The implementation of the healthcare reform bill that was passed in March has now begun. Unfortunately, it is becoming obvious that the promises made such as: a) you can keep your physician and medical plan if you like them; b) your healthcare costs will go down; c) there will be no healthcare rationing; and d) everyone will be covered simply were not true.

We were fed a steady diet of fear, distraction and falsehoods to sell healthcare reform.

• We were told that unless something was done healthcare costs would bankrupt the country

The Congressional Budget Office (CBO) released a report admitting that the actual cost of the healthcare system would be far higher than was initially estimated  - a cost of more than 1 trillion dollars

• We were told that healthcare premiums would decrease for families

The CBO report estimates that the cost of healthcare premiums would go up by $2100 for the average family next year

• We were told that if we liked our health insurance and doctor we could keep them

Thousands of Medicare recipients from Massachusetts to Maine will lose supplemental insurance through Medicare advantage thereby increasing there healthcare costs exponentially.

• There will be no healthcare rationing

The choice of Donald Berwick speaks for itself. He is a champion of the British model of socialized one size fits all medicine. It is a broken system that is based on rationing of care that is collapsing under its own weight.

There have also been examples of nascent rationing here in the US. e.g, in Colorado the cancer drug Avastin is not covered by Medicare although it is covered in other states. In addition, the effectiveness of screening tools such as mammograms are being questioned. It is likely that these studies will eventually be used to argue that mammograms are not effective and therefore will not be covered by insurance.

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Have you wondered how healthcare reform will play out? You only need to look at how healthcare has been laid out by the World Health Organization (WHO). The International Classification of Disease also known as the ICD is the coding system that is used to classify diseases. It is published by the (WHO), and it is also the basis for reimbursement for hospitals and physicians.

There have been several iterations of the ICD. The most recent is ICD-10. Seven countries have adopted it to date. The first country to adopt it for clinical use was Australia in 1998 then Canada in 2000. The most recent country to adopt it was Thailand in 2007. The United States is scheduled to adopt it in 2013. Just in time for the major pieces for the healthcare reform pieces to take effect. The mad rush to pass healthcare reform makes a lot of sense when this time table is taken into consideration. It finally brings the US healthcare system into the global healthcare system overseen by the WHO.

How will our healthcare system change when 30 million new people will be covered and will need healthcare? The system in British Columbia, Canada provides an example of what we can expect. They have adopted a healthcare system that has clinical treatment guidelines set forth by a protocols advisory committee. Our healthcare reform system also sets up an advisory panel that will use evidence based medicine.

These advisory panels set up treatment flow sheets that will make it easy for healthcare providers such as physician assistants to provide care. Now I understand how Governor Rendell can make the statement that he did a couple of weeks ago that health care providers are “just as good as primary care physicians”. Although we have a shortage of physicians, the statement is clearly based in the premise that anyone can use algorithms to cookbook medical care. All you need to do is connect the dots.

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The controversy surrounding the accusations and resignation of Rep. Eric Massa (D-NY) is a bit bizarre.  When he lashed out at the administration, and particularly chief of staff Rahm Emanuel, it was viewed as a peek beneath the veil of Washington inside baseball.

It’s a veil few have the stomach to look beneath.  Regardless, Massa’s comments were seized upon as proof of what has been said all along about the administrations tactics to do anything necessary to pass ObamaCare.

Is Massa telling the truth?  I don’t know.  It seems plausible.  It certainly seems to fit the matrix of what the administration has done in the past to twist arms and pressure members of Congress to pass its bill.

But I do know Massa took heat last summer when his meeting with a group of liberal bloggers was recorded and put on YouTube.

Massa: So what happens at my town hall meetings, frankly, is important, because I’m in one of the most right-wing, Republican districts in the country.  And I’m not asking you guys to go back to wherever and send people to me, this is a generic statement about ‘what can I do?’ Well, that’s one thing we can do.

Blogger: So if we got your meetings to 60/40 and there was single payer in a bill, you’d vote for it?

Massa: Oh absolutely, I’d vote for single payer.

