"Congress is moving quickly to add $2 billion to the government's "cash for clunkers" program Friday, after strong demand threatened to swamp the program."Great. Now each dealership can sell (on average) 36 cars in the program.
In considering whether to expand the government's role in the delivery of health care or in health care insurance, it is worth looking at Medicare and Medicaid.
These two huge programs already make the government the largest player in the health care industry. The profligate nature of these two programs should raise lots of doubt about the Obama program doing anything but "busting" the budget.
In 1968 total spending by the federal government was $178.1 billion dollars. Forty years later in 2007, total spending had risen to $2,728.9 billion dollars. So the budget of the U.S. increased in dollar terms 15.3 times in that 40-year span.
But all programs did not rise in unison. Some rose more, others less.Rudy Boschwitz and Tim Penny
Outlays for Social Security rose from $23.3 billion in 1968 to $581.4 billion in 2007, an increase of 25 times. So Social Security drove the budget higher at a substantially faster rate than the budget rose as a whole.
Medicare rose from $5.1 billion in 1968 to $436.0 billion in 2007 an astounding increase of 85.5 times over the 40-year period. Will Obama-Care be better?
When Medicare was being considered in the mid-1960s, the government projected that the outlays for the program 25 years down the road would be $10 billion. Instead, in 1990, 25 years later, the outlays were $107 billion. Government estimates were off by a factor of more than 10!
Medicaid, the other large medical program currently in effect, outdid Medicare. Medicaid outlays in 1968 were $1.8 billion. In 2007 they had risen to $190.6 billion, an increase in dollar terms of 105.9 times.
And that is only the Federal outlay number. There is a roughly equal Medicaid amount spent by the states due to federal mandates. Without those mandates we would not be reading about the large deficits that most states endure.
The idea of expanding the federal role in the medical arena is truly fiscally irresponsible. The claim that money will be saved through government competition with the private insurance system (with government setting the rules!) is the height of fantasy.
"Imagine the sort of car you’d drive if government regulations made it illegal to sell any automobile that didn’t feature 380-horsepower direct-injection V6 engines, computer-controlled electric power steering, eight-speed automatic transmission, four-wheel-drive, automatic climate control, “smart key’’ technology, touch-screen navigation, backup cameras, LED headlights, acoustic glass, surround-sound stereo, and leather seat stitching.
What is true of transportation is true of everything else: Increase the number of amenities that a product or service must include, and more consumers will be unable to pay for that product or service. That is why one of the simplest strategies for making health insurance more affordable is to reduce the minimum number of benefits that insurers are required to cover.
In every state in the union, legislators and regulators drive up the cost of healthcare by making insurance policies more comprehensive. Rather than allow the free market to determine which medical services health plans will cover, states force consumers to pay for an array of covered benefits they may not need or want.Jeff Jacoby
As it is, health insurance in Massachusetts - which already mandates coverage for more than 40 itemized benefits, providers, and patient populations - is among the nation’s most expensive. The last thing the Bay State (or any state) needs is for government to drive the cost of medical coverage higher still. It should be left to the market, not to lawmakers and lobbyists, to decide which medical services should be included in a basic-vanilla insurance policy. When lawmakers yield to special-interest pleas that this or that benefit be made compulsory, the results are less choice, higher premiums, and more individuals priced out of the market."
Mass. medical leaders wary of healthcare overhaul’s cost
"If you want to know how the proposed overhaul of the US healthcare system may play out nationally, talk to top executives at the biggest medical and life sciences companies in Massachusetts.
As the heads of leading hospitals, insurers, and biotechnology companies, they have dealt with the complexities of near-universal healthcare since 2006, when Massachusetts became the first state to mandate insurance coverage. That gives them a unique perspective on the national effort to overhaul healthcare.
