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12/12/18

Nicking the Animal’s Ear

My family left the farm when I was fairly young, so I don’t have a lot of direct memories from that time, but apparently, I was a tender soul, often visibly troubled by things that appeared to cause pain to the cows.  I protested when they got the whip at the auction to keep them moving along and didn’t like it when a calf got a vaccination shot.

The ear tagging was the worst for me.

Someone would literally wrestle the cow into a headlock and someone else had a stapler-like thing that would pierce the cow’s ear and insert an identification tag.  Who knew 50 years later people would pay someone to use a similar machine to poke unnatural holes in their body from which they could hang their own identification tags?

The tag system was an improvement on the old method.  Alongside branding, ear marking was a way for a farmer to stamp ownership on their animal.  Just cut your own unique gash in the animal’s ear.  You even went down and registered your mark.  Tags are less bloody.

We only bring this up because you will need the etymology of the term ‘earmark’ handy next year once the new Congress is sworn into office.

Yesterday, incoming House Majority Leader Steny Hoyer (D-Md) announced that they planned to bring back earmarks as a key aspect of how the government should, and will, function. ‘I am for what the Constitution says Congress has the authority and responsibility to do: to raise and spend money,’ Hoyer stated.

You can have your own internal conversation about that particular interpretation of what the Constitution really says about the division of powers between Congress and the Executive branch, but there are two large political realities at play here.

First, if your party is on the east end of Pennsylvania Avenue and some joker from the other party is down the street in the White House, you like the idea of Congress telling the administration exactly how to spend the money.

Second, if you do work down on the hill, you obviously want to get reelected, which means you need to show the folks back home that you can bring home the goodies.  The 2010 elimination of earmarking in the appropriations process made that tricky. 

Earmarks – pork-barrel spending, pick your metaphor – are back.

Well, guess who is right at the top of the earmark recipient list? Non-profit hospitals and university medical centers.  New wings, cancer centers, community outreach, specific treatment programs, here we come.

And with health system margins getting squeezed (Whoever just suggested a little expense control, ssshhh!  How dare you?), you can bet reopening the earmark process will be seen as manna from heaven.   

Yes, the big non-profit health systems are about to get yet another gift. As are the DC-based healthcare lobbying firms.

Merry Christmas to everyone!  Except all of you profit-making, tax-paying folks.

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ALN

Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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