Wednesday, November 25, 2009

Change We Really Don't Need

I could try to write my own piece on why "ObamaCare" does not offer the short and long-term reform of health care this country really needs. But I'm certainly no expert on this very complex topic. Yet there is no shortage of experts who are analyzing the proposed health care reform package known as Obamacare and find its proposals to be bad for the pocketbook, bad for freedom, and ironically, bad for health care. For example, Jeffrey Flier, dean of Harvard Medical School, offers a compelling analysis of the current health care reform in a recent article, "Health 'Reform' Gets a Failing Grade".

Flier first summarizes the problems in the current system:

Our health-care system suffers from problems of cost, access and quality, and needs major reform. Tax policy drives employment-based insurance; this begets overinsurance and drives costs upward while creating inequities for the unemployed and self-employed. A regulatory morass limits innovation. And deep flaws in Medicare and Medicaid drive spending without optimizing care.

His article points out that the proposed "reform" is no reform at all. It seems the primary achievement anticipated from Obama's package is that millions more people will be added to a dysfunctional health care system. It will neither make health care better nor less costly, yet by over regulating, will stifle innovation. He explains:

In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care's dysfunctional delivery system.

The system we have now promotes fragmented care and makes it more difficult than it should be to assess outcomes and patient satisfaction. The true costs of health care are disguised, competition based on price and quality are almost impossible, and patients lose their ability to be the ultimate judges of value.

Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.

In effect, while the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system— now with many more participants. This will make an eventual solution even more difficult. Ultimately, our capacity to innovate and develop new therapies would suffer most of all.

Mr. Flier argues that many he has spoken are fully aware that although this health care package brings down the number of uninsured, the system will require drastic long-term reforms in the way health care is organized and funded. Indeed, he writes, he has "met many people for whom this strategy is conscious and explicit"-- in other words, they know the current package doesn't accomplish true reform of the health care system but are willing to vote for it as a means of beginning the process of reform. Flier concludes that the American public should be made explicitly aware of this strategy, saying, "We should not be making public policy in such a crucial area by keeping the electorate ignorant of the actual road ahead."

Michael D. Tanner of the Cato Institute has also critically analyzed the current health care reform package in brief but informative articles such as "Obamacare to Come: Seven Bad Ideas for Health Care Reform", "Halfway to Where? Answering the Key Questions of Health Care Reform" and "The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World".

Among Tanner's conclusions:
  • Contrary to the Obama administration's repeated assurances, millions of Americans who are happy with their current health insurance will not be able to keep it. As many as 89.5 million people may be dumped into a government-run plan.
  • Some Americans may find themselves forced into a new insurance plan that no longer includes their current doctor.
  • At a time of rising unemployment, the government would raise the cost of hiring workers by requiring employers to provide health insurance to their workers or pay a fee (tax) to subsidize government coverage.
  • Every American would be required to buy an insurance policy that meets certain government requirements. Even individuals who are currently insured — and happy with their insurance — will have to switch to insurance that meets the government's definition of "acceptable insurance."
  • Americans will pay more than $820 billion in additional taxes over the next 10 years, and could see their insurance premiums rise as much as 95 percent.
  • The current health care bills will increase the budget deficit by at least $239 billion over the next 10 years, and far more in the years beyond that. If the new health care entitlement were subject to the same 75-year actuarial standards as Social Security or Medicare, its unfunded liabilities would exceed $9.2 trillion.
  • While the bills contain no direct provisions for rationing care, they nonetheless increase the likelihood of government rationing and interference with how doctors practice medicine.
  • Contrary to assertions of some opponents, the bills contain no provision for euthanasia or mandatory end-of-life counseling. The bills' provisions on abortion coverage are far murkier.
Looking at countries with nationalized health care systems, Tanner points out that theses systems have serious problems and should not be the model for America. Though per capita expenditures for health care may be less, the following troubling facts are also true:

  • Health insurance does not mean universal access to health care. In practice, many countries promise universal coverage but ration care or have long waiting lists for treatment.
  • Rising health care costs are not a uniquely American phenomenon. Although other countries spend considerably less than the United States on health care, both as a percentage of GDP and per capita, costs are rising almost everywhere, leading to budget deficits, tax increases, and benefit reductions.
  • In countries weighted heavily toward government control, people are most likely to face waiting lists, rationing, restrictions on physician choice, and other obstacles to care.
  • Countries with more effective national health care systems are successful to the degree that they incorporate market mechanisms such as competition, cost sharing, market prices, and consumer choice, and eschew centralized government control.
Tanners also finds that in these countries "the broad and growing trend is to move away from centralized government control and to introduce more market-oriented features."

Conservative commentator Chuck Norris (yes, that Chuck Norris) also has contributed a helpful article, "6 Reasons Obama-Care Is Bad Medicine. "

Norris shows that unnecessarily rushed policy-making, hugely increased deficits, greater burden on the American taxpayer, creation of more inefficient, expensive Federal bureaucracy, stifling of competition and innovation are all solid reasons to reject Obamacare. Unfortunately with a Democratic majority in Congress and the mad rush to pass this legislation, Americans may very well end up with a "reformed" system that brings us further along the road to socialism and at the same time does little to improve the quality or expense of health care.

Get educated and make your voice heard-- tell your Senator you don't want ObamaCare! Join with the many organizations fighting on behalf of the unborn who are therefore also fighting hard to keep Congress from passing versions of this legislation that include hugely expanded abortion coverage at taxpayer expense.

Further resources
Americans United for Life
Ideas for Free-Market Health Reform
Susan B. Anthony List
10 Reasons ObamaCare Is Bad for Your Health and Your Pocketbook
Defend Your Health Care

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