As the debate in Washington heats up, local executives warn that two goals of the Obama administration - expanding insurance coverage and controlling spending - may prove incompatible. And as Massachusetts strains to deal with the increasing costs of its successful healthcare program, they raise questions about who will pay for the projected $1 trillion cost on the federal level.Robert Weisman, Boston Globe
“Healthcare isn’t free, and if more people want an MRI on demand, that isn’t going to reduce costs or improve care,’’ said Ellen M. Zane, president of Tufts Medical Center in Boston. To make reform work on such a big scale, Zane said, the burden will have to be shared by providers, insurers, employers, and patients."
"President Obama has been a fierce and relentless critic of America's medical care. Indeed, it's hard to recall when, if ever, he has had anything good to say about our private health care system.Donald Lambro
Throughout his presidential campaign and the first six months of his presidency, he has made a practice of attacking just about every sector of our nation's health care business: Hospitals are inefficient, wasteful and inept. Insurance companies charge way too much and make obscene profits. The pharmaceutical industry overcharges for the drugs it produces, despite research costs in the hundreds of billions of dollars and millions of lives saved and prolonged._________________________
"If the federal government is allowed to
expand its role in medicine, our country
will see the long waiting lines for care...
and the medical discovery and innovation
that has saved and enhanced lives across
the country will end."
_________________________
His generic mantra is that our health care system is dysfunctional and that despite all the medical tests and high-tech, diagnostic breakthroughs we've invented, we're not any healthier than before."
Really? Has Mr. Obama missed the medical revolution our health care system has undergone in recent decades? The wonder drugs that keep Americans alive and active; the less invasive microsurgery that shortens hospital stays, cuts costs and hastens recovery; the new PET (positron emission tomography) scans that spot cancers early enough to save lives; and the many health insurance plans for a wide variety of incomes.
How is it that Mr. Obama, who is not a doctor, can have a dismal and critical view of America's health care system that is so sharply at odds with how our medical leaders see the present system?
"Congressional advocates of the latest health care reform proposal claim that it will not cost ordinary Americans more--the costs will be borne by "the rich" and by employers. After all, both the House and the Senate versions require employers who do not provide health benefits to pay higher taxes.James Sherk and Robert A. Book, Ph.D._________________________But the Congressional Budget Office (CBO) recently reported what economists have long known: Regardless of who is formally required to pay, the burden of these taxes and costs will ultimately fall primarily on employees through lower wages. An employer mandate does not give workers without health insurance something for nothing but rather forces them to purchase it out of their wages whether they like it or not--and no matter how low those wages are. Congressional rhetoric to the contrary, much of the burden of paying for an employer mandate will fall on ordinary Americans, and lower-income workers will be hit the hardest."
Congressional rhetoric to the contrary...
paying for an employer mandate will fall
on ordinary Americans, and lower-income
workers will be hit the hardest."
_________________________
"First, Congress should give Medicare enrollees a voucher, let them choose any health plan on the market, and let them keep the savings if they choose an economical plan. Medicare could even give larger vouchers to the poor and sick to ensure they could afford coverage.Michael F. Cannon_________________________
And nobody spends other people's money
as carefully as they spend their own.
_________________________
Second, Congress needs to give consumers who purchase their own coverage the same tax break as workers with job-based coverage. Leveling the playing field — whether with tax credits, a standard deduction for health insurance or "large" health savings accounts — would boost purchases of non-job-based coverage, which is critical to cutting the overall number of uninsured.
Americans deserve the freedom to purchase coverage across state lines. One study estimated that that move alone could cover 17 million uninsured Americans without costing taxpayers a dime. Compare that with Sen. Ted Kennedy's reform bill, which spends $1 trillion and covers just 16 million uninsured.
Finally, large HSAs would provide a tax relief even to those who are too sick to obtain coverage at all."
"We hear endlessly about how many Americans don't have health insurance. But, if we stop and think — which politicians hope we never do — that raises the question as to why that calls for government-controlled medical care._________________________
...Nothing is cheaper just because part
of the price is paid in higher taxes.
