What NBC Didn't You Tell About Health-Care Reform; J. Orient

RWJF has played a crucial role enabling the passage of health-care reform legislation in various states. Key members of the Pres ident's Task Force on Health Care Reform also were funded by RWJF. (The secret war-room operation of the Task Force is being challenged in federal court as a gov ernment violation of the Sunshine laws, in the case of Association ofAmerican Physi cians and Surgeons, et at., versus Hillary Rodham Clinton, et at.) The sponsor's role in the televised "town hall" was simply to provide money for education. NBC was responsible for the content of the program-except for choos ing the general subject matter. RWJF did not fund a program on rising illiteracy, declining morals, welfare-state failures, government corruption, or other pressing issues. Just coincidentally, the sub ject involves a mammoth piece of legislation Dr. Orient practices private medicine in Tucson.

She is also Executive Director ofthe Association of American Physicians and Surgeons. that the Administration is desperate to pass-urgently, quickly, before potential patients find out what it willdo to them. The star of the show was the foremost proponent of that legislation: Hillary Rodham Clinton. The vigorously stage-managed presenta tion had some huge blind spots. The most important one was what health-care reform would do to the patients who told their sad stories to a national audience. Naturally, the audience would assume that health-care reform is supposed to help people who have lost their insurance and come down with cancer. Not so. The reformers stated their agenda, but you might not have understood: our current system has a sickness orientation. They want to change it to a health-care or well ness orientation. What does this mean to a person who cannot benefit from a school-based clinic, a blood-pressure check, or a substance abuse program? What about that uninsured, wheelchair-bound man who was too ill to come into the auditorium?

A spokeswoman for the model Oregon rationing program, a featured panelist, could have told the audience what was in store for that man under her program. But she didn't. And people like me, who pro vided "balance" by sitting in our assigned seats in the audience, were not allowed to ask her. 598 WHAT NBC DIDN'T TELL YOU ABOUT HEALTH-CARE REFORM 599 On the Oregon Prioritized List of Physical Health Services, "cancer with distant metas tases" (the man had lung cancer that had spread to his brain)is number672out ofabout 700. The man in the wheelchair was bald due to the chemotherapy he had received, albeit with a few weeks' delay. According to the narrator, he had accumulated some $30,000 in medical bills, which probably will never be paid. (That's about one percent of the cost of the televisionprogram. But don't bother to apply to the RWJF for a grant. As a matter of policy, they do not help individuals.) Under the Oregon plan, the man might have been in a coffin, but at least he would stillhave hair. His wifewouldn't have medical billsto worry about-although she mighthave less money because of being forced to pay premiums for the "health" plan.

The $30,000that might have paid for this patient's care would be allocated to things with a higher social priority: for example, sterilization operations (number 88-89); preventive services (141 and 174);abortions (279);and the bureaucratic infrastructure to enforce the priorities. For its cynical (or unthinking) exploita tion of human tragedy, NBC's educational effort merits an "F." There were also other failings. The spec trum of views was by no means complete. The featured dissenters were zealous and disruptive advocates of a government take over of insurance and medicine (the" single payer" system). On the other side, small business execu tives spoke eloquently about the harmful effects of employer mandates. Unfortu nately, some viewers might conclude that hardened businessmen were the only obsta cle standing between health care and the poor. It is hard to find someone with the insight to say, "I lost my job because the government ruined my employer's busi ness, and now I'm on welfare."

Senators Dole and Mitchell provided an appearance of bipartisan balance by sitting together on the stage and saying very little. Senator Mitchell spoke glowingly of the success of Medicare, despite its monstrous costs and NBC's technically brilliant exhi bition of its paperwork forest. Absent from the discussion (save for the briefest mention of Medical Savings Ac counts) was any proposal to replace the current system of prepaid consumption with economically sound insurance. No one spoke of the proven benefits of putting decisions-and money-back in the hands of patients, wresting it away from the new elite managerial class that has caused much of our current problem. There is one way to defeat this idea, which can reduce costs while preserving freedom: keep it a secret. After viewing the NBC program, on lo cation and on television, I would revise my question: How much propaganda value can $2.5 million in tax-exempt educational funding buy? [] Ideas and Consequences Of Meat and Myth A dvocates of the spontaneous order of freedom and free markets are forever stomping out the fires of fallacious reason ing, anti-capitalist bias, and twisted history.