I'm not reading other people's opinions about yesterday's U.S. Senate election in Massachusetts where Republican Scott Brown beat Democrat Martha Coakley. It will just make me angry, I'm sure. I need to focus on things I can change...things I need to do for myself. But I will offer some observations about how understandable this vote was in the context of health care reform...

I attended the Neponset Valley Chamber of Commerce annual meeting this morning where Jim Roosevelt, Tufts Health Plan CEO spoke about the challenges of health care reform. He's also a leader in the Democratic effort to make changes to the health care system. I believe his heart is in the right place, but does anyone else see a problem with having the head of a Health Plan leading reform??

Tufts is a "good" plan--it is the insurance I have and I can think of a lot worse. Roosevelt made the point that the main cost driver in health care is the unit cost of services--and that it is all passing through Tufts which has low administrative costs and minimal profit. He even gave an illustrative example of one of his staff showing him a statement of benefits and being appalled at the costs that are normally hidden from individuals. I've seen those bills too and they anger me and convince me that this system is a corrupt enterprise. But I come to a far different conclusion about the remedy.

Roosevelt informed the crowd that legislation had been filed to create something in Massachusetts that would help small businesses and indviduals by creating an affordable health plan option that would save as much as 22% and offer a level of service comparable to the "Bronze" level plans of the Massachusetts Health Connector. Thanks for the scraps. So you are telling me that after revolutionary change in our country...after all this hard work, I will be able to purchase lame health insurance for $800/month instead of $1000?

Let's go back to that statement of benefits. Why does some drug cost $3600? Why does the time it takes a nurse to hook up someone to an IV cost $250? Why, if I don't have health insurance, does the same bill come to me with dramatically inflated prices? Honestly, I'm tired of asking why or even caring. We need to reduce these costs.

Instead, what is happening is the government is trying to provide health insurance to all and then distribute the additional costs to the rest of us. Since most people get their insurance through an employer, this translates into crippling taxes on small businesses. OF COURSE THEY OPPOSE THIS KIND OF REFORM! That is like telling me, hey, we did it! Now, homeless people in Boston have free health insurance and your premium went up to $1200 a month. That is not what I ever wanted from health care reform. I should not have been paying $1000 in the first place!

I want someone to figure out how to provide a basic level of care to all Americans for something like $400/month. That's an arbitrary number, but my point is that this idea of saving 20% is about as credible as a Macy's sale where every item in the store is constantly on sale and no idiot would ever pay full price. What do we need to change to lower the costs?

The Democrats have convinced themselves--as I did yesterday before I grudgingly cast my vote for Martha Coakley--that any reform is better than no reform. We recognize the reality is that while Republicans talk about reform and cost-cutting, the real agenda is simply to kill reform so everyone can heave a big sigh of relief and get on with the business of making lots of money for insurance companies and "big pharma."

Small business owners are caught between a rock and a hard place. Whose bullshit do you believe? It's not that hard when one candidate is trying to sell you a bill of goods and the other is calling her out on it.

People feel anger and frustration when they realize what is really happening: that compromise is purchased in back room deals, and scraps of mitigation are doled out to special interest groups while life goes on in a fundamentally corrupt system. It is enough to push people into a rejection of that representation and, unfortunately, a rejection of the whole reform process.

What are we left with? Well, perhaps we are left with a Senator who will cause this process to be rebooted. Perhaps he will represent small businesses who say $800/month instead of $1000 is no bargain for me! Certainly the pain of rising health care costs for business will not go away.

So, to be clear, I DON'T think we had a case of Mass. Insanity yesterday. Pushed into a corner, people made a choice they could believe in, rather than accepting that they had to vote for Martha Coakley or it would be the end of the world. Today is a new day and after all the pundits get done pontificating about realignment and the impact on Obama, maybe someone will start asking more fundamental questions about this corrupt system. So instead of asking what if or even why, I guess the real question is what next?