Ka-Ching Factor In Health-Care Reform

The highest of the many hurdles that the Obama administration will have to clear on the road to health-care reform is what I will call the Ka-Ching Factor.

That factor was summed up brilliantly, albeit unintentionally, by the director of personnel at a Level One trauma center in a major metropolitan area who after several glasses of wine at a get-together the DF&C attended over the weekend opined whenever she heard a medevac flight approaching the helicopter pad outside her hospital the beat of the rotors represented the ka-ching sound of a big cash register.

Never mind that this personnel director was unaware that the DF&C is a career critical-care nurse with more certifications than you can shake a rectal thermometer at, and also bragged about how she keeps costs down by treating nurses -- who are the key players in hers or any other hospital -- like slaves on a plantation. That is an aspect of the health-care crisis that I will save for another rant on another day.

But as the president again took up the issue of overhauling the health-care system yesterday in a White House meeting with the people most responsible for the meltdown -- doctors and representatives from hospitals, drug makers and insurance companies (but not nurses) -- with the goal of pushing through reform legislation this year, the Ka-Ching Factor was the elephant in the room.

That was so obvious that in the run-up to the meeting the health-care industry pledged to try to cut $2 trillion in expenses over the next decade to slow the rising cost of care.

To which I have a simple one-word response. Bull shit.

Okay, two words. By any measure, $2 trillion is a lot of simoleons, and it is not difficult to see the pledge for exactly what it is: The industry knows that with Obama in the Oval Office it is no longer business as usual, hence their willingness to be a part of the political coup that brought them together. They also know that aligning themselves with the Party of No is a no-win game.

There is enormous merit in cutting costs, as this consortium proposes to do, by stressing preventive care and doing stuff like curtailing unnecessary tests and procedures, among other things.

But post-preventive care and unnecessary tests and procedures (in other words, waste) are the industry's profit centers, and any effort to cut deeply into profits has to be greeted with considerable skepticism if not outright disbelief.