Foreseeable yet unforeseen

Commentary January 26, 2011 at 07:00 PM
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Mike Mansfield had a long and distinguished career in politics and public service. As the longest-serving majority leader of the U.S. Senate, he knew a thing or two about crises. He once opined, "The crisis you have to worry about most is the one you don't see coming." A lot has changed since Mansfield retired from the Senate in 1976 — especially since it now seems that the crises we have to worry about are the ones most of us saw coming.

In the 2,000-page bill that turned health insurance companies into public utilities, there was little or nothing done to address the increased demand for medical services that is an inevitable consequence of an aging population. According to a 2010 report from the Association of American Medical Colleges, that increased demand will require an additional 130,000 doctors (both general practice and specialists) over the next 15 years.

Another completely foreseeable consequence of the new health care law is the unprecedented wave of health care mergers — exactly the opposite of what Congress said they wanted. We all recall the oft-cited example of states that had only one or two carriers and the hue and cry over the lack of choice and cost-checking that situation wreaked on an already overburdened populace.

The carrier situation is getting worse, not better, and we are beginning to see the same situation in the hospital community. Johns Hopkins Medicine is on a Pacman-like binge, swallowing hospitals in the Washington, D.C., area. They say this buying spree is driven largely by health care reform, which demands an integrated regional network.

Those on the Hill suffering from a terminal case of blind ideology either didn't see — or didn't want to see — these coming. Worse, these foreseeable "unforeseen crises" are not likely to diminish in number anytime soon. At this point, I'm with Henry Kissinger, who said, "Next week there can't be any crisis — my schedule is already full."

Check out more blog entries from David Saltzman.

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