By Jed Horne, The Lens contributing opinion writer |

With Louisiana’s David Vitter in faithful lockstep, U.S. Senate Republicans made good on their promise to put repeal of “Obamacare” to a vote and just as predictably have been defeated. The party-line vote came amid Democrats’ accusations that the GOP had no alternative, no meaningful plan that even begins to address the nation’s spiraling health care costs and dysfunctional approach to health insurance.

That doesn’t mean the moment lacked opportunities for political theater. In the run-up to the vote, Vitter got a couple of minutes on Fox News with Greta Van Susteren. But even a reliable right-winger like Van Susteren had to tell Vitter that she sees the Senate posturing as just so much “chatter and wishful thinking.”

Check out the video. Vitter looks crestfallen as Van Susteren dishes up simple truths. The eye-popping and mouth-twisting enunciation that characterize earnest Vitter speech are suspended as Louisiana’s junior senator absorbs the stab in the back – Et tu, Greta? –  by one of the actual leaders of today’s Republican Party.

But while the party may have nothing to offer in place of a law it so despises, let no one say the same of Vitter. In a letter to constituents, he pledges to push hard for two legislative commitments. They are, he suggests, the kind of incremental, money-saving reforms that conservatives, at least those generously sponsored by the insurance industry, see as preferable to the comprehensive bill that passed in March and – as Van Susteren points out somewhat ruefully – is already entrenching itself in the hearts and minds of early beneficiaries.

One of Vitter’s cost savers is something with which his constituents are already familiar: a bill that would allow “reimportation of safe prescription medicines.”

“This has been a top priority of mine since arriving in the U.S. Senate,” Vitter says, adding that this time out he’ll try for new requirements to “promote the safety of domestic and imported medicines including requirements to fight counterfeiting and the use of tamper-proof packaging.”

With this sop to senior citizens out of the way, Vitter turns to his other cost-saving medical reform. This time he angles for the support of women – a group that pollsters found less enthusiastic about him after the awkwardness involving a prostitution service whose madame later committed suicide, not to mention the aide Vitter had to can last summer amid reports that the aide had attacked an ex-girlfriend and held her hostage.

The bid to reawaken female delight in their senator – and save money on health care –  is Vitter’s call to exempt mobile mammography units from paying the excise tax on fuel.

Let’s set aside the charge that Vitter is pandering. (All politicians have to pander at least a little bit; it comes with the territory, and here, of course, his embrace of  a “women’s issue” is reinforced by his habitual obedience to oil interests.) But instead of examining the senator’s motives, let’s take Vitter at his word when he proposes that removing the excise tax on mammovan fuels is a meaningful way to reduce the exorbitant cost of American health care. In short, let’s do the math.
Garden-variety mobile mammography units are specially equipped RV’s that usually run on diesel. The federal excise tax – the portion of diesel fuel pricing that is within the U.S. Senate’s control – is 27.2 cents per gallon. The vehicles average 10 to 12 miles per gallon on the road and then an additional gallon an hour as they operate. That fuels the generator that powers the X-ray machinery and keeps the interior temperatures comfortable and the clinic illuminated.

The numbers come to us courtesy of Donovan Farber, who’s in the business of turning RV’s into rolling medical clinics, including mobile mammography units. Farber is based in Cleveland, but the business is national. New Orleans has no Farber mammography vans on order, but it is days away from taking delivery of one of the company’s rolling health clinics, fully equipped.

Extrapolating from Farber’s numbers, it would be reasonable to estimate fuel usage for a typical mammography unit at 10 to 12 gallons a day. That allows for a roundtrip of perhaps 20 miles, from the downtown hospital zone to, say, Venetian Isles at the extreme tip of eastern New Orleans, plus a solid nine hours on the generator.

But let’s be conservative here; let’s err on the side of caution. Let’s say the van gets hopelessly lost on the way to Venetian Isles and that the lines of women seeking mammography are so long once it gets there that it stays open well into the evening. Let’s posit the fuel usage, not at 12 but at 30 gallons a day. Erase the federal excise tax, and you’ve saved $8.16.

But why stop there? Let’s not just repeal the federal excise tax. Let’s suppose that back in the day when he was a state rep in Baton Rouge, Vitter devoted himself to repeal of Louisiana’s 20-cent-per-gallon state excise tax and, in contrast with his record of non-accomplishment in the U.S. Senate, actually won passage of a bill he had initiated.

With neither state nor federal excise tax, the mammography unit, last seen heading the wrong way on Chef Menteur Highway in a lengthening search for Venetian Isles, would be spared 47.2 cents per gallon. That comes to $14.16 a day in savings (call it 15 bucks) – more than enough to buy lunch for two at Dong Phuong, and maybe on the way out, the cheerful Mrs. Tran at the cash register can give more reliable directions to Venetian Isles.

A free lunch at Dong Phuong is nothing to sneer at, but is it really a savings sufficient to increase access to mammography and the early detection of cancer that can save lives? A turnkey mobile mammography van is not cheap. Fancy units top out well above $800,000, but in the spirit of austerity, let’s concentrate on one of the stripped down models that, says Farber, come in at around $650,000.

Let’s see: Savings of $15 a day comes to $5,475 a year, assuming the unit is in use every day. Divide that into the sticker price of  $650,000 …

Eureka! Vitter is right: The savings could be used to buy a new mammography unit – in 119 years.

Oh, sure, there are ways to compound the savings, just like we used to do with the excise tax before Vitter repealed it. But as a diagnostician might say, some complications are expected. Call them side effects. Without the excise tax, road maintenance has lost its funding. Chef Menteur has reverted to hummocky swampland. Venetian Isles lives up to its poetic name. The only access is by boat.

It’s good to see Vitter looking for ways to bring the federal government into the business of health care. Let’s hope subsequent inspirations will prove better rooted in reality. Absent that reality check, a cynic might have to conclude that the senator really wasn’t serious about repealing the new health care law, only about exploiting the issue for partisan purposes.

True to form, Vitter begins his letter announcing his strategy for “total repeal of Obamacare” with slighting remarks about the president: “… pretty speeches are nice,” Vitter sniffs, with reference to the president’s recent state of the union address, “but what really matters to Louisianians is follow-through.”

Amen to that, senator.

Jed Horne is the news editor at The Lens.