Monday, August 03, 2009

Three Views Of Health Care

Let us examine three views of the health care debate today: What is right with the current system, why Obamacare is politically dead, and the alternatives likely to arise to Obamacare. First up, Scott Atlas at the conservative think tank the Hoover Institution with Ten reasons why America’s health care system is in better condition than you might suppose:
  1. Americans have better survival rates than Europeans for common cancers.
  2. Americans have lower cancer mortality rates than Canadians.
  3. Americans have better access to treatment for chronic diseases than patients in other developed countries.
  4. Americans have better access to preventive cancer screening than Canadians.
  5. Lower-income Americans are in better health than comparable Canadians.
  6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.
  7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.” Compare that to
  8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).
  9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain.
  10. Americans are responsible for the vast majority of all health care innovations.
Yes, we have the most expensive system in the world, that is what it takes to get those ten advantages for our people. Socializing our health care a la mode Obama would create a uniformly crappy system. The esteemed Charles Krauthammer tells us how President Obama has struck out in his bid to reform it.
Reforming the health-care system is dead. Cause of death? Blunt trauma administered not by Republicans, not even by Blue Dog Democrats, but by the green eyeshades at the Congressional Budget Office.

Three blows:
  • On June 16, the CBO determined that the Senate Finance Committee bill would cost $1.6 trillion over 10 years, delivering a sticker shock that was near fatal.
  • Five weeks later, the CBO gave its verdict on the Independent Medicare Advisory Council, Dr. Obama's latest miracle cure, conjured up at the last minute to save Obamacare from fiscal ruin, and consisting of a committee of medical experts highly empowered to make Medicare cuts. The CBO said that IMAC would do nothing, trimming costs by perhaps 0.2 percent. A 0.2 percent cut is not a solution; it's a punch line.
  • The final blow came last Sunday when the CBO euthanized the Obama "out years" myth. The administration's argument had been: Sure, Obamacare will initially increase costs and deficits. But it pays for itself in the long run because it bends the curve downward in coming decades.
The CBO put in writing the obvious: In its second decade, Obamacare significantly bends the curve upward -- increasing deficits even more than in the first decade.

This is obvious because Obama's own first-decade numbers were built on arithmetic trickery. New taxes to support the health-care plan begin in 2011, but the benefits part of the program doesn't fully kick in until 2015. That excess revenue is, of course, one time only. It makes the first decade numbers look artificially low, but once you pass 2015, the yearly deficits become larger and eternal.

Three CBO strikes and you're out cold.
So if Obamacare is dead, and Krauthammer gives us reason to be optimistic. President Obama must save face. I argued that the Obama health care bill would morph in to something more subtle... more sinister. What will the likely replacement look like? Oh no... it might look like Fannie Med.
[The] Senate is talking about government-sponsored co-ops, and that means multiple devils are in the details. Mr. Conrad confirmed this week that the current plan is to have the feds provide $6 billion in start-up cash, then appoint an “interim” national board to set policies for a network of state or regional co-ops. Mr. Conrad said this new network could attract 12 million people, making it the third-largest health insurer in the country.

Mr. Conrad suggests the federal board overseeing this network would be temporary, meaning at some point government appointees would be replaced by elected private directors. Mr. Grassley is said to be resisting federal control, but even if he succeeds for now, neither he nor Mr. Conrad can bind a future Congress. When was the last time government supervision became less onerous over time, especially in health care?

All of which makes these co-ops sound a lot like a health-care Fannie Mae and Freddie Mac, which Congress created because there was supposedly no secondary mortgage market. The duo proceeded to use their government subsidy to dominate the market and drive out private competitors.

Note that Barney Frank still manhandles the secondary mortgage industry, do you want him -- or anyone in congress -- on a Fannie Med congressional oversight board?

1 comment:

OBloodyHell said...

> do you want him -- or anyone in congress -- on a Fannie Med congressional oversight board?

It depends. Can we waterboard anyone on it? I might let Frank on any board where that is an option. Especially if we can do the activity in, oh, say, Egypt, rather than Gitmo...