The ACP Advocate Blog

by Bob Doherty

Tuesday, November 22, 2011

“Can’t anybody here play this game?”

In a moment of justifiable exasperation, Manager Casey Stengel blurted this out to a reporter about his hapless 1962 New York Mets—the team that ended up with the worst single season record in baseball history. The same might be asked of the 112th Congress, says Michael Hirsh of The Atlantic. He wonders “whether any Congress has ever been more dysfunctional, with less cause, than this one?”

Yesterday’s spectacular failure by the “Super Committee” to produce a bipartisan deficit reduction package certainly hits new heights—or depths, if you prefer—of being dysfunctional. (As bad as it was, though, it doesn’t come close to matching Congress’s lowest points during the decade leading to the Civil War. In 1856, Senator Charles Sumner of Massachusetts barely survived a brutal caning at the hands of Rep. Preston Brooks of South Carolina. It is a small comfort that Congress today wages its fights via talk shows, blogs, and Twitter, not in hand-to-hand combat!)

But by modern standards, Hirsch is right on the mark: this Congress is the most dysfunctional of any I’ve seen in my 32-plus years of advocacy in Washington. It is singularly incapable of finding the compromises needed to move essential legislation forward.

(Incidentally, comparing the 112th Congress to the '62 Mets isn’t fair—to the Mets. By playing poorly, the Mets disappointed millions of fans—yours truly included—who gave them our misguided support, but no one really got hurt. And for all of their 120 losses, the Mets at least were entertaining to watch because of the unsurpassed level of incompetence. Marvelous Marv Throneberry, the Met’s first baseman, made fans both laugh and cry because of his stupendously dumb base-running mistakes and poor fielding.)

But I am not entertained by the antics of Congress, because the stakes are so much higher.

It is no laughing matter that Congress’ failure to reach an agreement on the deficit puts the health of millions of seniors, military families, and disabled patients in great peril, as ACP pointed out in a blistering statement released yesterday on the wreckage left after the failure of the “Super Committee” process.

Because the Super Committee process failed, doctors face a scheduled Medicare payment cut of more than 27 percent on January 1, 2012. Congress is likely to take up legislation soon to avert the January 1 cut, but organized medicine’s efforts to get permanent repeal bundled into the deficit reduction package itself has been dashed by the Super Committee’s failure.

Because the Super Committee process failed, another $1.2 trillion in cuts in federal spending will automatically go into effect, through a process called sequestration, starting on January 1, 2013. Kaiser Health News reports that under the automatic sequestration cuts, funding for non-defense discretionary programs will be cut by 7.8 percent next year, dropping each year to 5.5 percent in 2021—with the CDC, NIH, and prevention and wellness programs being particularly vulnerable.

Already, there is talk of Congress passing a law next year to prevent the sequestration cuts from going into effect, but President Obama has promised to veto such an effort. Obama held out the possibility of signing into law a replacement measure that restores at least some of the cuts if it offers a “balanced” package of tax increases and spending cuts.

For all of the uncertainty, several things are clear.

First, Congress must act before January 1 to prevent the 27.4 percent Medicare physician payment cut.

Second, there will be a big debate in the 2012 election year about how best to reduce the federal deficit, with the huge 2013 cuts mandated by sequestration looming in the background.

Third, there is no reason to believe that the current Congress will finally figure out how to play the game right.

More likely, they will continue to show a singular inability to put their partisan interests aside and do what is best for the American people. There’s a reason that Congress’ 9 percent approval rating is lower than Nixon’s during Watergate, or BP’s during the oil spill, or the number of people who approve of the United States going communist, or polygamy or pornography, for that matter. And this is based on polling that took place even before the public has digested the Super Committee debacle!

Today’s question: What do you think of the “Super Committee” debacle? And do you agree that this Congress is the worst in modern times?

4 Comments :

Blogger junebug388 said...

