Health-care debate: Think you'll save money? Think again
By: Health Insurance
Submitted: 2009-11-20 12:42:25 | Word Count: 1108
"Good news," your editorial trumpeted, "Bill improves Medicare." It seems you've joined the chorus of those imitating Chatty Kathy dolls in Congress spewing out that incessant mantra of "affordable, quality" health care.
Your contention that H.R. 3962 (disingenuously named the "Affordable Health Care for America Act") adds "major new, lifesaving" benefits to money-saving features sounds just like Sen. Max Baucus's drivel that "the only thing that will change is lower costs and higher quality" (AARP Bulletin, June '09).
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Wow, major new features for everyone at less cost? What's not to like about this "reform"? Sobering reality - that's what.
LBJ once noted that when someone came along with a plan to save him a lot of money, he took a firm grip on his wallet. Well, it's time to clutch our wallets because the proposals to lower our medical costs just don't make sense. One of the most powerful tools to "bend the cost curve" is for the federal government to flex its negotiating muscles. But Obama nixed the idea of negotiating with hospitals and insurers to lower costs as a tradeoff for their support of his plan. Competition in health care is essential for controlling costs - that's what all the "cost curve" advocates tell us. But when the possibility of competition between entities who want to do business with the federal government is before us, our leaders cave in (or sell out). Is this one of the "money-saving" features you refer to?
And then there's H.R. 3961, the Medicare Physician Payment Reform Act, which increases payments to providers by $247 billion over 10 years. If someone advocated saving money in education by increasing teacher salaries by $247 billion over 10 years, you'd say they were nuts. Furthermore, we didn't lower the costs of running West Virginia this year by giving state workers pay increases. We froze their pay - that's what stabilizes the "cost curve." No, H.R. 3961 bends the cost curve upward! Is this another example of the "money-saving" features you referred to?
You mentioned the CBO in your piece. Are you aware of the CBO report that health-care costs will rise by 6.2 percent a year for the next 10 years, while employee wages will remain stagnant and many people will remain unemployed or underemployed? (Washington Post Weekly Edition, first week of November). It's not just the Post illuminating these dismal CBO data. On the Lehrer News Hour (Oct. 27) we were informed by a debate participant that the House "reform" bill taxes those households making $55,000 per annum a health insurance premium of approximately $5,600. (Other Lehrer guests on different dates expanded on this "sliding scale" of health-care taxes on the hypothetical family of four). So, how do you tell all those families of four making $55,000 they must pay an additional $5,600 in health-care taxes as a "money-saving" feature?
And if all this lowering of costs is so real, why are state governors so concerned about Medicare/Medicaid costs they may have to absorb in future years? That "affordable" House bill looks disturbingly like an unfunded mandate to many governors who face the prospect of increasing state taxes to deal with Medicaid expenses. Some lawmakers are so alarmed about the potential financial tsunami headed their way they are seeking special protections for their states. Sen. Harry Reid, for example, unapologetically cut a "stealth deal" with Finance Chairman Baucus to make sure that the federal government would pay the full costs of expanding Medicaid in Nevada for, I believe, a five-year period. (And if Nevadans don't have to pay for their Medicaid costs, others will simply have to pay more to subsidize the Reid agreement).
Reps. Mollohan and Rahall should have held out for a similar deal. Indeed, given the close vote on H.R. 3962, their votes would have been deal-breakers. In that scenario, those highly coveted votes could have easily secured "affordable" (free) Medicaid coverage for West Virginians for many years to come.
Such is the workings of Washington. People decry the "evils" of socialized medicine, but the Reid deal warns of a much greater threat - politicized medicine, medical coverage based on your congressperson's pecking order in the legislative hierarchy. We won't see rationed care as much as bartered care (i.e., if you promise not to raise your rates over 6.2 percent, I'll see that you don't have to bother with negotiating for contracts as long as I'm in office).
The economics are absurdly skewed. Here we are paying twice as much per-capita than any other industrialized nation and yet health-care systems of those other countries cover all citizens and provide better outcomes (e.g., in France the average life expectancy - one might say the ultimate outcome - is two years greater than in the United States). How do they do it?
I think we had better find out how they do it, because we not only face continued "upward bending" of the health cost curve with H.R.s 3961 & 3962, but lost "opportunity" costs, as well. How much are we willing to lose in educating our citizens by shifting education money to health care? What are we willing to forego in our highway infrastructure as we shift infrastructure dollars to health care? How many small businesses do you think it's OK to drive into bankruptcy by demanding they whittle away at their already razor-thin margins to fund their workers' health care? How far will we allow our cities to decline as we shift resources meant for municipal services to health care? What is our society going to look like when we've taken so much "opportunity" from our citizens and demand that they pony up even more money for health care? (Paying twice as much as those in other countries isn't enough?)
And to lay insult on that injury, we'll fine them, and the small businesses that employ many of them, if they don't comply. This is your idea of making our citizens "better off than they are now"? Be careful what you wish for, because you'll surely get the bill.
