INSIDE THE CURRENT ISSUE

November 2008

Fast Foreward

Time to buoy health-care with a bailout?

If anyone thought in the waning weeks of the presidential campaign that healthcare would return as an election issue worthy of media headlines the slovenly banking and credit industries pretty much put a $700-billion kibosh on that.

Prior to September 2001, few outside of the fictional world of Hollywood and thriller novelists could fathom terrorists in real life flying passenger jets into buildings. Flash forward seven years: Prior to September 2008, few outside of the frictional inner circle of Washington could fathom the federal government bailing out mismanaged publicly owned financial corporations beset by bad business decisions and downright greed – regardless of the deregulation blame game, incessant finger-pointing and the pointless Henry Waxman-orchestrated Congressional grandstanding.

Now, taxpayers will end up footing the bill for corporate CEOs and Congressional leaders – all of whom either have retained their jobs or have "escaped" to retirement with hefty golden parachutes and pensions, despite their despicably subpar performances. Bottom line: They all should be fired, forced to pay back their ill-gotten gains (even if they retired or left appointed or elected office a decade ago) and required to perform community service.

Accountability is the operative word.

So what about healthcare? Imagine if Hillary Clinton and her Jackson Hole group in 1993 could have used this "strategy" to implement universal healthcare. That would be then-Speaker of the House Newt Gingrich you hear hacking up a hairball at the proposition and even the prospect. Not anymore.

The parallels between the banking and credit institutions and healthcare organizations – particularly insurance companies, managed care organizations and payers – are uncanny.

Sure, the healthcare industry doesn’t have derivative profiteers, speculators, house flippers and those with little-to-no ability to assume responsibility for a mortgage but "earn" one anyway, courtesy of incredibly relaxed rules and standards that stretch logic (as an aside, why hasn’t former Fed Chairman Alan Greenspan weighed in on all of this yet?).

But imagine what a $700-billion infusion of cash into the healthcare industry could do to yank it back from the brink? Nothing, you say? Not necessarily. On the surface it would seem simply enough like the money would shoot pneumatic tube-style through the system only to end up in a black hole without fixing the inherent operational inefficiencies.

Ah, but au contraire. If someone like Treasury Secretary Henry Paulson (he of Goldman Sachs stock) were to apply his draconian white knight heroics to the Department of Health and Human Services, as well as the Centers for Medicare and Medicaid Services, he should be able to accomplish more than, say, any medical doctor in Congress whose family owned the largest investor-owned hospital chain in the nation.

With great loans comes great responsibility – as in rules. Or at least, that’s how it should be with plenty of legal and regulatory strings attached. Think of the possibilities: Under a Paulsonic-initiated and federally backed universal healthcare system, access would be guaranteed, errors would not be tolerated, electronic health records would be mandated, quality would be enforced and reimbursement would not be denied for pre-existing conditions – specifically if the feds became part owners of the payers.

Some will argue that because hospitals have to treat patients regardless of their ability to pay (because that’s the foundation for the charitable ER Inc.) we already operate a form of universal healthcare. At least that’s more realistic than a federal bailout of the healthcare system.

Fixing the "broken" healthcare system requires some agonizing decisions that will generate considerable pain that all must suffer – not just a particular class or creed. The same should happen in the fiscal frat-like financial system. Alas, that’s not happening either.