Not long ago, lawmakers made an effort to change Medicare's system for purchasing walkers, wheelchairs and other medical equipment for elderly and disabled patients. The idea was to make a simple and sensible cost-cutting move: Rather than keep paying an inflated set-price to the closed club of corporations that supply these devices, open the system up to competitive bidding. Medicare embraced the change and ran a test program in 10 cities. Success! Instead of a few outfits like Invacare, Praxair, and the Scooter Store locking up the business, 325 companies won contracts, and prices paid by Medicare dropped 26 percent, for a projected savings of a billion dollars a year for taxpayers and some $200 million in co-payments made by the patients.
The change is scheduled to go nationwide this month -- except that the enemies of change are on the move. Guess who they are. Of course! The firms that have been enjoying the billion-dollar annual overcharge for Medicare equipment prefer to keep enjoying it, so they goosed up their campaign donations to key lawmakers, hired lobbyists, and are moving a bill through Congress to kill the open-bidding program. The House has already passed this blatant subsidy protection bill, and the Senate is heading in the same direction. Congress is killing its own change.
What we have here is but a small example of how hard it is going to be to produce the "change" that the American people are loudly demanding from Washington. This is why the change agenda -- on everything from universal healthcare to Iraq policy -- cannot be left to the insiders. Political will is easily suffocated in Washington. Instead, the insistent demand and ceaseless pressure must come from us outsiders, asserting our grassroots power.