The Right Prescription

Remember Richard Foster?

Can we repeal to our better natures?

By 5.4.10

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He's the CMS official whose report on Part D costs were "suppressed" during the debate over the Medicare Modernization Act. That was in 2003 -- when he was a whistle-blowing darling of Congressional Democrats. That was then. This is now. Today Mr. Foster asserts that the new health care law says it will not slow the overall growth of health spending because the expansion of insurance and services to 34 million people will offset costs in Medicare and other programs

According to Mr. Foster, "Overall national health expenditures under the health reform act would increase by a total of $311 billion," or by -- as the New York Times' Robert Pear put it -- "nine-tenths of 1 percent, compared with the amounts that would otherwise be spent from 2010 to 2019."

In his report to Congress, Mr. Foster states that some provisions of the law, including cutbacks in Medicare payments to health care providers and a tax on high-cost employer-sponsored coverage, would slow the growth of health costs. But he said the savings "would be more than offset through 2019 by the higher health expenditures resulting from the coverage expansions."

The counter-argument? Nancy-Ann DeParle (director of the White House Office of Health Reform) said that fear was "unfounded."

The White House is going to have to do better -- a lot better -- because such wave-of-the-hand answers will certainly add fuel to the fire of those calling for repeal.

But rather than repeal we should be talking "appeal" -- like in appealing to the better angels of our nature. In other words -- being for something. And that something is called "the truth."

Let's start a movement -- and let's call it "Appealism." Here's how it works: Rather than calling for "repeal" (which is a negative thing), let's be for "appeal." That means appealing to common sense and un-fuzzy math. It means calling a spade a spade and (most importantly) being honest.

I know -- how naïve. But…

Even if the GOP realizes its most optimistic November projections, the likelihood for legislative repeal is still, well, a highly optimistic projection. And, even if all the stars and planets align in an elephant-friendly fashion, there's no scenario that provides for a two-thirds majority override of a 100% predictable Presidential veto.

Hence, the need for "appeal." The Foster analysis is a good place to start because the finish line isn't repeal; it's controlling the rule-making process. And that's where "appeal" comes in.

Appealing to reality. Appealing to facts and figures rather than rhetoric and double-sided political coin of bribes and threats.

Appealism. Yes we can.

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About the Author

Peter Pitts is partner/director of global health at Porter Novelli, a senior fellow at the Center for Medicine in the Public Interest, and a former FDA associate commissioner.