Congressional Conflicts: Premier’s Blair Childs Offers His Perspectives on The Year Ahead in DC

I think it’s going to be a really tough year. And I think the question is, how will this year play out? It clearly looks like it’s going to be a sort of 2011/2012 redux. It’s going to be the same thing, where we’re going to be sort of lurching from one deadline to the next. We’re lurching now from the fiscal cliff situation to the debt ceiling. And that’s because, while there was an agreement this week on the taxes, the deficit is going to increase over the next decade by nearly $4 trillion. So how are we going to manage this? We didn’t solve the problem.

It really was just a patch over a crisis.

Yes, and in this case, the crisis was about disagreements over tax increases. The longer-term issue is how to balance the federal budget. And unfortunately, hospitals have already gotten a reduction. The optimist in me says that this is an opportunity to push for more reforms that will actually help bend the cost curve. The pessimist in me says that the short-term, expedient thing is to make across-the-board cuts in some form or fashion, rather than having more nuanced types of discussions that could end up in solutions that could bend the cost curve.

It just seems to me that this is an environment more conducive to "meat cleaver" cuts rather than to those more nuanced types of discussions.

I think you are probably right about that. And while some people are saying dire things about dysfunction in Washington, the reality is that this is how things work in Washington, and have worked for a long time.