t so bad. It’s the amount of red tape associated with getting treatment approved which discourages most primary care physicians from participating. The government simply makes it too difficult for Medicaid patients to receive care. Yet the President clearly deflected the notion that having coverage doesn’t necessarily equate to having care.  He was more focused on his statistic that 31 million more Americans will have health coverage, end of discussion.

The most worrisome part of the proposal is the fact that it’s simply too long for anyone to review.  We basically don’t know what’s in it.  We can logically conclude, however, it will give the Federal government enormous control over our healthcare industry.  Democratic Senator Chuck Schumer made a specific point during the summit that doctors are too often rewarded for quantity care and not quality care, a notion President Obama supports. Schumer said part of reform necessitated the government to make the discrimination.  It’s as if to say doctors do a poor job at making honest, ethical, and reasonable decisions for their patients.  I’m not sure society agrees with that assertion.  And I’m pretty sure society doesn’t want a government dictated healthcare structure born from such a pessimistic attitude.  It is no wonder every poll conducted says 2 out of 3 people are against the proposed reform.

Ultimately, unless one considers shoving an extra 17 million people onto Medicaid as favorable, this plan does little to help anyone beyond suggestions the Republicans have as well proposed such as eradicating a pre-existing conditions rule, comes with a mammoth cost burden, and imposes 2700 pages of bureaucratic legislation onto our health care.

The President clearly doesn’t want to listen to the majority of the population as well as half of Congress.  So then, what will it take to make him listen?  Perhaps, the answer lies in giving the President a dose of his own Democratic medicine (pardon the pun).  Maybe this is a calling for a National Physicians Union to be formed as an advocate for patient rights. Maybe it is time for doctors to coalesce and embrace the responsibility of safeguarding health care from foreseeable government rapacity.