The Kaiser and Mr. Begich

Sen. Mark Begich has often cited the Kaiser Family Foundation (KFF) as his preferred resource on the subject of health care reform.  On more than one occasion, and multiple times during the September town hall session, the young senator suggested a visit to KFF to those individuals who might question his judgment, or for anyone who might want to become better informed.  Nearly every time the young senator mentioned the foundation he also pointed out that a link to it is available at his web site


Surprisingly, despite the rhetoric touting KFF as a vital source of information, the web link to it is not as strategically positioned at the Begich web site as it is strategically positioned in his personal presentations.      


The young senator’s oft-mentioned KFF provides needed credibility to his position.  Concurrently he also uses the foundation’s esteem to marginalize suggestions that he might limit reforms to specific problems and develop targeted interventions designed to remedy them.  Thus, KFF is not a just a resource for the young senator, it is a tool on which the he leans to demonstrate that he is “committed to ensuring quality, affordable health care for all Alaskans” and that he “…will not allow opponents of reform and the special interests who back them to delay the health reform we all deserve.  “Quality, Affordable Healthcare For All Alaskans”         


KFF supports a total overhaul of the system, and so do the young senator and his party.


Proof of this accusation is in a 10/23/09 publication in “Pulling It Together” from KFF President Drew Altman titled “The ‘Third School’ For Controlling Health Care Costs” In that article Altman writes, “The President (Obama) also gave Systems Reformers a huge boost by embracing these themes until switching the emphasis more recently to ‘health insurance reform’ when it became clear that Systems Reformers resonated better with insiders and policy wonks than with the public.”  (Bolded are author’s emphasis)


Altman’s article described Systems Reform in a reference to an article published 1/26/09 in The New Yorker, “Getting There from Here” by Atul Gawande:


In a feat never before seen in our field, Atul Gawande’s wonderful New Yorker piece traveled through the White House and across Capitol Hill in about two days, not so much because the research he was describing was new (Wennberg had reported similar findings many times for thirty years) or because his analysis was so brilliantly written (which it was).  The timing was right for a new strategy to bend the curve through delivery, information and payment changes that did not divide policymakers and stakeholders along the familiar ideological lines. The article also rippled through the medical profession with similar speed. For many practitioners this was health reform they could relate to; getting under the hood of medical practice and health care institutions and changing practice as well as pursuing quality improvement and cost containment in tandem.  News media attention to the New Yorker piece and policymaker interest in it brought attention to Systems Reformers’ ideas to new levels.


The Altman letter leaves little doubt as to why President Obama switched emphasis from Systems Reform to Health Insurance Reform.  It also explains that there is even less doubt regarding the Kaiser Foundation President and Chief Executive Officer’s position on health insurance reform, and presumably the foundation itself. 


Hence, as a result of the young senator’s strong self-affiliation with KFF, there is no doubt where the young senator from Alaska stands on health insurance reform.  The young senator is not a marketeer, nor is he a regulator.  He is a Systems Reformer and, since that position does not resonate well with the public, the young senator obfuscates and deflects his intentions using KFF as a smoke screen.  Moreover, the young senator’s behavior demonstrates conclusively that he is not as interested in solving health care problems as he is interested in molding a far-reaching and burdensome nationalization of the entire health care delivery system.  Instead of fixing the failing entitlements promised by liberals past, the young senator and his party are intent on creating an all new and improved entitlement that they can only hope will finally fulfill their ambitions for a utopia. 


Furthermore, at the Kaiser web site’s President’s Message page in an article titled “The Kaiser Family Foundation’s Role in Today’s Health Care System,” published 6/09, there is a telling but subtle phrase innocuously positioned in the body of the article that provides significant insight into the philosophical and political position of the organization.  According to President Altman, “the recorded intent of the donor (Henry J. Kaiser), somewhat like the U.S. Constitution, is living language that must be interpreted by successive generations of foundation executives and trustees in light of changing circumstances and opportunities.”  A living and breathing will or trust is fine for a philanthropic organization, but it is a substantial point of divergence between liberals and conservatives when it is applied to the Founding Documents.  (Bolded are author’s emphasis)        


President Altman described the foundation’s view of itself as a legitimate public resource, writing “We have a clear sense of our three audiences: policymakers, the media, and the general public.  We work to put the fruits of health services and health policy research into formats that these three audiences can readily digest.”


Easy to digest perhaps if the reader is a university professor, a jurist doctorate or a high school educated U.S. senator.  To this average Alaskan however, an extended visit to the Kaiser Family Fund’s web site was cause for indigestion complicated by vertigo. 


Although this article documents some specific philosophical and political implications found at the KFF web site, reading the site was an exercise in futility in an attempt to evaluate the myriad proposals and bills to reform health care insurance.  Moreover, using the side-by-side comparison tool was a journey to nowhere, with one major exception.


Of particular interest in a side-by-side comparison of the four primary plans now before congress, three of them begin with the word “REQUIRE,” as in require individuals or require most U.S citizens.  Paraphrasing a great president from the old Democratic Party, it appears as though the American people will soon decide if we question not what the federal government requires of you, but question what you require of your federal government.


It is unfortunate that those people who seek radical changes in health care delivery are less than candid in the process that they have engaged to implement the changes.  This lack of candor raises the suspicions of the average citizen and further enables the antagonists.  Statements and decisions attributed to the highest office in the land suggesting the use of focus groups to determine the terminology (System Reform or Health Insurance Reform) best suited to sell an important policy is extremely unhelpful.         


On the other hand, honest and forthright presentations of a politician’s goals, if they are noble to begin with, would be a helpful choice.  Otherwise, assertions such as “If radical System Reformers succeed in nationalizing health care, then say good bye to liberty as it is currently known” can flourish in the suspicious environment produced by the lack of candor and perceived ignobility. 


Moreover, while most System Reformer antagonists claim that people will become fearful to speak out against a government that has the power to grant or withhold health care services, not much has been mentioned of the propensity for countless many Americans who will avoid accessing care for fear of being labeled an abuser of the system or, worse yet, a malingerer or a mental case.  Labels such as these can easily be generated by undesirable government officials.    


Imagine then, Mrs. Jones, who just received a letter from the Office of the Secretary, National Health Services, informing her that any future visits to the clinic will have to be pre-approved by the Secretary. 


Now imagine what behavioral changes that letter, and many others like it, will have on all of Mrs. Jones’ friends and neighbors.  Big brother doesn’t have to watch everyone now, does he? 


Ultimately, everyone will question what they demand of their government.
























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