_________________________
A bigger question is whether medical care will be better or worse after the government takes it over. There are many available facts relevant to those crucial questions but remarkably little interest in those facts.Thomas Sowell
None of the people who are trying to rush government-run medical care through Congress before we have time to think about it are pointing to Medicare, Medicaid or veterans' hospitals as shining examples of how wonderful we can expect government medical care to be when it becomes "universal."_________________________
...Refusing to pay the costs is not the same
as bringing down the cost.
_________________________As for those uninsured Americans we keep hearing about, there is remarkably little interest in why they don't have insurance. It cannot be poverty, for the poor can automatically get Medicaid."
"On Friday, the House Ways and Means Committee approved a bill that would radically change our current system and expand coverage for the uninsured. The action came a day after the head of the Congressional Budget Office said none of the plans under review would slow health care spending. None of them.Investor's Business Daily
Still, lawmakers and the White House press on, relying on GOP weakness in the House and a new veto-proof majority in the_________________________Senate. They're also relying on a lack of awareness that claims made on behalf of national health care may be mostly false. Among them:
...less than 4% of a population of
305 million are unable to buy insurance.
For this we need to change the
current care that 89% like?
_________________________
America has a health care crisis -When it's all whittled down, as few as 12 million are unable to buy insurance — less than 4% of a population of 305 million. For this we need to nationalize 17% of our nation's $14 trillion economy and change the current care that 89% like?
Health care reform will save money - the CBO's current chief, Douglas Elmendorf says they'll lead to substantially higher costs in the future — costs that will be "unsustainable."
Only the rich will pay for reform - Workers who decline to take part will pay a tax of up to 2% of earnings. And small-businesses must pony up 8% of their payrolls. The poor and middle class must pay in other ways, without knowing it. The biggest hit will be on small businesses, which, due to new payroll taxes, will be less likely to hire workers.
Government-run health care produces better results - The biggest potential lie of all. In countries with nationalized care, medical outcomes are often catastrophically worse. Take breast cancer. According to the Heritage Foundation, breast cancer mortality in Germany is 52% higher than in the U.S.; the U.K.'s rate is 88% higher. For prostate cancer, mortality is 604% higher in the U.K. and 457% higher in Norway. Colorectal cancer? Forty percent higher in the U.K. Then there are the waiting lists. With a population just under that of California, 830,000 Canadians are waiting to be admitted to a hospital or to get treatment. In England, the list is 1.8 million deep.
The poor lack care - Many may lack insurance, but that doesn't mean they lack care."
"We own our cars, are responsible for the cost of maintaining them, and decide what needs fixing based partly on balancing the seriousness of the problem against the expense of repairing it. Our health-care system rests on the principle that, although we own our bodies, the community or state ought to be responsible for paying the cost of repairing them. …The concept of reimbursable health-care service rests on the premise that the medical problem in need of servicing is the result of involuntary, unwanted happenings, not the result of voluntary, goal-directed behavior. Leukemia, lupus, prostate cancer, and many infectious diseases are unwanted happenings. Are we going to count obesity, smoking, depression and schizophrenia as the same kinds of diseases?
…Everyone recognizes that the more fully we wish insurance companies to defray our out of pocket expenses for our car repairs, the higher the premium they will charge for the policy. Yet foregoing reimbursement for trivial or unnecessary health-care costs in return for a more suitable health-care policy is an option unavailable under the present system …
The idea that every life is infinitely precious and therefore everyone deserves the same kind of optimal medical care is a fine religious sentiment and moral ideal. As political and economic policy, it is vainglorious delusion. Rich and educated people not only receive better goods and services in all areas of life than do poor and uneducated people, they also tend to take better care of themselves and their possessions, which in turn leads to better health. … We must stop talking about "health care" as if it were some kind of collective public service…No government can provide the same high quality body repair services to everyone …
If we persevere in our quixotic quest for a fetishized medical equality we will sacrifice personal freedom as its price. We will become the voluntary slaves of a "compassionate" government that will provide the same low quality health care to everyone.
