(skillfully produced political theater)


Wednesday’s presidential performance about health care reform clearly showed that, this President, is as adept at producing high political theater in support of an issue, as any of his predecessors, such as Washington, Lincoln, Teddy Roosevelt, FDR, and JFK, to name but a few.


Cleverly allowing all kinds of interests involved with health care, to spend months venting on the subject of reforming it, he shrewdly remained on the sidelines hardly saying much about it, one way or the other. Then, with a well-timed bit of political guile, he called a recalcitrant Congress to heel, for a rare joint-session command performance to hear what he had to say about it all.


Taking center stage, he assumed the hybrid-character mantle of a kick-ass CEO, castigating his worker-bees for a less than stellar performance, on the one hand; then, on the other, that of an evangelical preacher-man exhorting a befuddled congregation to suspend any lingering unbelief in his proposals on the subject, or, face a future of hellfire and unimaginable ruin and misery.


Having thus hammered everyone concerned with his displeasure at the lack of progress on such a vital part of his domestic agenda, he then switched over into an incentive offering mode. First, offering to the extreme Left side of the chamber some half-loaves of consolation to soothe its radical impulses. Next, to the extreme Right of that chamber, some conciliatory crumbs of concessions to help assuage its resistance to any proposed changes. As for everyone else packed in the Middle of that chamber, these just received an earful of good intentions to relieve any ongoing angst about his plans for the issue. It was, clearly, a masterful, Oscar-quality bit of political theater. 


It remains to be seen if anything of substance results from it.


All of that aside, some very critical aspects about health care reform remain un-clarified and un-defined. These are:

1)What, exactly, did he mean by “a robust public option”?

2)If the proposed reforming process generates sufficient economies to offset the costs of reforming the current system, why is he projecting some $90 billion per year in budgets for that over the next ten years ($900 billion total), since he claims the government won’t be involved because of his proposals?

3)Just exactly how will all that control our up front costs?

4)What will be the mechanism to decide where costs are to be cut or contained, who gets what care, and when and how is that to be provided?


At this moment….no one really knows.


Is it any wonder then that everyone still remains on tenterhooks of angst about the subject of health care reform? Most of us may appreciate, and even enjoy, a good theatrical production, now and then, including a political one, but, for an issue as critical to all of us as this is….that’s not much help, nor is it appreciated.


What’s depressing about this state of affairs is that none of our career politicos, not the President, no member of Congress, not even any of the many expert bobble-heads expounding about it all on TV, appear to have perceived a possibly simple answer to the whole problem. Which is: When faced with a giant alligator of a problem, the best way to resolve it is to cut it up into smaller alligators, which you can then more easily overcome.


In this instance that giant alligator is the fact that the two main components of the health care problem are still combined into one humongous beast! And no one is looking at ways and means to properly dismember it, so we can achieve the reform goals and objectives we all want. 


That is:

a)Primary care and maintenance services.

b)Hospitalization and care for major health related episodes.


Separating these two components from each other (chopping that alligator beast into two parts) might give us more workable means to handle the problem of accessibility and affordability….for everyone. More importantly, it could allow us to retain our freedom of choice, and, freedom from dependence on any employer or government provided health care programs….and at a cost any of us could handle besides.


Let’s take a look at how that might be done and if it could work:

1) If all of us had ready access to primary and preventative health care, at very low 

    cost, either to us or to the public purse, most of our health care concerns would   



    That could be accomplish by simple enabling legislation authorizing the creation 

    of NFP “Chartered Health Centers”, part of a national network, in every urban 

    neighborhood and rural part of the country, offering membership at nominal cost 

    per person. Even the lowest paid workers could afford it.


    These Chartered Health Centers would provide basic health and medical care, 

    focused on health maintenance and prevention priorities, using whatever 

    combination of conventional, alternative, or wholistic, therapies which might be 

    appropriate for any particular patient, all aimed at minimizing the need for higher 

    cost medications or procedures. These would be mainly staffed by general 

    practitioners, family medicine, pediatrics, gynecologists, etc..Since the tax code    

   already provides for NFP entities, little or no tweaking of it would be necessary by  

   Congress, to enable their creation and activation. It would just be a more creative 

   application of it, and, half of that alligator beast would thus be gone.

2)The remaining half of the beast, that is, hospitalization for serious illness, major 

    surgery, advanced rehab therapies, high technology medical treatments, high 

    cost specialists, equipment, etc., could be covered by separate special medical 

    insurance policies, similar to conventional liability policies, both in terms of 

    scope and coverage. But here, the costs of these would be determined by several 

    factors, such as….whether the insured belonged to one of those Chartered Health 

    Centers….what deductible options the insured selected….and lastly, allowing such 

    medical policy insurers to adopt the Lloyds of London formula for sharing 

    underwriting of risks, thereby further lowering the premium costs to those being 

    insured. And because insurers would be able to share those underwriting risks 

    there would rapidly evolve a whole range of policies offering a wide array of 

    coverage, and premium costs, allowing everyone to have such coverage, at a cost 

    they could afford.


    Most important, there would be no arguments about what might or might not be 

    covered. It would all be governed by the dollar limit of any given policy. We 

    should also keep in mind that, since every insurer involved would be competing 

    for a piece of such a broadened market, that competition would further contain 



    Lastly, such an approach for this more expensive aspect of health care would 

    relieve employers from having to come up with their own coverage plans. They 

    could, to better attract quality employees, offer to subsidize part or all of the 

    cost of such premiums. Of course, Congress would have to make its contribution 

    to the cause here, by agreeing that such subsidies would not be taxed as income 

    for the employee, and allowed as a deductible business expense for the employer. 

    Which would only be a fair exchange since, the government, would then be saved 

    the expense of having to provide a coverage program of its own (except perhaps 

    for those truly indigent and helpless members of our society).


   Well, perhaps by the next millennium something of this sort might come to pass. 

   Meanwhile, we can all pray a lot. From the looks of things, the way things are 

   moving, we may soon need steel-plated underwear if Congress has anything to do 

   or say about it.