Take Over the Health Care of All To Provide it to 5% Who Don't Have it Now?

This article appeared here.

December 17, 2009

Government Shouldn't Control Health Decisions

By Larry Elder

Americans overwhelmingly like their health care and their health insurance. While Americans reject ObamaCare, the President and Congress insist on driving it through.

Most Americans, up to 85 percent, already have health insurance and are satisfied with it. Lacking health insurance is different from lacking health care -- which, by law, emergency rooms must supply. Millions go without health insurance by choice and not due to lack of resources. Deduct from the number without insurance those who have access to it via entitlement programs, those temporarily without it while between jobs, those here illegally and those who could go on their parents' insurance plans by paying affordable amounts -- and you're down to 10 million to 15 million people without health insurance for longer than a year. This represents 5 percent of Americans.

To address this, the President and the Democrats are this close to a complete government takeover of health care. And a takeover it is. Assuming some kind of plan reaches the President's desk, it will -- at minimum -- force all Americans to purchase health insurance or pay fines or worse. It will force nearly all employers to provide health insurance or pay fines. It will tell health insurers that they must accept applicants with pre-existing illnesses and restrict their ability to "discriminate" based on factors like sex and age.

Incredibly, the President and Congress tell us that our economic recovery hinges on "health care reform" and that they can achieve it -- providing millions of people with health insurance estimated to cost a trillion dollars in the first decade -- while simultaneously reducing the deficit. The plan anticipates cutting hundreds of billions from the popular Medicare programs, whose beneficiaries vote in numbers greater than any other age group. Doctors and hospitals already complain that Medicare reimbursements fall short of costs, let alone profits. Good luck with that.

"Health care reform" achieves its deficit-reducing magic by collecting taxes in the early years -- building up money -- while paying out very little. Only after the first four years does money go out. It also forces states to pick up part of the tab. So, voila, it actually reduces the deficit -- at least in the first decade.

Then what? The Congressional Budget Office -- in cost estimates full of caveats, conditions and on-the-one-hands -- says that it could/might/may reduce the deficit in the second and third decades, too. Again, this assumes continued cuts in doctor and hospital reimbursements.

Despite the White House photo op of docs in their white frocks, most physicians oppose ObamaCare. They resent further government supervision and control over their practice. A poll commissioned by Investor's Business Daily found that 65 percent "oppose" ObamaCare and that 45 percent would consider taking early retirement or leaving their practice if the bill went through.

Given the broad opposition -- most Americans, most doctors and seniors in fear of cuts in Medicare -- why do it?

First, the Democrats -- now in control of all three branches of government -- have convinced themselves that they face a political price if they fail. ObamaCare supporters, based on bogus assumptions and inflated numbers, argue that many, if not most, bankruptcy filings are due to health care bills. If, as President Obama asserts, "reforming" health care and economic prosperity go hand in hand, how can they abandon it?

Second, while a large majority of Republicans and most independents oppose these "reforms," Democrats overwhelmingly support them. They consider health care and health insurance a right -- never mind the Constitution or the price tag -- and think "the rich" should bear the costs. Congresspersons fear an electorate upset at a failure "to deliver" a victory over the evil, money-grubbing insurance companies.

Third, many believe in good faith that this is the "right thing to do." This breathtakingly ignores the mountain of evidence that government command-and-control health care reduces quality, reduces innovation and inevitably leads to rationing. The president of the Canadian Medical Association says Canada's system -- a single-payer kind, favored by President Obama -- is "imploding." She calls for more competition.

Critics of America's health care system say that citizens in other countries enjoy longer life expectancies. But after adjusting for homicides, increased infant mortality due to teen pregnancies and low birth weights, obesity and other behavioral factors, the discrepancy disappears. Compare American medical outcomes against those of other countries. Our system produces the world's best results for cancer patients who go into medical care at the same time similarly situated patients enter their countries' care. Our pharmaceutical companies lead the world in coming up with new life-extending and -enhancing drugs, a record at risk given new controls and taxes under the guise of "reform."

When the ObamaCare bill comes due -- when the deficit explodes and the costs are "controlled" through government-directed rationing -- supporters, including President Obama, will long have departed Washington, leaving others to deal with the mess. In the meantime, bend over and cough. Or else.

Copyright 2009 Creators Syndicate, Inc.

