Galactic answer to health care is 41

Suddenly there are 41. In Douglas Adams' bizarrely funny "Hitchhiker's Guide to the Galaxy," the answer to the search of the meaning of everything was 42. In the universe of U.S. politics, at least in the Senate, it is 41. Forty plus one is the magical number needed to sustain debate in the chamber of 100. And when they continue to debate they continue to talk, and as long as there is talk there is no action, and with no action America has no health care reform.

With the election of Republican Scott Brown to the U.S. Senate from Massachusetts, based on your point of view the nirvana of obstructionism has arrived or the sanction of common senses has been restored.

Now the fun begins. The irony that a Republican was chosen over a Democrat to fill the seat of the late Ted Kennedy, "Mr. Democrat," a champion of health care reform for the length of his congressional career, has not been lost on anyone. The fact the seat of the Senate has once more become the chair of the people and not Kennedy's personal recliner or footstool of the Democrats speaks volumes to the power of democracy and the fear of the voters. It is especially poignant to have this shocking outcome in a state with a law of universal health coverage much like the anticipated health bill now so conveniently stalled before the Senate.

But it goes back to the first question. What are the Republicans going to do with this new found tool? Is it going to be a delicate instrument that they can use to craft a better reform or is it going to be a cruel hammer to simply bash and pound. It is never power alone that matters. It is what one does with the power that counts.

So what will come of this 41? Will they sit down and work toward a better solution to a real problem or will they just block all change? In the Republican response to the State of the Union, Gov. Robert F. McDonnell of Virginia repeated the disappointing line, "America has the best health care system in the world." What follows that is to use the power of the 41 to stop all change. Why reform something that is the "best"? Yet it can't be the best without addressing the problem of non-insurability, eligibility waiting periods, exemption for pre-existing conditions, accelerated costs of everything, overuse of services, medical errors and liability, drug advertising and enormous expenses to promote expensive new colored pills, executive bonuses and employers dumping coverage for their workers.

With 41 Republican senators, will there be an effort to address the cost of care? What really is the best way to encourage good outcomes, not bad results? Should for-profit stockholder return-driven companies be part of the solution or are they part of the problem?