What’s Wrong With Paper?

Aug. 1, 2009

Recently, in an address to the AMA, President Obama commented on paper being a singular culprit in the rising cost of healthcare, to which I ask, how? How is paper even partly responsible? Other industries use paper; it’s considered a bottom-line cost of doing business. Every office in America has paper on its desks, in boxes and pinned to walls.

Recently, in an address to the AMA, President Obama commented on paper being a singular culprit in the rising cost of healthcare, to which I ask, how? How is paper even partly responsible? Other industries use paper; it’s considered a bottom-line cost of doing business. Every office in America has paper on its desks, in boxes and pinned to walls.

Paper is not a culprit; it’s a tool that cannot be easily replaced by e-mail, Outlook or electronic displays. I’ve tried for the paperless office; ultimately, though, jotting a note with pencil on paper is usually the fastest, easiest solution to my immediate need. If instead, I use electricity to power my computer and display, how am I reducing the cost of anything? I’m just transferring it, which would be the same in healthcare. The cost is simply transferred to the use and maintenance of the electronics. The brain trusts in government must realize this.

The president is practicing the age-old illusionist’s art of misdirection. The rising cost of Medicare and Medicaid is the actual culprit. This system, which rewards providers for ordering more tests, drugs and procedures, but not for preventing disease or proactively taking an active role in the healthcare of their patients, has been growing exponentially since its inception.

For years, advisory economists to our presidents warned of Medicare’s coming insolvency, as has the Congressional Budget Office (CBO). Medicare’s demise would leave most elderly, America’s fastest-growing population, without healthcare, and Medicaid’s end would mean the poorest of our citizens would go without coverage. This is not an option, so what are we to do?

I suspect that focusing on incidentals such as paper is intended to distract us from the real question:
 How are we going to pay for all this reform?

The most expedient solution is for the government to absorb the private health insurance industry and all the funds paid into it in the form of premiums, transforming such payments into taxes. Such an influx of capital would extend Medicare’s solvency by half a century, although the thousands of workers and stakeholders in private health insurance companies might not like their industry being snuffed out by the government.

Focusing on incidentals such as paper is intended to distract us from the real question: How are we going to pay for all this reform? In a recent Washington Times, article, Democratic Sen. Charles Rangel, chairman of the House Ways and Means Committee, is quoted as saying that he would “walk away” from any bill that reaches a cost of $3.5 trillion, as the Republican analysis of the latest incarnation of the reform bill is projecting the cost will be. What happened to the CBO’s $1 trillion cost estimate? I thought Congress was attempting to reduce the final bill for reform. Why is it growing instead? By comparison, the idea of a mere $1 trillion price tag now brings relief, even though no one had any idea how we would pay that amount either.

Other questions not being asked: What is truly in need of reform – the entire healthcare industry or simply government’s role in it? Is health IT truly the cure? For if Medicare is the problem, how will extorting my local physicians to implement EHRs fix it? I look forward in the coming months to following our government’s attempt to resolve these issues, and to digging deeply into the technology available that might actually work, such as open source.

By resorting to a club, rather than a scalpel, the government does not have to own up to the fact that it is over-regulating healthcare, and a flawed government welfare program that has grown so exponentially beyond its intended purpose as to no longer even remotely resemble the original program, which is indeed the actual culprit and cause of this crisis. Unfortunately for us all, Congress’ solution to the problem of excessive spending is, of course, to spend even more and regulate
even more.

Incidentally, at last count, the healthcare reform bill is topping out at about 1,000 pages. Assuming all members of Congress will need a review copy, that is more than half a million pages for one bill to be read by just 535 people. Now that is a lot of paper usage. Maybe the rising cost of government is what we should be worried about.

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