NEOAVATARA

c/o Michael Ramirez, IBD

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/15/AR2009061501545.html

The Health Care debate has been heating up in the last few days.  This week, the CBO estimated that Democrats plan to cover health care will cost, at the low end, $1.6 Trillion…or more than 50% more than Obama has stated.  Another CBO report said that if they implement the Public option, and slowly roll it in, that 15 million of the 45 million people now without insurance could be covered; at a cost of $1 trillion. $1 trillion for a 1/3 solution?  Not much of a bargain for a public option that is supposed to ‘reduce costs’.  And the public is starting to notice.

So when Democrats talk about the ‘Public option’ on medical care, what are they talking about?

Let us simplify it:  they are talking about making Medicare universally available.  They want a similar program to cover people from birth to death.

Here is the problem:  Medicare has no answers to the major problems with our health care system either.

That’s the message of a report yesterday by a commission that advises Congress on the federal medical program for older Americans.  To eliminate wasteful spending, policymakers must transform economic incentives for doctors, hospitals and other providers of medical services — though it isn’t clear how, according to the report.

To illustrate what it might take to save Medicare, the commission describes how primary-care doctors, specialists and hospitals could be reorganized into “accountable care organizations” (commonly referred to as ‘bundling payments’) whose members would receive bonuses if the organizations met quality and cost targets. To ratchet up the incentives, health-care providers that fail to meet cost and quality targets could be penalized, the report says.  Even then, any projected savings would be highly uncertain, the report says. What is certain is that Medicare cannot maintain its current trajectory, it adds:

“If current spending and utilization trends continue, the Medicare program is fiscally unsustainable. . . . Part of the problem is that Medicare’s fee-for-service payment systems reward more care — and more complex care — without regard to the quality or value of that care.”

Yes.  This is the system that Barack Obama wants to bring to your front door.  Some Democrats, including Tom Daschle, are asking Obama to move past the public option for a number of reasons.  Daschle has joined a bipartisan commission called the Bipartisan Policy Center with George Mitchell, Bob Dole, and Howard Baker calling for a much more conservative health care plan…one that is surprising closer to my own health care plan.

Even worse, Mr. Obama is not telling the truth on this issue.  Many groups (such as the American Medical Association and Insurers of America) are against this, because they believe that this will push private insurers out.  Mr. Obama accused people like me of lying about this.  Is he calling liberal Democrat Russ Feingold a liar? Because Feingold has clearly stated that the public option will lead to a single payer system.  I am sorry, but it is not me that is failing to tell the truth.  I ask one simple question:

How many totally independent health care plans are there for people over age of 65?

The answer is none.  Yes, there are some HMOs and others that work with the government Medicare system, and provide care.  But totally independent?  There are none. Why?  Because Medicare has such a price advantage and monopoly, that there is no competition to be had.  Second, the monopoly is like any other monopoly…smaller players have great trouble competing.  Furthermore, once you give a ‘free’ option, who would choose to pay for it?

People will argue that if Medicare is cheaper, why not continue with it?  Simple:  it is not significantly cheaper.  For one, many of the costs in Medicare are hidden costs; the government shows them in other accounting methods, and not clearly within the Medicare system.  Second, health insurers pay corporate taxes, while Medicare dollars don’t.  And since the Medicare fund is going to run out in less than a decade, those tax dollars are essential to the long term funding of Medicare.  Additionally, in some senses private insurance already subsidizes public insurance.  The public systems (Medicare, Medicaid, and the Veterans Affairs Administration) don’t pay enough to meet costs…so those costs are shifted to patients with private insurance.  Ed Morrissey at AIP has an excellent, more detailed explanation of this.

Second, how does Medicare keep costs low?  Easy:  they ration.  They ration care to patients, and ration payments to doctors.  It is estimated that doctors and hospitals only get around 30% of what they bill.  Let me ask you:  if you went to work , and your boss paid you 1/3 of what he said he would pay you, how would you feel?

Oh, and if you don’t think this is an authoritarian?  Listen to this:

Getting doctors to join accountable care organizations may require pressure, MedPAC Executive Director Mark E. Miller told reporters: “If you want people to voluntarily organize, you may want to make sure that the current system isn’t as pleasant a place to be.”

Understand the repercussions.  Doctors already are stretched to the breaking point, even though they make good incomes.  What will they do if you restrict their incomes even further?  They will provide less service.  They have no incentive to provide after hours services, weekend services, etc.  Right now, they do those things because it is financially beneficial for them to do it.  You think hospitals can or will maintain the same level of services they do now, if they get even less funding?  Of course not.  Government officials would like to think physicians would remain static in their actions:  that is a true lie.

So in short, we come down to the simple reality, no matter what name calling Mr. Obama is involved in:  the only way the Mr. Obama’s plan reduces costs is by rationing, one way or another.  That is a fact, Mr. President.