Smoke-Free White House?

It seems the White House is a smoke free zone. So what will happen when Barack Obama, who we find has yet to quit smoking, takes up residence there?

"Uh, excuse me Mr. President, we have to ask you to put out that cigarette."

"Tom, I'm tired of all of your nagging! You big ol' senators think you know it all. If I weren't so perplexed about the health care system and needed someone to take the fall when the next attempt at reform fails, you'd be fired! You hear me? Fired, I tell you! So be glad I offered you that post over there at the Department of Health and Human Services. Hey, how's the sale of your book going now that I appointed you? Good? Glad to hear it! Now you go about your way now and leave me alone. I've got bigger fish to fry with this damn economy. Criminy!"

"But Mr. President, sir, the White House has balconies..."

"Tom, dammit! Stop! Wouldn't you suck on one of these babies if you had to figure out a way to shore up our economy? I don't see you working like I am. I hired all of those famous economists and they keep telling me this and that - who knows what's right? And if I get cancer, well then, heck, at least I'd be leading by example and supporting the continued reliance on health care to support our economy, right? I mean look at all the new jobs we've created there - even now as the rest of the economy tanks. You could scan me and test me time and time again, then give me one of those super duper chemo drugs that costs, what, $5000 per month, and save my sorry little butt so I can get back to work. So I don't have to stop smoking, Tom. The nation needs me in this time of crisis to show them the way!"

"But health care's struggling, too, Mr. President. I mean ER's are seeing more and more of the uninsured, they're overcrowded. Pressures being put on hospitals to see these folks who can't pay..."

"What do you mean, hospitals are hurting? I know that some are doing quite well. Some are building like crazy. Some are growing. Don't tell me hospitals are hurting!"

"Really, Mr. President, some are. Lots of them have thought about closing - not because they can't continue seeing patients and raising prices. It seems it's really because they couldn't get credit to update their facilities and make 'em look as nice as their competitors. So all they could see were the locals. They couldn't attract people from outside their locale that could actually pay their bills and got stuck with the hoi polloi - and lots of those common folk have lost their insurance when they lost their job, Mr. President."

(Loud sucking sound heard, followed by a plume of smoke rising from the Predident's lips) "Oh, hell, Tom, you're such a fuddy duddy. We all know who's paying their bills! Medicare! What the hell you taking about? Those guys just keep seeing the over-65 crowd and they're set! You know as well as I do that we're providing them a bigger continuing bailout package than GM! Maybe WAY more! They just hire those hospitalists to keep ordering tests and workin' like beavers and with all those fancy electronic medical records auto-ordering tests and immunizations and drugs, hell, they're in the money. We pay 'em well enough, Tom. They'll make it. Let's focus on the big stuff. Don't weigh me down in such trivialities - we have the finest health care system in the world."

"But Mr. President, aren't we suppose to find all that waste, fraud and abuse in the hospitals? With those damn electronic records, that's getting hard! Won't that take even more money from the hospitals?"

"Tom, seriously. You know how this works. If the programs are making it tough to find some loopholes, just change the rules! That's what we do, remember? All we have to do is find a few million here and there so the press feels we're doing our job to save our health system from ourselves and it'll buy time. Don't get bogged down in such trivialities. We need our hospitals right now! Just make those doctors fall in line a bit more! Withhold a few more billion of their pay and then offer them a chance to earn back a few more percent in payments by prescribing electronically! We all know only 15% of those suckers don't have EMR's, so that should be a win-win for us, right? And the pharmacies and drug companies will love us, too, as those scrips go flying out the door! And speaking about the drug companies, can't we jack up the FDA's drug review fees some more? They're under your umbrella. There's a revenue stream if I've EVER seen one! And what's up with Grassley? Doesn't he know what's important right now? Geez! Isn't there another committee we can give him?"

"(* cough *) Mr. President. The smoking..."

"There you go again, Tom. Look, just give the people what they want. Make it look free, or affordable, and for God sake, universal. Right now we've got the world by the balls. Make a new line item deduction on peoples' paychecks. Make the businesses pay, too, and we'll get through this. Don't start to ask about why things cost so much. Just get it done. Don't worry about all the middle men. Hell, if we start trimming there, we'll have a real mess on our hands! You know what the unemployment numbers would look like then? Just keep it complex. Keep it fuzzy, and keep those billing, collections, and regulatory people employed, dammit! You know how to do it: make sure every last sucker scrubs their hands with expensive gels rather than plain ol' soap and water. Feed the economy, Tom, feed it! (*sssslllluuuurrrrrpppp*)"

"Okay, Mr. President, but what about your daughters. What will they think about your smoking..."

"Tom, leave them out of this. Look, I'm already giving them a puppy..."

-Wes