“Buck Up”, Mr. Obama, On Health Care

   On July 15th, the Whitehouse wordsmith was whooping up support for the House of Representatives “Un-Healthy Care Pill” he wants all to swallow. Like an impatient mommy, the ‘Archduke of Deficits’ told all to open wide and “buck up”

   Buck up? In the 1700’s that referred to the testosterone tirades and antics in the antlers of male deer in rut. In the 19th century it meant that dressing up dandy made you feel better and powerful. Today, it means stop being a wussy.

   “Obamanation” oratory struck again as he told all to “quit tinkering”, get on with it and we’d all feel better. So let’s see; to slake adolescent thirst for a political victory of something he and his minions clearly know little about, cannot pay for and have not even fully read, the greatest albeit imperfect health care system in the midst of a hysteric recession should just, “buck up”, and undergo unaffordable revolutionary global impact change.

   America is nonpareil in advancing the quality of life of mankind because of, not in spite of our economic and political system. One more budget breaking debt against us and the ship of state will capsize, taking the last great hope of capitalism and federalism into the deep.

   I am three quarters through a careful read of this behemoth bill. No, it is not all bad and yes, change is needed.

   However, as early as page sixteen, in twisted tortuous grammar, the death of the wonderful dividends of private competitive insurance and the emergence of a single payer governmental system is very clear. You will soon have no choice.

   Around page 425, Uncle Sam gets green; “Soylent Green”, like the movie. Bureaucrats are empowered to slither into the hearths and hearts of our elderly with mandatory counseling about their use of limited resources at the end of life. This is holy ground. Legislation addressing the time and place of living wills and durable powers of attorney already exists. Read the bill, take two aspirin and call you congressman when you’re mourning.

   “Obamacare” is not some endlessly flowing balm from a holy grail. Single source solutions are breeding grounds of mediocrity, fraud and outrageous expenses. Were he alive, James Madison, a beloved principle architect of the greatest secular document ever conceived would be hosed, eh? In Canadian fashion, after waiting too long for too little, he’d be advised that owing to his age a little hospice shuffle off this mortal coil might be best for all.

   Diminishing individuals’ control over their personal health care decisions through single payer systems enfeebles innovation, competition and solutions which would have lead to expanded coverage of quality care. Generating unsustainable federal spending will worsen the budget crisis and create inferior clinical outcomes, rationing of care and non clinicians making too many decisions.

   When you have a process that is almost one fifth of the whole show and it is ancestrally and incestuously related to other core processes (Medicare, Medicaid, Social Security) you think systematically and long term.

   Whether building Rome, the Manhattan project or developing polio vaccines, you do not do it in a daze, or two. That is as silly as building an engine without regard for the rest of the car, the roads, the fuel and whether you need it.

   If every legislator had to take a proctored exam on the bill or the data or toss in their lot with us, we know the result.

   Tell those uppity bucks that this bill is no dandy, keep their pants on and let’s pull together like we did forty eight years ago. This is not rocket science.

   Admit quality is costly and excellence bears great dividends. Commit that we will not hemorrhage our future or our political system. Buck up, just say no and buckle up for long term thoughtful reengineering of a complex but great system.

Kevin Ryan ©2009