Schubert's Cost-Contained Unfinished Symphony; A New Perspective on Health Care Reform

President Obama's efforts to reform health care reminded me of a piece I wrote in 1995:

SCHUBERT'S COST-CONTAINED UNFINISHED SYMPHONY
A NEW PERSPECTIVE ON HEALTH CARE REFORM
By BumbleBeeBoogie - March 15, 1995

Have you ever wondered what would happen to the quality of your medical care under a draconian rationing program in your health plan? Let's look at it another way. Imagine, if you can, how a Bach fugue would sound with a harmonica instead of a pipe organ; a Sousa march without a booming tuba; or the Beatle's without Ringo's throbbing drum beat. Would the quality of the music be affected? Would you want to listen to it? Now, apply these examples to understand what could happen to the quality of medical care under the cost-containment goals of a health plan. Imagine Schubert's Unfinished Symphony as it would be performed by a civic orchestra under these circumstances.

The following memo from the symphony's treasurer may make you sick---but with laughter:

Under the Symphony's new cost-containment program, the attendance of the orchestra conductor will be unnecessary for public performances. The orchestra musicians obviously are required to practice. They have the conductor's prior authorization to play the symphony at a predetermined cadence and at an expected level of quality. Considerable money will be saved by merely having the conductor critique the orchestra's performance during a retrospective peer review meeting.

For considerable periods, the four oboe players have nothing to do. Reducing their numbers and spreading their work over the whole orchestra will eliminate peaks and valleys of activity.

Dispensing with either the snare drums or the kettle drums will eliminate an obvious redundancy and still produce the needed cadence for the musicians.

All twelve violin players produce identical notes with identical motions, an unnecessary duplication. The violin section will be drastically cut, resulting in substantial savings. Electronic amplification, with its high reproductive quality, may be used if more sound volume is desirable.

Much effort is expended by the musicians playing 16th notes, or semi-quavers, an excessive refinement. Most listeners can't distinguish such rapid playing. All notes will be rounded up to the nearest 8th. When this is done, it will be possible to use trainee musicians without loss of quality.

No useful purpose is served by repeating with horns, the same passage already been played by the strings. Elimination of all redundant passages, as determined by a cost-containment committee, will reduce the concert from two hours to twenty minutes. A great savings in salaries and overhead will be achieved. In fact, if Schubert had attended to these matters on a cost-containment basis, he probably would have been able to finish his symphony.