Don't always agree with you Mr Doherty , however I always learn from listening to dissenting opinion. Congress could benefit from that novel idea as well. Here you are right on. Our 5 man practice lost 1 member to the VA last year during the crisis, 1 partner to a salaried position in a clinic here in March and now the three of us are selling our practices to the hospital December 1. We are already EMR driven since 2006, are nearly free of debt and qualified for meanfulnes use, and all PQRI this year....Through the fall the handwriting in on the wall ... the current system will be destroyed before the new evolves. We and many others i am sure do not have the resource or the stomach for another several month interuption of revenue.

November 22, 2011 at 10:23 PM  
Blogger Harrison said...

I think it might be helpful to sequester Congress.
Seriously.
When they are in session sequester them. During those months or weeks they can only talk with themselves, and their families.
No dinners with lobbyists.
No meetings with constituents.
Their staff can give them messages, but the legislators can't.
They can meet with consituents whem they are out of session and not making policy.
When making policy they should have to take what they know, and their own values, and meet then with their colleagues to solve problems.
During that time they can meet periodically with the President also, because with his signature he basically has a vote on all legislation.

Maybe they would be more willing to work together.

Can't hurt.

Harrison

November 23, 2011 at 12:02 AM  
Blogger Steve Lucas said...

This is obscene in the extreme. These people have put the whole country at risk for some undefined political gain.

The ACP proposals, along with the Republican corporate tax plan of lowering rates and eliminating certain deductions, would broaden the base and generate additional revenue that taken together these two ideas almost get us to the $1.2T needed. Throw in some good Democratic ideas and we could be at $2T without breaking a sweat.

Instead we have this mess where the concept of someone being able to take credit for any idea is so politically unpalatable that the whole system has ground to a halt.

Harrison and I disagree again. He wants to lock them up. I want to throw them out. Harrison is a much nicer person than I am.

Let all the members of Congress look for a job, or try to run a business in this economy, given the rules and regulations they have put in place. They need to understand this is hurting real people, with real families. This is not a reality show but real life.

Snookie don’t live here.

Steve Lucas

November 23, 2011 at 9:51 AM  
Blogger doc777 said...

I'm not sure where to start so let's start at the top. Many Presidents have worked with very polarized congresses and still got things done. Our problem is that we essentially have no President. President Obama was no where to be found during the supercommittee discussions. At least one GOP member of the supercommittee reached out to Obama on several occasions to help work something out, but Obama never called back. We are on the brink of another recession, the Middle East is in chaos, Iran is nearing completion of a nuclear weapon, and the Euro is collapsing. But instead of Obama taking charge and providing the leadership a President should, he is out eating hot dogs at an NCAA basketball game (I guess it's too cold to play golf). If we are sticking to the sports analogies, it would be like football teams playing a whole season without their coaching staffs. First and foremost, Obama did not want a deal. Therefore, there was no deal.

Second, here were go again with the tactic of scaring our elderly patients. It's our own dang fault we are in this situation. Money was available to fix the SGR issue, but instead of using that money to fix the SGR, organized medicine supported taking those cuts to Medicare and starting up a whole new entitlement program. I cannot wait until the political adds start coming out describing how Obamacare was funded on the backs of our seniors.

Finally, I'm actually not all that upset that our congress cannot get anything done. If Obama had his way, he would be spending 100s of billions of dollars more in stimulus, despite the fact that the first stimulus failed miserably. Those looking for a Kumbaya moment need to understand that this country is at a crossroads. If we keep spending like we are, we will be Greece in 5-10 years. Our debt is increasing at unsustainable levels, and the best we can do is slow the growth by a trillion or so. Unlike Greece, we have no Germany or France to bail us out. Even China and Japan do not have strong enough economies to save us. We are creeping closer and closer to the cliff. Once we fall off, America will no longer be America.

November 28, 2011 at 6:57 AM  

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About the Author

Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog

Email Bob Doherty: TheACPAdvocateblog@acponline.org.

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