Monday, July 9, 2012

What Bosons Can't Teach Us About Health Care Reform

Partly because it's a brain tonic for jet lag, the Disease Management Care Blog is trying to come to grips with the "Higgs Boson."

As it understands it, these invisible motes permeate our universe and interact with strangely named subatomic particles in ways that confer mass. The identification of the "boson" apparently explains a lot, like how electrons are so light (little interaction) and why toilet seats are so difficult to raise (much interaction).

Which provides an apt metaphor for Washington's bosonic permeation of the health care universe.  CMS rates set payment benchmarks, its device approvals determine coverage, IPAB says when a treatment is evidence-based and insurers have little say on the definition of administrative costs. In the meantime, the Federal Register fills space with the microwave radiation of rule-making and now the Supreme Court has set off a Big Bang.

Unfortunately, the DMCB isn't making much progress on the theoretical physics of bosons, photons,leptons, quarks and gluons or, for that matter, on the legal Big Bang physics of mandates, taxes, assessments, collections fines or penalties. If the DMCB is reading Justice Roberts correctly, a low-amount "exaction" that is configured as a "shared responsibility payment" for behavior that is not "unlawful is "within" Congress' taxing authority.  Right.

No wonder the Romney campaign is so confused. Without the genius of Peter Higgs or the opaque jurisprudence of John Roberts, they're as probably perplexed as us normal folks. Better to move on to topics better suited for the rhetoric of the fall campaign, like whether it's all really Bush's fault or truly Bush's fault.

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