Joe Leto, President, Garden City Retired Men’s Club with Robert Mc Millan, George Salem, Programs Director, Garden City Retired Men’s Club On November 16, the Garden City Retired Men’s Club’s monthly speaker was Robert R. McMillan—a Garden City resident and member of the Mineola law firm of Bee Ready Fishbein, et al. His topic was “Toward an Understanding of the Current Health Care Debate in the U.S. Congress.” Mr. McMillan’s credentials on this topic are excellent; he served six years until 2005 on the National Board of Trustees of the American Medical Assn. and 11 years through 2005 on the Board of Blue Cross/Blue Shield.

Mr. McMillan’s presentation—which contained a “power point” slide show—was, in a nutshell, complete, timely, up-to-date and very educational. The responses of the members in the Q&A session were numerous. He reminded us that any health care reform bill that comes out of Congress will be over 1,000 pages long. In addition, regulations to implement the bill could aggregate roughly 8,000 pages. The effective date for any new bill will be January 1, 2013. It is unlikely that most observers, even Congressmen, will feel confident that they understand the bill well. Mr. McMillan cited government payments for abortions and the private health care option as the most crucial and contentious elements in the current debate. Other controversial issues which need to be deliberated are: whether the U.S. is headed for a full nationalization of health care; illegal aliens’ rights; end of life care; who will pay the hundreds of billions of dollars the plan could cost; the projected bankruptcy of social security and medicare in coming years; and the adverse potential effect of doctors’ willingness to continue to practice.

An eye-opening slide showed how many interested groups have a stake in the outcome of any signed bill. Among these are: insurance companies, pharmaceutical companies, labor unions, corporate business managements and non-unionized employees, manufacturers of medical equipment, doctors, nurses, hospitals, patients and the legal profession. Can all of these concerned parties agree on overall health care reform? It seems unimaginable that President Obama’s year-end 2009 goal for a final bill can be realized.

Mr. McMillan did not give us his opinion as to the timing and content of any potential bill that will emerge. No one really knows answers to these questions. However, he did open our eyes to the complexity and controversiality of the health care reform challenge. We give him high marks for his depth of knowledge and effective delivery of an enormous puzzle.