"It has been said that democracy is the worst form of government except all the others that have been tried." – Winston Churchill
For me, the past week has been a tale of two cities.
In Washington, DC, the potential for political gridlock to derail even bipartisan healthcare reform efforts was on full display. It took about a year for Democrats and Republicans in both houses of Congress to craft a "Doc Fix" for Medicare's broken physician payment system.
After two months of squabbling over the new value-based payment system's $180 billion tab, Congress punted, voting to patch Medicare's much-maligned Sustainable Growth Rate formula rather than to replace it.
The American Medical Association released an exasperated statement soon after the Senate endorsed the House version of the "Doc Fix" patch Monday night: "The American Medical Association is deeply disappointed by the Senate's decision to enact a 17th patch to fix the flawed Sustainable Growth Rate (SGR) formula. Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good."
In an alternate reality last week at the Statehouse in Concord, NH, the potential for politicians to work together to enact healthcare reforms in the interest of the general citizenry soared like the frosty peaks of the White Mountains.