Random thoughts while wondering if the healthcare industry will take the lead on true cost-saving structural reform or, as usual, wait for someone else (a reluctant Congress)…

At midnight on Monday we either filed our taxes or filed an extension.  This epic annual event prompted a Financial Times columnist to observe that "the 1040 form is to financial planning what waterboarding is to asking a few questions."

The new political catch phrase in the non-stop rhetoric regarding our horrendous debt crisis is "have an adult conversation."  The new game in Washington, apparently, is to see which political party can out "adult" the other in their various public statements on this subject.

Meanwhile, Donald Trump is emerging as a "Tea Party" favorite for President. Conservative columnist David Brooks of the New York Time reported on Tuesday morning that in one poll "he is in (remote) striking distance in a head-to-head with President Obama."   Given some of Mr. Trump's statements of the past, that is a startling development.  Roger Simon of Politico reports today in the Daily Digest that Mr. Trump "… in 2006, when he was 59, (said) that his daughter, then 24, 'does have a very nice figure. I’ve said if Ivanka weren’t my daughter, perhaps I’d be dating her'.” Nice. Very adult.

Comedian Chris Rock was quoted by the Financial Times last week as saying that he would not vote for Mr. Trump.  "He will probably just find a better looking country and leave us."
If Mr. Trump wants to raise questions about the President's citizenship and birthplace, then I think it is only fair that he certify that the blonde "thing" perched atop his head is really hair, not a pet or the property one one of his ex-wives. (Former Speaker Newt Gingrich is, by comparison, looking more mainstream in the GOP family values department.)  

Back to his column, Mr. Brooks points out that in 2009 Mr. Trump published yet another inspirational book, Think Like A Champion, in which he praised President Obama's "amazing" and "phenomenal" accomplishments.  "Barack Obama proved that determination combined with opportunity and intelligence can make things happen  – and in an exceptional way," Mr. Trump wrote.  Apparently semi-candidate Trump now is comfortable in saying that President Obama is "the worst President in American history," Mr. Brooks writes.
Mitt Romney, who is "exploring" whether he should do what everyone believes he is already doing — run for the GOP presidential nomination — continues to excoriate the Patient Protection and Affordable Care Act (PPACA) which is also remarkable since PPACA strongly resembles the plan he championed and signed into law while Governor of Massachusetts. 

Meanwhile, back at the budget debate, President Obama is firing away at the GOP budget plan that passed the House last week, suggesting that it was somehow unAmerican. I am not sure how the President will describe the terms of austerity that most assuredly will be imposed by the bond market in the event Democrats and Republicans cannot come to an agreement to extend the deficit limit. When one of your biggest bankers is China, the term unAmerican does have a certain ring to it…

There is good news.  The U.S. debt is only growing at the rate of $4.09 billion per day. This is down from $4.15 billion day from a couple of months ago, no doubt the result of all the adult conversations and austerity the Republican-controlled House is imposing.
Healthcare executives and physicians — the adults who actually run health systems, hospitals, multi-secialty clinics and other health service providers — are wondering how they will cope with significantly less money in year 10 of the GOP budget proposal.  That is when the voucher system will kick in with Americans paying the difference between what Medicare pays and the hospital charges.  It is only natural that they hope this crisis — and the need to reduce Medicare spending — will go away.  It won't.
The nice thing about "adult" conversations in the political arena:  when they are not filled with invective that can be absolutely ironic.

© 2011 John Gregory Self

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