George Will Answers That Chirping Sectarian, Ron Paul

At Bernanke's recent confirmation hearing on his nomination for a second four-year term, Jim DeMint, a South Carolina Republican who is co-sponsoring a Senate version of Paul's bill, asked Bernanke: "Do you believe that employment should be a mission, a goal of the Federal Reserve?" Bernanke, who had already noted Congress' "mandate" that the Fed "achieve maximum employment and price stability," answered that the Fed "can assist keeping employment close to its maximum level through adroit policies."

That mandate was, however, improvidently given. Congress created the Fed and can control it, and eventually will do so if the Fed eagerly embraces the role of the economy's comprehensive manager. America's complex, dynamic economy cannot be both "managed" and efficient. Attempting to manage it is an inherently political undertaking and if the Fed undertakes it, the Fed will eventually bring upon itself minute supervision by Congress.

Rep. Paul Ryan, R-Wisc., has, as usual, a better idea: Repeal the Humphrey-Hawkins Full Employment Act of 1978 that, he says, "dangerously diverted the Fed from its most important job: price stability." For 65 years after its creation in 1913, the Fed's principal duty was to preserve the currency as a store of value by preventing inflation from undermining price stability. Humphrey-Hawkins gave it the second duty of superintending economic growth.

There's just one little problem with this line of reasoning from George Will. It is that the Federal Reserve didn't do its principal duty from 1913 to 1978, either, during which time the purchasing power of the dollar fell to fifteen cents.

For the complete article, go here.

Insurance is for Accidents, Not Oil Changes

Political meddling in healthcare has driven up its costs and reduced choice. It's time to end that, not expand it, as yet another excellent thinker has made plain here.

November 3, 2009

The "Costs" of Medical Care: Part IV

By Thomas Sowell

What is so wrong with the current medical system in the United States that we are being urged to rush headlong into a new government system that we are not even supposed to understand, because this legislation is to be rushed through Congress before even the Senators and Representatives have a chance to read it?

Among the things that people complain about under the present medical care system are the costs, insurance company bureaucrats' denials of reimbursements for some treatments and the free loaders at hospital emergency rooms whose costs have to be paid by others.

Will a government-run medical system make these things better or worse? This very basic question seldom seems to get asked, much less answered.

If the government has some magic way of reducing costs-- rather than shifting them around, including shifting them to the next generation-- they have certainly not revealed that secret. The actual track record of government when it comes to costs-- of anything-- is more alarming than reassuring.

What about insurance companies denying reimbursements for treatments? Does anyone imagine that a government bureaucracy will not do that?

Moreover, the worst that an insurance company can do is refuse to pay for medication or treatment. In some countries with government-run medical systems, the government can prevent you from spending your own money to get the medication or treatment that their bureaucracy has denied you. Your choice is to leave the country or smuggle in what you need.

However appalling such a situation may be, it is perfectly consistent with elites wanting to control your life. As far as those elites are concerned, it would not be "social justice" to allow some people to get medical care that others are denied, just because some people "happen to have money."

But very few people just "happen to have money." Most people have earned money by producing something that other people wanted. But getting what you want by what you have earned, rather than by what elites will deign to allow you to have, is completely incompatible with the vision of an elite-controlled world, which they call "social justice" or other politically attractive phrases. The "uninsured" are another big talking point for government medical insurance. But the incomes of many of the uninsured indicate that many-- if not most-- of them choose to be uninsured. Poor people can get insurance through Medicaid.

Free loading at emergency rooms-- mandated by government-- makes being uninsured a viable option.

Within living memory, most Americans had no medical insurance. Even large medical bills were paid off over a period of months or years, just as we buy big-ticket items like cars or houses.

This is not ideal for everybody or every situation. But if we are ready to rush headlong into government control of our lives every time something is not ideal, then we are not going to remain a free people very long.

Ironically, it is politicians who have already made medical insurance so expensive that many people refuse to buy it. Insurance is designed to cover risk. But politicians have mandated that insurance cover things that are not risks and that neither the buyers nor the sellers of insurance want covered.

In various states, medical insurance must cover the costs of fertility treatments, annual checkups and other things that have nothing to do with risks. What many people most want is to be insured against the risk of having their life's savings wiped out by a catastrophic illness.

But you cannot get insurance just for catastrophic illnesses when politicians keep piling on mandates that drive up the cost of the insurance. These are usually state mandates but the federal government is already promising more mandates on insurance companies-- which means still higher costs and higher premiums.

All this makes a farce of the notion of a "public option" that will simply provide competition to keep private insurance companies honest. What politicians can and will do is continue to drive up the cost of private insurance until it is no longer viable. A "public option" is simply a path toward a "single payer" system, a euphemism for a government monopoly.