"Market dominance doesn't necessarily mean insufficient competition. Microsoft's dominance of software didn't prevent the rise of Google, and Google's dominance of search-engine traffic didn't prevent Microsoft from offering Bing. If a few health insurance providers were suppressing competition at the expense of consumers, you'd expect to see obscene profits. But net profit margins in the business run about 3 percent, only slightly better than the median for all industries.
There are reasons, though, to think that the president's real enthusiasm is not for competition but for government expansion. Free-market advocates want to foster competition by letting consumers in one state buy coverage offered in other states. If WellPoint has more than half the business in Indiana, why not let Indiana residents or companies go to California or Minnesota to see if they can find options that are cheaper or better?Steve Chapman, Chicago Tribune
But the administration and its allies show no interest in removing that particular barrier to competition. Maybe that's because it would reduce the power of state regulators to boss insurers around.
Nor does Obama believe in fostering competition in other health insurance realms -- such as existing government health insurance programs. John Goodman, head of the National Center for Policy Analysis, suggests letting Americans enrolled in Medicare, Medicaid and the State Children's Health Insurance Program (SCHIP) select a voucher to buy private coverage if they want. Don't hold your breath waiting for the administration to push that idea."
"Under current law, the federal budget is on an unsustainable path, because federal debt will continue to grow much faster than the economy over the long run. Although great uncertainty surrounds long-term fiscal projections, rising costs for health care and the aging of the population will cause federal spending to increase rapidly under any plausible scenario for current law. Unless revenues increase just as rapidly, the rise in spending will produce growing budget deficits. Large budget deficits would reduce national saving, leading to more borrowing from abroad and less domestic investment, which in turn would depress economic growth in the United States. Over time, accumulating debt would cause substantial harm to the economy."Douglas W. Elmendorf, Director
"Vice President Joe Biden told people attending an AARP town hall meeting that unless the Democrat-supported health care plan becomes law the nation will go bankrupt and that the only way to avoid that fate is for the government to spend more money."So we have to spend more money on health care so the nation does not go bankrupt? If anyone can explain that logic to me, please contact me.
"Private for-profit clinics are a booming business in Canada -- a country often touted as a successful example of a universal health system.We have been saying all along that a national health plan will result in 1) Rationing of care and 2) a two-tier system.
Facing long waits and substandard care, private clinics are proving that Canadians are willing to pay for treatment.
"Any wait time was an enormous frustration for me and also pain. I just couldn't live my life the way I wanted to," says Canadian patient Christine Crossman, who was told she could wait up to a year for an MRI after injuring her hip during an exercise class. Warned she would have to wait for the scan, and then wait even longer for surgery, Crossman opted for a private clinic.
…"No question, it was worth the money," said Crossman, who paid several hundred dollars and waited just a few days.
..."I think there is a fundamental shift in different parts of the country that's beginning to happen. I think people are beginning to realize that they should have a choice," says Luc Boulay, a partner at St. Joseph MRI, a private clinic in Quebec."
"According to the CBO, the legislation would add $1 trillion to the deficit over the next 10 years, while covering only about 16 million more people with health insurance. For that amount of money, we could simply write checks to all of the uninsured.Israel Ortega
Another Senate Democratic proposal, the Senate Finance Committee bill, is expected to cost $1.5 trillion. That's a lot of money. In fact, if one were to have spent a million dollars every year since the time of Jesus' birth, it would still not come to a trillion dollars.
Of course, this liability would be on top of the government's unfunded liabilities -- benefits already promised but not paid for -- of Social Security and Medicare."
Why do we need President Obama's big-bang health care reform at all?Lawrence KudlowYes, they need help. And yes, they should get it. But not with mandatory universal coverage, or new government-backed insurance plans, or massive tax increases. And certainly not with the Canadian-European-style nationalization.
- 89% of Americans are satisfied with their health care. That means up to 250 million people could be happy with their plans.
