Laugh to Keep From Crying

By John Ballard

When political reporters start using phrases like "behind closed doors" it's a sure sign that the sausage grinder is humming away. For practical purposes the health care debate is over and all that is left for most of us, like expectant family members outside a surgery, is waiting. As one TV character famously said, "The avalanche has already begun; it's too late for pebbles to vote."

Before we go, take a moment to read a post by J.D. Kleinke, whom Matthew Holt (blogmaster at THCB) called "the Arianna Huffington of health care."  When he's not being the well-informed serious expert that he really is, he moonlights as a stand-up comic in exclusive private clubs.Think Don Rickles, Art Buchwald or (if you're really old) Harry Golden. Check out the mordant humor of  Health Care Reform Lite.

�The only constant in health care is change.� It�s one of those shop-worn things you hear too often on health care�s rubber-chicken circuit; and not only is it not true, but it is exactly untrue....

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Under the plan that looks most likely to pass after some classic Capitol Hill 3 a.m. horse-trading - this time between the grumpy far left and poll-sitting centrists on both sides of the aisle - health care �reform� will involve little of substance beyond (1) the long overdue jamming of 46 million people currently outside the system into that system, and (2) an equally long overdue prohibition against health insurers kicking them back out. For the middle-class taxpaying swing voter in denial of what could happen in 90 horrifically unlucky days at their job and within their bone marrow, i.e., the average voter with coverage they might not be able to afford after simultaneously being fired and getting leukemia, #2 is worth the entire effort - and the reason any politician of calculation if not conscience should vote for the plan.

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The Medicare Drug Benefit may be working no more perfectly than anything else in health care, but it is working just fine for millions of Americans who had too often been forced to choose between medicine and food, between certain death and slow starvation. Maybe that�s why so few on the right or the left have brought it up in the debate: its embodiment of political compromise and its programmatic success constitute enough actual empirical evidence to sully anyone�s ideological polemics.

Consider the Medicare Drug Benefit a perfect trial run for what we all should hope will pass into law in the next few months: health insurance market reform. It�s not true health care reform � this would apparently require an Act of God rather than an Act of Congress....