Plan B?

"There was no Plan B." So said David Axelrod yesterday following the abrupt end of Tom Daschle's bid to be the white knight of our failing health care system.

I think Daschle did the right thing in bowing out. It was the first right and non-stupid thing he did in a little while. I'm not sure how on earth someone avoids more in taxes than most people earn in in salary and thinks it won't get in the way of a senate confirmation. I also don't understand why taking $5 million in fees from the health care industry (my people, admitted) and thinks that won't come up as a legitimate conflict.

But we're all in agreement now, right? Daschle acknowledges the problem and dropped out. Obama acknowledges the mistake in allowing it to go this far, which created what even the most love-struck Obamanite would agree is an inconsistent rule: no lobbyists or murky ethics in the new administration, except when it suits the administration's needs. I feel better knowing that people in DC can do the right thing, even when it screws up the plan.

And as for the plan--meaningful improvement of how we deliver health care in America? Well, according to David Axelrod, Daschle was it. "There was no plan B."

Super. I'll be Congress will have a plan B, and it won't include universal coverage, guaranteed primary care services (prevention and chronic disease management), nor any kind of incentives for more students to enter primary care.

We've arrived at the time we've been talking about, when our health care system is unsustainable. Companies can't afford to keep the lights on, much less pay huge health care premiums for employees. Employees lose benefits or just lose their jobs. Patients come to me asking for six months of medications because they're losing coverage, and ask for hard copies of their scripts to take to WalMart for the $4 medication plan instead of filling for a few dollars more at our clinic pharmacy.

And there is no plan.

Having the federal government cover 30% of COBRA costs for out of work families is kind of like giving them a buck to help with the rent. Not enough. Out of work is out of work, zero income doesn't cover 70% of a health care premium.

That's not a plan.

There will be some kind of change, but I worry it won't actually help anyone. Those who spend a good part of the year shelling out cash while they wander around in the Medicare Part D donut hole understand meaningless change.

Let's hope for a good, solid plan B, and fast.

And by the way, Mr. President, good for you for admitting your mistake. I expect the learning curve in your job is steep. If you learn from the mistakes, we'll all benefit.

Hope lives on.