If you want to take a pulse on the political vibe in this country, one need only look at Wisconsin.  The state has become the barometer for judging not just the public’s appetite for political battle, but the competitive landscape as well.  The spotlight on anything that has six degrees of separation from a Koch brother has been great drama for Wisconsin’s ongoing soap opera, but audiences in the state and nationwide might get a better show by turning their attention leftward.  Few have examined the strange pattern of money and favor trading that’s been pervading Wisconsin’s beloved circle of progressive politics.

The activity in Wisconsin over the last few months becomes crucially pertinent as the state gears up for the 2012 Wisconsin Senate race.  It’s worth looking at the financial innards  of the Supreme Court race and the protests against Governor Scott Walker in order to assess what the fight for the Wisconsin Senate seat, soon to be vacated by retiring Democratic Senator Herb Kohl, will look like.  What many don’t realize is that this race could have broader implications – not just in national politics, but in specific policy areas, like health care and your personal medical records, for example.  Lots of money, fueled by liberal business interests and an ever-growing progressive movement in Wisconsin, has already been freely flowing.

But is anyone watching? Who are some of these donors?

Let’s start by looking back at the recent Wisconsin protests and the Supreme Court election, and then dissecting some of the money trail.

The hostility stemmed from the union reform bill signed by Wisconsin Governor Scott Walker on March 11^th as a stand-alone portion of the overall budget repair bill.

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Did you ever wonder exactly what evidence-based medicine is? The National Center for Clinical Excellence bases it in on the philosophy “that as much medical practice as possible ought to be carried out using proven algorithms based on empirically valid evidence from controlled scientific experiments, rather than individual clinical judgment.”

Congressional health care reform relies heavily on both Evidence-based guidelines and evidence-based individual decision making to set the standards of care for medical treatment and outcomes. In fact, House bill 3962, in an effort to control costs, creates a new layer of government bureaucracy that inserts itself between the doctor and the patient. A national health commissioner and task forces will evaluate and decide everything from what medications a physician will be allowed to prescribe for a patient, to what surgery will be approved, to what outcomes will be expected for a particular medical condition. The ‘universal healthcare Czar’ along with the task forces will also decide whether or not hospitals will be reimbursed for care rendered based on predetermined outcomes. For example, if a patient is re-admitted within a prescribed number of days after discharge, the hospital will not be reimbursed for care given. It does not take into account factors such as how ill a patient may be. This new layer of government effectively removes the power of the individual physician and patient to decide what is the best course of treatment.

Why should you care?

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In Massachusetts, where 97% of us have health insurance by mandate since 2006, we have learned a few things about health care reform.

We have learned that universal coverage does not mean universal access to a doctor.  The Massachusetts Medical Society reports that there is a critical shortage of family physicians and severe shortage of internal medicine doctors.  Seven physician specialties are also operating in critical or severe physician labor markets.

A recent study by the Robert Wood Johnson Foundation showed that 75% of non-emergency ER visits occurred because a regular physician was not available after hours, and half of these visits occurred because a timely appointment was unavailable.  With more than half of all the doctors trained in Massachusetts leaving the state, citing the practice environment and low salary levels, and one out of every four currently practicing doctors considering a career change, it does not appear that access issues are going to improve soon.

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With Democratic support coalescing around Sen. Max Baucus’s (D-Mt.) health care reform proposal, passage of a comprehensive overhaul now appears more likely than ever.  Opponents had their summer of protests.  But, Democrats have shown a renewed sense of energy since discrediting Sarah Palin’s “death panels” and Sen. Charles Grassley’s claim that ObamaCare would “pull the plug on grandma.” Still, while those charges may have been a little overwrought, there is plenty to be concerned about with the Democratic health reform effort.

As I explain in a new Competitive Enterprise Institute paper, “A Cure Worse than the Disease: Obama Care Won’t Cut Costs, But May Cut Quality,” most of the alleged cost-cutting measures in the Baucus bill merely shift costs from the federal government onto the states or private payers, without affecting long-term health care inflation.  The only measures that could reduce the annual rate of growth in health care costs would erect government barriers between patients and their doctors, while jeopardizing long-term medical innovation.

Skeptics have made hay arguing that the so-called Sustainable Growth Rate can’t be counted on to cut $245-billion in Medicare spending. But Senate Finance Committee negotiators have designed a Medicare Commission—what the White House previously called an Independent Medicare Advisory Commission—to make similar cuts in physician and hospital payment rates in a more opaque way.

In an April New York Times interview, President Obama suggested that such a group, working outside of “normal political channels,” should guide decisions regarding that “huge driver of cost…the chronically ill and those toward the end of their lives.”  That’s not exactly a death panel roving the country to pull the plug on innocent grandmas who’ve survived past their sell-by dates, but the effects could be equally pernicious.

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