If It Ain’t Broke Don’t Fix It
I certainly didn’t coin that phrase, but I might have been the first to use it when I referred to how our government often operated when it came to our healthcare back in 1996. More recently I used it in this blog in 2021 as we were facing President Biden’s trek toward making big changes in our healthcare – including to Medicare Part D. I don’t want to brag (every time someone says that, the very next thing they do is brag, which, with a nod to tradition, I will precede to brag) but the five things that I pointed out in that blog have in many ways come to fruition. I would like to revisit those things and see what we might learn and how they might help us predict how best to move forward, but before I do that, I need to rant a little about why we need to limit our government’s insertion into our lives.
Government institutions are driven by incentives that drive them to become bloated and inefficient. Our lawmakers get reelected by showing us how many ways they have got involved in our lives, they don’t get reelected by telling us how many bills they didn’t submit. Our lawmakers, almost by default think they must take action, fix something, change things. I don’t think it ever crosses their minds that leaving something alone that’s working might be a valid option. I commend the current administration in their quest to reduce regulations and reduce the size of government. I personally might have chosen some less disruptive ways to do it, but I think the goal is to be applauded. As you might have guessed, I’m a fan of small government.
As we look at the “Big Beautiful Bill Act” that has passed the House and is now on the way to the Senate, I want to focus specifically on the proposed cuts to Medicaid and Medicare and how the five things I wrote about in the blog four years ago still apply.
First – I pointed out that Executive Orders (EO) were a bad way to govern . . . they bypassed the checks and balances in the constitution, and they can be rescinded by the next President. President Biden rescinded many of President Trump’s EOs and he has returned the favor - as I predicted. Now during his second term, President Trump started quickly and has already issued more than 150 EOs.
Second – I didn’t think it was fair to use money extracted from Medicare to fund other parts of government. I think this applies even more today. Cutting Medicaid by as much as $800 billion is not fair to those of us who need this program the most. I am all for cutting waste, fraud, and abuse. Let’s do our best to reclaim this money but, instead of funding some other non-healthcare programs, why don’t we invest the money we saved into preventative health benefits like dental and hearing benefits? This reinvestment will keep us healthier and save even more money over the long run. Doesn’t that make sense?
Third – I predicted that the chaos caused by Biden’s EOs would upset the supply lines for medicines. I was right, many prescription drugs are now, or are predicted to be, in short supply.
Fourth – I questioned the wisdom of Biden’s quest to chill investment in new cures by fixing the prices of many drugs even as we witnessed the lifesaving speed that the COVID vaccine was developed. He did, and now we are already seeing the reduction in research and development. Do we want to double down on this government insertion in our healthcare by adopting the Most Favored Nation approach that has just been proposed?
Fifth – I pointed out that the pharmaceutical manufacturers and insurance companies have always been ready to sit down and talk of ways to make our healthcare more accessible. It didn’t happen four years ago but there has been some willingness recently to talk about ways to get other countries to share in paying for the costly R&D required to develop new medicines. I hope this develops into some real back and forth discussions.
It has been evident at the conferences I’ve attended this year that the cuts to government healthcare agencies have been stressful. I’ve already talked about how dangerous it will be to those who rely on the benefits of Medicaid if we make large and arbitrary cuts to this program. Is there waste, fraud and abuse in Medicaid . . . yes, but we can’t throw the baby out with the bath water. It will be interesting to see what the Senate does with this proposed bill that barely passed in the House. There are bound to be changes. I will do my best to keep you up to date on how things are progressing. Just a reminder, call your lawmakers and tell them you want changes that make their healthcare more accessible, changes that actually will make a difference to older Americans.
Best, Thair