Re: Jim de Bree, “Political Mythology Postscript,” letters, Dec. 28.
Aw, Geez, Jim. Is it really a conspiracy? This is America. We have human faults and graces.
It is possible to do horse trading in our government. It is possible that the actors within the system do in fact take advantage in order to assure their constituents are served. A conservative or liberal, or Democrat or Green Party member will advocate and listen to the voices on his or her side of the argument. That same man or woman or gender-nonspecific person will accept support, even money, from supporters. That is no fault. It is humanity.
If protections against certain proprietary information about substances (FDA-speak for “drugs”) is maintained, it could very well be a strategic decision that protects the interests of constituents indirectly, by assuring that a critical U.S. industry maintains leverage worldwide. Thus, protection for pharmaceutical patents and molecules could be a sort of “intellectual property tariff” forged to protect the U.S. industry and maintain its hegemony and its vitality while under attack from lower-cost locales (e.g, China, India) where generics are manufactured. Besides, pharma stocks are part of many CalPERS and other government agency portfolios and thus these vast public employees’ skin in the game also drives the behavior, albeit indirectly. Foreseeably, California government would identify the need to assure that the assumed CalPERS 7.3% actuarial return is met or exceeded, in order to assure pension system stability and delay the burden of pensions onto taxpayers.
In that case, California itself, and Santa Clarita civic leadership, would support the initiative.
Likewise, the silver loading is likely a horsetrade that was implemented to shift the burden of revenue shortfall – due to outright cancellation of the “Cadillac tax,” rather than more delaying tactics – from the highly compensated and onto the middle. That is America.
From personal experience, you have my agreement with the assessment regarding the “surprise billing” initiative, though I am woefully uninformed about its detail. Personal experience was that bills continued for years after procedures. It is dutiful to examine and pay only those charges that one is responsible for. I contested some, and found that through either incompetence, laziness, poor incentive, resource paucity, or intentional dissociation that I was being charged in duplicate, or for service I did not receive. It really happens. I felt it was up to me to call them on it, and by policy I did not pay anything I could not rationalize or get explanation for. I “paid myself” (through cost avoidance) around $200 an hour for the effort.
The one glass of lemonade in this health care harvest of lemons is that the system is evolving. They are tweaking and refining it, improving it, as Lyndon Johnson himself tried to do and every single president since him has tried to do. Thank goodness they are finally working on it. Odds are we will get better as long as we keep trying.