In a preview of a fight you can expect every year if health reform passes, Massachusetts on Thursday passed a compromise aimed at controlling health care costs.
Among the key provisions are annual public hearings on costs, incentives for doctors to choose primary care, and a requirement for electronic records by 2015.
Key questions on cost control were punted to a commission.
What drew the most public attention, however, was a limit on gifts to doctors, which biotech firms say will damage the state's medical industry. Gifts over $50 will now become public record.
The original Massachusetts plan, with its requirement for everyone to have health insurance, was dubbed RomneyCare after then-Governor Mitt Romney. Conservatives are now hanging it around his neck as he tries to become John McCain's nominee for Vice President.
The gifts provision won't make a big difference on costs, but the fact that this largely-symbolic act became the whole focus of debate is telling.
Health care reform requires ongoing government involvement, political involvement that risks making all health questions into political footballs.
The enemy here isn't waste so much as irrelevance and grandstanding on all sides. No one, in any democracy, has yet come up with a cure for that.
(The illustration, from the Torontoist, is an attack on a local politician there for political grandstanding. My guess is the feeling behind the tape is universal.)