Send In the Health-Care Clowns

As the public option starts to morph into an expansion of Medicare and Medicaid in the main tent, two Senate buffoons, Harry Reid and Joe Lieberman, are stepping up their side shows in the health care circus.

The Majority Leader is dragging slavery and woman's suffrage into the debate by invoking them as precedents for Republican resistance:

"When this country belatedly recognized the wrongs of slavery, there were those who dug in their heels and said 'slow down, it's too early, things aren't bad enough'...When women spoke up for the right to vote, some insisted they simply, slow down, there will be a better day to do that, today isn't quite right."

In another corner of the freak show section, Joe Lieberman's antics are drawing so much attention that TV ads for an opponent of Connecticut's other senator, Chris Dodd, are taking shots at him: "Joe never forgets who he ran to represent: Himself. It's not about you. It's all about Joe."

Hundreds of protesters from an interfaith organization, reports the Washington Post, "showed up at Lieberman's home in Stamford and at his office in Hartford, to plead (and pray) for him to support the bill. Among them was Rabbi Ron Fish, of Congregation Beth El in Norwalk, Conn., who was so supportive of Lieberman's 2006 reelection bid that he rushed through John F. Kennedy International Airport in search of a mailbox in which to send his absentee ballot before boarding a flight to Israel."

Meanwhile, behind the vaudeville, some liberals are pushing to lower Medicare eligibility to age 55, expand Medicaid to cover those with incomes up to 150 percent of the poverty level (up to $33,075 for a family of four) and/or effectively cap insurance company profits by requiring them to spend 90 percent of premiums on clinical services and activities that improve the quality of care.

None of these proposals can compete with Reid and Lieberman for amusement value, but they indicate that some serious negotiating is going on.

A Home Run for Health Care?

Under the oddest byline ever, an unlikely trio tells New York Times OpEd readers today how to fix American health care--by applying the expertise of baseball's number crunchers to medical treatment.

A skeptical reader starts with a bit of resistance based on the track record of the authors: Billy Beane, general manager of the Oakland A's, who finished third out of four teams in their division this year; Newt Gingrich, author of "Contract With America," the failure of which led to an exit from Congress in disgrace; and John Kerry, who couldn't counter the swiftboating that resulted in George W. Bush's reelection in 2004.

How these losers got together, the OpEd editors explaineth not, but the essence of their argument is that computer analysis of treatment will revolutionize the American health care system, which now "behaves like a hidebound, tradition-based ball club that chases after aging sluggers and plays by the old rules: we pay too much and get too little in return.

"To deliver better health care, we should learn from the successful teams that have adopted baseball’s new evidence-based methods. The best way to start improving quality and lowering costs is to study the stats."

Nobody would begrudge more information in any field, including medical treatment, but we may be forgiven for skepticism about the formulations of Gingrich and Beane, two self-promoting reformers without results, and for wondering how staid old John Kerry fell in with this crew.

Meanwhile, health insurers have done enough damage in hampering doctors from using their best judgment and experience by nagging them with cost-benefit analysis, where outcomes are more serious than winning or losing ball games.

Feeding Frenzies, Here and There

The rising threat of childhood obesity in America is in the Washington Post spotlight this weekend offering a bizarre contrast to recent headlines about worldwide hunger and starvation.

"In ways only beginning to be understood," the Post reports, "overweight at a young age appears to be far more destructive to well-being than adding excess pounds later in life...

"Doctors are seeing confirmation of this daily: boys and girls in elementary school suffering from high blood pressure, high cholesterol and painful joint conditions; a soaring incidence of type 2 diabetes, once a rarity in pediatricians' offices; even a spike in child gallstones, also once a singularly adult affliction...

"With one in three children in this country overweight or worse, the future health and productivity of an entire generation--and a nation--could be in jeopardy."

The inequality mirrored in overfed children here and starving children elsewhere is complex on both sides of the equation.

Crop failures, hoarding, corruption, manipulated food prices, even natural disasters exacerbated by political stupidity (as in Myanmar) are part of the politics of starvation that resist humanitarian and financial aid efforts.

The alarming rise in American childhood obesity has roots in a culture of sedentary pastimes, among other causes, but fast food and nutritional ignorance contribute to an epidemic that may overwhelm our health care system in generations to come, even as increasing economic disparities of the Bush years leave pockets of hunger and malnutrition here that resemble Third World suffering.

If human beings can't get their act together on something as basic as rationally providing and consuming food for the survival of the species, what hope is there for progress on the knottier problems of civilization?