The next four years should be good for nothing. For some people, as Martha Stewart might say, nothing is a very good thing. A lot of high-powered Washington lobbyists, including some in the healthcare realm, keep themselves in Gucci and BMWs by keeping the government where they want it. They ensure that the delicate balance of government money and benign neglect is maintained. The last thing they want is the feds altering their economic picture.
Lobbyists are fond of the old saying that no man and his property are safe while the legislature is in session. In this dreary and uncertain November, the chances of such danger seem remote. With slim majorities or none at all in Congress, lawmakers will find it difficult to pass anything besides congratulatory resolutions. With a new president lacking a clear public mandate and weakened by post-election wrangling, the most exciting activity at the White House may be the annual Easter egg hunt.
There could be some commotion if tax cuts or an economic slump turn congressional eyes toward the Medicare budget to achieve savings. And there will be the usual regulatory queasiness and bickering. More tinkering with prospective payment systems. More fraud warnings from HHS' inspector general's office or the U.S. Justice Department.
But you can be sure there will be no Rube Goldberg-style healthcare reform plans from the Ira Magaziner Wonk Works. In fact, don't look for any comprehensive plans at all, however sane or logical. Even incremental ideas will have a tough time breathing in this atmosphere. If recent history is a guide, partisan rhetoric will rule and bipartisan compromise will qualify as an endangered species.
Although the risk of governmental mischief will be minimized, this laissez-faire approach will inflict its own pain. While Washington twiddles, the problems ailing healthcare fester. Drug costs continue to rise, harming hospitals and senior citizens. Patients continue to die (at whatever rate you choose to believe) because of medical errors. Managed care rankles patients and providers. Privacy is threatened. Millions lack health coverage. Businesses strain under the burden of providing increasingly expensive health insurance.
But in Washington, we will have a continuously running sequel to "Seinfeld": unlikable, selfish people doing nothing.
Only it won't be as funny as the original.