2009 Health Reform Belongs To The Insiders

As a past wannabe Kremlinologist, the Disease Management Care Blog remembers how the CIA was repeatedly stymied in its attempts to penetrate the upper echelons of the Soviet Union's nomenklatura. As a result, America's intelligence analysts were reduced to scrutinizing pictures of the Rodina's super-elite as they gazed upon Moscow's May Day parades from their perches high above their common people. U.S. foreign policy depended in part on who was standing next to who and for how long with what smiles or frowns or body language.

And such is the state of an outsider trying to figure out what's going on with health reform in Washington D.C.. For example, news reports noted that President Obama paid a rare Sunday visit with the Senate's Democrats on their pending legislation. The Disease Management Care Blog puzzled whether this unusual weekend visit was a pre-victory pep-talk or the mark of an impending Waterloo? Was his failure to mention the public option an inadvertent oversight or the telltale treadmarks from being thrown under the bus? Exactly what compromises aren't being discussed and how long have they been off the table? Sorry, said the President's handlers, no questions? What did independent Sen. Joe Lieberman's grin portend? Should we put our medium range missles up for negotiation?

The naive DMCB can't tell what's going on. It's come down to being very much an guesser's game, where the coin of the realm is rumor, insider contacts and experience with connecting the power dots. The media is not only about feeding the 24/7 news machine, but also influencing the outcome.

So this is transparency, participation and collaboration? The darkly suspicious DMCB doesn't think so, and thinks the similarity to the Soviet Politoburo is not a credit to our democracy. In the meantime, we will have to await the outcome of the political swordsmanship from afar. The good news is that, unlike the Soviet Union, our political elite are not entirely immune to Main Street and the November 2010 elections.