- In a new Pew Research Center poll, only 41% of those surveyed believe the U.S. health care system needs to be completely rebuilt. In early 1993, when Mr. and Mrs. Clinton started on health care reform, 55% said the system needed a complete overhaul. So something has changed.
- In a new CBS-New York Times poll, 38% say the economy is the most important problem facing the U.S., 19% say jobs and only 7% say health care.
- According to the Census Bureau we don't have 47 million folks who are truly uninsured. When you take college kids plus those earning $75,000 or more who choose not to sign up for a health care plan, roughly 20 million people are removed from the list of uninsured.
- After that you can remove the 10 million who are not U.S. citizens and the 11 millioneligible for SCHIP and Medicaid but for some reason have not signed up for those programs. That leaves only 10 million to 15 million people among the long-term uninsured.
- And remember, existing health care entitlements are estimated to be roughly $80 trillion in the hole over the decades to come. Wouldn't it make sense to solve these bankrupt entitlements before we layer on new ones?
So why is it that we need Obama's big-bang health care overhaul in the first place?
"Most Americans do want different health care: They want 2009 medicine at 1960 prices. Americans spent much less on health care in 1960 (5 percent of gross domestic product as opposed to 18 percent now). They also spent much less -- nothing, in fact -- on computers, cellphones, and cable and satellite television.George Will________________________Every product, from a jelly doughnut
to a jumbo jet, is rationed --
by price or by politics.
The conservative's task is to explain
why price is preferable.________________________Your next car can cost less if you forgo GPS, satellite radio, antilock brakes, power steering, power windows and air conditioning. You can shop for such a car at your local Studebaker, Hudson, Nash, Packard and DeSoto dealers.
...health care is increasingly competent. When the first baby boomers, whose aging is driving health-care spending, were born in 1946, many American hospitals' principal expense was clean linen. This was long before MRIs, CAT scans and the rest of the diagnostic and therapeutic arsenal that modern medicine deploys.
As market enthusiasts, conservatives should stop warning that the president's reforms will result in health-care "rationing." Every product, from a jelly doughnut to a jumbo jet, is rationed -- by price or by politics. The conservative's task is to explain why price is preferable. The answer is that prices produce a rational allocation of scarce resources."
"Regardless of how it was structured or administered, such a government-run plan would have an inherent advantage in the marketplace because it ultimately could be subsidized by American taxpayers. The government plan could keep its premiums artificially low or offer extra benefits since it could turn to the U.S. Treasury to cover any shortfalls. Consumers naturally would be attracted to the lower-cost, higher-benefit government program, thus undercutting the private market.
A government program also would have an advantage since its enormous market presence would allow it to impose much lower reimbursement rates on doctors and hospitals the way Medicare and Medicaid do today. Providers would shift their costs to private insurance, driving up premiums, making private insurance even less competitive with the taxpayer-subsidized public plan.
...To see how this would work, one need only look to other areas where the government has set up insurance programs "in competition" with private insurance, such as crop insurance, flood insurance or some workers' compensation plans. The government programs have squeezed out private competition."
Ava Isabella Stinson was born last Thursday at St. Joseph's hospital in Hamilton, Ontario. Weighing only two pounds, she was born 13 weeks premature and needed some very special care. Unfortunately, there were no open neonatal intensive care beds for her at St. Joseph's — or anywhere else in the entire province of Ontario, it seems.
Canada's perfectly planned and cost-effective system had no room at the inn for Ava, who of necessity had to be sent across the border to a Buffalo, N.Y., hospital to suffer under our chaotic and costly system. She had no time to be put on a Canadian waiting list. She got the care she needed at an American hospital under a system President Obama has labeled "unsustainable."IBD editorial
...It must be embarrassing to Canada that a G-7 economy and a country of 30 million people can't offer the same level of health care as a town of just over 50,000 in rural Montana. Where will Canada send its preemies and other critical patients when we adopt their health care system?
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