Health care reform should be taken off the table COMMENTARY William A. Levinson

“IF YOU’RE not at the table, you’re on the menu” underscores the case against federal health care reform.

It embodies what Dr. Stephen Covey’s “Principle-Centered Leadership” calls the scarcity mentality: a bankrupt paradigm that assumes there are only so many resources to go around, and whatever is given to one stakeholder must be taken from another. The “reforms” in question are primarily about which special interests – such as health insurance companies, pharmaceutical companies, medical device manufacturers and unions – can get a place at the table at the expense of senior citizens (as shown by proposed cuts in Medicare) and the American people as a whole. Those who cannot get a place at the table will, meanwhile, raise prices to cover their additional costs and taxes, such as taxes on medical devices.

Erich Maria Remarque’s “All Quiet on the Western Front” summarizes in one sentence why we must put the kibosh on the entire initiative. In this story, a military surgeon thinks he has found a way to cure flat feet, and he offers to perform his new and wonderful operation on hospitalized soldiers. A man warns the protagonist: “He operates on you for flat feet, and there’s no mistake, you don’t have them any more; you have club feet instead and have to walk all the rest of your life on sticks.” This is what House Bill 3200 and the Baucus bill will do to our health care system.

If either bill makes it through Congress, it should be challenged all the way to the Supreme Court. A good attorney might even find a way to demonstrate that the individual insurance mandate is effectively an illegal poll tax or fee on the right of American citizens to live in the United States. The analogy to auto insurance is dishonest because driving is a privilege as opposed to a right, and auto insurance is mandatory only for harm you might cause to others. You do not have to insure your own vehicle unless a bank owns part of it.

If you do insure your vehicle, you get a much lower premium if you accept a high deductible for comprehensive and collision insurance. The same goes for health insurance plans; our deductible is $10,000, but our current policy costs less than $1,700 a year (male, early 50s). HB 3200 and Baucus will make high-deductible policies illegal, and thus make insurance less, as opposed to more, affordable.

Our health care system has numerous deficiencies, including inefficiencies and costs of poor quality that range from 30 to 60 percent. I have corresponded with nurses who spend more than 30 percent of their time walking. A nurse who must walk 2.5 hours per day can be paid only for the 5.5 hours he or she spends with patients, even though this pay is spread over eight hours. None of the federal legislation even begins to address these root causes of our high medical costs, whose correction could save in a single year what the legislation proposes to spend over a decade.

Unlike Congress, however, many Pennsylvania legislators think in win-win terms: Dr. Covey’s abundance mentality that says a pie can be made bigger so everyone can have a bigger slice.

House Bill 246 underscores this kind of thinking. It would encourage health care providers to implement quality management systems such as or similar to the ISO 9001:2008 quality system standard. This would reduce the cost of health care enormously while eliminating up to 80 percent of what is commonly known as malpractice, because this is the approximate fraction that results from deficiencies in the complex systems in which doctors and nurses must work.

Flat feet are far from desirable, but you can still walk on them. This is something to keep in mind before we welcome the current “cures” that Congress has on the table.

William A. Levinson, a Wilkes-Barre resident, is the owner of Levinson Productivity Systems.

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