Snowe Job

So much for Olympia Snowe’s attempt at bi-partisanship. Her extended olive branch was wilted by the big bad public option, ushered in by democrats Reid and Pelosi. Will the public option be in the final bill? And in what form — with a trigger, an opt-out clause? Although pushing a government run health plan is the current hot-button reform issue, the larger question in this cantankerous debate remains unanswered: how will the final bill curtail our runaway healthcare spending?
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Obama said that healthcare reform was necessary for the solvency of our economy. That was a huge part of his pitch. Well at the beginning at least. Remember the little border town McAllen, Texas, featured in the New Yorker story by Atul Gawande. His article was accompanied by a graphic showing a patient as an ATM machine. It explored why some communities across the nation spend triple the amount of Medicare dollars as other communities, without added health benefits. President Obama read it and put it on his staff’s reading list.

Peter Orszag has said that eliminating this type of variation could cut Medicare expenses nationally by as much as 30% and actually improve the quality of care. That’s what I call reform. But what happened to Orszag?

McAllen Texas should have been at the heart of our healthcare reform debate. This small town that spends way too much of our precious healthcare resources is a microcosm of our system’s overall problem — across-the-board overuse of medicine.

Obama understands this. So do his cadre of healthcare eggheads. Unfortunately it’s just too difficult to explain because somehow intelligent use of healthcare services always gets politically tangled with the R word: Rationing.