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Good evening, and thank you for joining me.  Many of you in this room are my friends.  Some of you are members of “Organizing For America,” formerly called “Obama For America,” and before that “Operation PUSH.”

Many of you know me.  You have cheered for me.  I miss those days.  I just want to say to each of you, simply and directly, that I am deeply sorry for my irresponsible and selfish behavior.

I was unfaithful.  I consorted with Republicans.  I engaged in bipartisanship.  What I did is not acceptable, and I am the only person to blame.

As you know, I am trying to get a health care reform bill through Congress.  In so doing, I made a reach-around across the aisle.  I avoided talk of a single-payer system.  I watered down and then removed the public option.  I took out the death panels, benefits to undocumented immigrants, and federal funding for abortion that our critics so callously and falsely observed were in the bill.

I know I have bitterly disappointed all of you.  I have made you question who I am and how I could have done the things I did.  I am embarrassed that I have put you in this position.

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I find it a little ironic that liberals continue to ruthlessly attack Joe Lieberman for killing the public option (and it’s evil twin, the Medicare buy-in) given the central role that liberals themselves played in precipitating it’s demise. Including some of the very same individuals now vilifying him.

While Lieberman has been hammered by the left for many of the supporting reasons he has given for opposing the public option, the centerpiece of his argument has always been that the public option was a policy instrument designed by liberals to move the country towards a single payer system. Here is Lieberman speaking on Face the Nation back on Nov. 1 when this controversy initially erupted:

The public option I think was raised in the last year by people who really want to have a government-controlled health insurance system. That’s their right. I think they’re wrong.

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First, a brief congratulations to all on having seemingly killed the public option. Without our efforts, it would be en route to becoming law. Now there will not be a government owned, government run and government subsidized insurance company that will put all others out of business.

But the current proposal Reid is loudly trumpeting is horribly flawed as well.

It has all of the old flaws (minus the public option) in that the government, through the Secretary of Health, will decide who gets what treatment at what cost and will force rationing through an artificial scarcity on all people, particularly the elderly. And it still has such high premiums for young uninsured people that it will compete with student loans for the honor of being their number one headache.

But the compromise itself is flawed:

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In part I of this article, I provided a little background on the history of the public option, including how John Edwards was actually the first to propose it during the Democratic primary campaign. I also demonstrated how the media has largely ignored the glaring inconsistencies between Edwards’ characterization of the public option during the campaign, and how Obama has promoted it to the public this year. Edwards quite openly acknowledged that a public option could result in the entire health system gravitating towards a government-run, single payer system. Obama, on the other hand, has flatly denied this is the case saying it’s all about “choice and competition”.

I also singled out Julie Rovner from NPR as an example of a media health policy expert who has failed to fully (and fairly) report on the public option. Including the fact that many of its original (and current) proponents believe it could ultimately lead to a single payer system. Instead, Rovner has been a consistent voice of support for the Administration’s assertion that this is only a “myth”. I asked Rovner to comment on this prior to publishing part I. Here is the relevant excerpt from her response (emphasis mine):

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Most casual followers of politics did not pick up on the debate over healthcare reform until some time this past summer. They mostly ignored the umpteen news conferences held by the President since the spring, but they couldn’t miss the broader media coverage of town hall outrage. But for a small number of media experts on health policy, and an only slightly larger number of interested followers, the healthcare debate actually began much earlier. In fact, even prior to this year, when the initial policy formulation and political posturing took place during the Democratic primary campaign.

All three leading Democratic candidates for President – Obama, Clinton, and yes, John Edwards – proposed virtually identical plans for healthcare reform. The only real substantive difference being that the Clinton and Edwards plans included an individual mandate for insurance, whereas Obama’s plan did not. (Obama has since come around to supporting this mandate.) But importantly, all the Democratic plans included the creation of a government-run insurance plan to compete with private insurers. What is now called, the “public option”.

Although he was destined to be a marginal candidate, Edwards played an important role in the healthcare debate. He was the first candidate to announce the details of his plan, and really put down a marker for liberal ambition on this issue leading into the election. Especially with the inclusion of the public option. And ultimately the other candidates largely followed his blueprint, even if they failed to credit him for his leadership on this issue.

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