Politicians and bureaucrats have become masters at stonewalling and grandstanding on important healthcare issues. A recent string of missteps, misfirings and misadventures sets new standards in confusion.
Most upsetting is HCFA's pathetic inability to cope with its year 2000 computer problems. So daunting is the challenge that the agency plans to delay Medicare reimbursement updates for hospitals and physicians, as well as the long-awaited prospective payment systems for home health and hospital outpatient care.
HCFA, lest we forget, operates with a fiscal 1998 budget of more than $314 million and a staff of 4,000. It's baffling why such a behemoth bureaucracy is unable to cope with computer snags that were years in the making.
Also puzzling is the recent pronouncement from HCFA Administrator Nancy-Ann Min DeParle that state Medicaid programs must pay for Viagra. Perhaps one day those crackerjack HCFA computers can estimate how many erections the government owes its welfare recipients.
At the risk of piling on the beleaguered DeParle, let's remember that Congress dumped more than 300 provisions on HCFA through the Balanced Budget Act of 1997 without granting the agency ample resources to implement them.
Speaking of Congress, the ambitious new Republican healthcare plan seems better suited for the campaign stump than as a realistic piece of legislation. Think of it as a GOP counter against the Democrats, who traditionally take the offensive on healthcare reform. But there is regulatory and economic danger anytime politicians play doctor.
In the end, it's doubtful that Republican lawmakers will support the kind of sweeping change publicly advocated by the GOP leadership. However, talking about it with voters may help them keep their jobs.