Sheldon Richman makes the case that health care reform is far from dead, in spite of last week’s election results in Massachusetts. Why? Because the ideologues on Capital Hill will not suddenly see the light and recognize their desire to micromanage the delivery of medical care and health insurance as the gross infringement of liberty that it is, rather they will just change their approach in accomplishing their ends.
It’s simple: In place of 2,000-page omnibus monstrosities, we are likely to see a series of micro “reforms” — that is, government interventions — that may well garner bipartisan support. The new buzzword on Capitol Hill is “incrementalism.” This is a strategy to break the big House and Senate bills into several small ones — to slice the salami into manageable portions. Instead of one 2,000-page piece of legislation, we might see ten 200-pagers, or perhaps 100 20-pagers.
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Instead we’ll probably see bills that embody most of the elements of President Obama’s, Speaker Pelosi’s, and Majority Leader Reid’s proposals. But since the series of small bills won’t look like an overambitious program to reinvent 16 percent of the U.S. economy in one unreadable fell swoop, much of the congressional opposition could be defused. Its previous talking points and photo ops regarding legislation that stacks three feet high will be useless.
So beware of “small, bi-partisan” ideas regarding health care we may see coming out of DC. Remember that the flaws in the current health care system are a result of a series of previous government interventions. Future interventions, no matter how small they may appear, will only lead to more interventions. Over the course of several years, we’ll find ourselves trapped in a government-run system wondering what happened.
Folks who have so vigorously opposed the mammoth proposals need to keep up the intensity in opposing future “incremental” changes – because we know what their endgame is.
This morning the NC Joint Legislative Healthcare Oversight Committee met to discuss the progress of health care initiatives in the state as well as future funding for new and existing programs. Another topic briefly discussed was the projected effect of national healthcare reform on North Carolina.
Dr. William Roper, the Dean of the UNC School of Medicine, addressed the legislature on some of the most pressing challenges in the state’s public hospital system. Among these the $300 million gap facing North Carolina hospitals as a result of uncompensated medical care – less than 12% arising from treating uninsured patients.
Of high concern was the Federal Government’s willingness to expand Medicaid by lowering the eligibility requirements to bring more people into the system. The current Medicaid reimbursement rate to hospitals does not cover the total cost of care and forces hospitals to raise its rates to private insurance.
In simple terms, increased payments from private insurance, not government subsidies, are covering the $300 million gap. Inevitably when private insurance is getting charged higher rates by hospitals, consumers pay higher premiums. The only thing that will be accomplished by the government expanding Medicaid is the continued rise of unfunded medical care liability in public hospitals and the eventual rationing of care.
Dr. Roper provided an interesting perspective. Covering the number of uninsured in the state at Medicare rates would reduce the unfunded cost of care slightly, but losing the financial support of private insurance would make the system exponentially worse off.
With the death of the debate over the public option Senate leadership has turned its sights to a hefty expansion of government programs already in existence – namely, Medicare and Medicaid.
As seen by the numerous closed door meetings in the past two weeks, Democratic leaders are set on ensuring the success of this new effort – as it could very well be the last hope they have to secure a government-run healthcare system. But many (including many in the Senate) are starting to realize just what a move like this could mean for taxpayers, not to mention the deficit.
The Associated Press reports today, Democrats don’t have the votes needed to pass this proposal. Perhaps this is why:
Let’s look at Medicare. Along with Social Security, Medicare already represents the nation’s largest unfunded liability. According to the Social Security and Medicare Trustees Reports for 2009, Medicare alone has an unfunded liability of almost $38 trillion. Medicare in fact consumes 47 percent of total health care spending in the country. Now add services and benefits for another 10 million people, the 55 and up crowd.
Result = crowd out of private insurance (an estimated 17 million people) further burdening the system, followed immediately by underpayment of doctors and hospitals, leading inevitably to less accessibility and availability of care and yes, higher premiums and higher taxes for all – resting on a government program that is teetering near the edge of bankruptcy.
Lowers health care costs and reduces the deficit? – not so much.
Sounds a lot like single payer, though, doesn’t it? …
Reid’s health bill is 2,074 pages and 371,949 words in length, and uses the word “tax” 183 times. According to CBO it spends $848B, raises taxes $486B, cuts Medicare/Medicaid $436B ($330B+ Medicare), and leaves 24M uninsured.
In an N&O article, Sen. Kay Hagan says, “I think people have to get their heads around this, that we can’t continue where we are right now …We’re in a window of opportunity right now, and it’s time for health care reform in our country.”
Reform – yes. The type of liberal reform Congress is proposing that will result in a higher deficit, higher taxes, and higher insurance premiums for everyone – NO.
The window of opportunity Sen. Hagan refers to might be quickly shrinking for the Democrats in Washington. The House bill was passed by an astonishingly slim margin – Democrats loosing 39 votes in the process. Change is beginning but not in the way Democrats envisioned last November. Republicans swept the gubernatorial elections in 2 key states NJ, and VA. And what if the 2010 Congressional election was held today? According to a Gallup poll registered voters prefer Republicans for the House 48% to 44% – a marked shift since the health care debate took center stage earlier this summer.
In North Carolina 53% of voters are opposed to the type of health care reform Congress is currently discussing.
The American public has demonstrated their disapproval – the Senate would do well to listen.
The Finance Committee health care reform bill would extend Medicaid eligibility to 133% of the Federal Poverty Level (the HELP Committee bill would extend it to 150% FPL).
What does a 44.2% enrollment increase mean for the state’s Medicaid program which is expected to lose $1.5 billion this year from 2009 budget cuts, will receive $440 million less from the federal government next year, and has already been forced to make significant and unpopular cuts to mental health spending and elderly care services?