The Health Care Reform Summit: A One Act Play

Whistleblower Grand Rounds Submissions!

Whistleblower will be hosting Grand Rounds on February 23rd.  All submissions are welcome.

Here are some tips to maximize your chances of acceptance, which will guarantee that your blog posting will receive worldwide exposure.

• Send your posts to MKirschMD@gmail.com
• Write Grand Rounds in the subject line.
• Include the URL of the post in the email message.
• If you do not receive an email confirmation, then I did not receive it.
• Remember, brevity is the soul of wit.  If you are torn between 2 of your masterpieces, please send me the shorter one.
• Please include a sentence in the email expressing the point of your post.  This is your opportunity to  wield your razor sharp wit.
• DEADLINE for submission is Sunday, February 21st at noon.  Earlier submissions are preferred. Please send your stuff at your earliest convenience. In other words, now is not too soon.

Now, on to this week's Whistleblower.

How many times have we all been issued the directive, choose the best answer, in our academic lives? In our society, those who test well enjoy many advantages, even though standardized testing skills may be less useful in real life. Pre-med students, for example, are measured numerically, even though the skill sets for MCAT success and clinical medicine are quite distinct. Nevertheless, we measure our students by the numbers. High school students and their hovering parents, who are aiming for elite institutions, hire personal coaches and tutors who promise 3 digit score increases on the SATs.

Most Whistleblower readers are well beyond the standardized testing zone and no longer have to fill in rows of ovals using #2 pencils. It was nearly 35 years ago that I faced off against the wily SAT opponent. But, the memories of these experiences are still vivid. Back then, we brought our school ID cards with us for verification. There were no fingerprint checks, retinal scans or other sophisticated biometric analyses to confirm a student’s identity. In a few years, a quick oral swabbing for a spot DNA check may be the new standard.

I still recall the bold faced warnings that were also read to us by humorless proctors.

Do not open your test booklets until you are told to do so.

Make no stray marks on your answer sheets.

Fill in the oval spaces completely.

Standardized testing skills are like tying your shoes or roller skating. They are lifelong. I’ll prove it to you with simple standardized test question that is so easy, that even a physician can get it right.

Which of the following scenarios is most likely to result in a harmonious outcome? Choose the best answer.

(a) A boa contrictor and a mongoose sharing a dorm room
(b) Ken Starr going on a hunting trip with Bill Clinton
(c) A medical malpractice plaintiff’s lawyer mountain climbing with a group of anesthesiologists and OB- GYN docs
(d) Bernie Madoff lecturing investment firms on how they can recapture lost assets
(e) President Obama meeting with GOP leaders on February 25th for a public airing of their respective health care reform (HCR) views.

Stumped?

The White House announced prior to the Superbowl that it was convening a half day conference to meet with Republican leaders to discuss the health care reform quagmire. Unlike the adminstration and the Democrats' previous backroom dealings, this meeting will be televised. The GOP readily accepted the President’s proposal to meet, but they are wary of his intentions.

The administration has described the meeting as bipartisan, but a duel is a more accurate description. Why should bipartisanship bloom now after months of bitter recriminations, misrepresentations and political intrigue? It won’t. Just this past week, Roll Call reported that Speaker Nancy Pelosi is disparaging the Republicans and threatening to ram HCR through with a simple majority vote that could defy a fillibuster. While this is red meat to the political left, it spooks Democratic moderates who fear that the ghost of of Scott Brown’s electoral masterstroke could haunt them this November. The GOP, in contrast, sees Brown’s victory as a magic carpet ride that could lead them toward the political promised land of majority control.

If the Democratic position at the meeting is to begin negotiations where the House and Senate legislation left off, the GOP will push back, knowing that the public is increasingly skeptical of these expansive and expensive health care ‘reform’ proposals. The Dems, of course, will reject rewinding back to the status quo ante, and will want their legislation to be the essence of the final product.  At this very moment, Democratic leaders are trying to meld the Senate and House versions in advance of the upcoming television special, provoking GOP angst.  Does any reader see the makings of an agreement here? If so, then you should be immediately dispatched to D.C. as you may be the only individual alive who can forge a deal.

This ‘summit’ meeting, as with much of HCR, has nothing to do with health or reform. It is about achieving political power and influence. It's unspoken objective is to tarnish the other side.  In the campaign, candidate Obama promised us C-Span coverage of health care deliberations. We never got the ‘Span’, only lots of spin. Now, with HCR teetering on a precipice, we will be able to watch live action of this political Kabuki dance. Desperation breeds transparency.

This will be political theater where each side will try to gain advantage over the other. The most recent New York Times/CBS polling shows that the public believes that the President gets higher marks for bipartisanship than the GOP.  President Obama hopes that the upcoming meeting will widen this gap, while the GOP aim to exploit public skepticism.  Each side will accuse the other of intransigence, while claiming to be compromising and conciliatory. This will not be a substantive policy review, but a carefully crafted performance by all players.  The speechifying may sound medical, but it will have nothing to do with health care. Every word spoken and every phrase uttered on the last Thursday this February is directed toward the first Tuesday in November.

When the 'bipartisan' health care summit fails, which of the following statements will be issued within minutes of the meeting’s conclusion. Choose the best answer.

(a) “We will not adopt the Republican’s Bush-Cheney Health Care Plan.”
(b) “The President extended a hand in friendship, and was greeted by GOP brass knuckles.”
(c) “Republicans stood with America and wouldn’t accept the President’s prescription of government-run socialized medicine.”
(d) “Their plan is great for the health of trial lawyers, but is bad medicine for the American people.”
(e) “The Professor-in-Chief lectured us like school kids. The Final Exam is this November.”
(f) All of the above.

Pencils down!

You've heard my view.  Now, what's your prediction?