October 1, 2009
Nothing for Everyone
Just about all of us want some kind of health care reform. But different people want different things from that reform. One trouble with crafting legislation that would make some people happy is that it would make other people unhappy. But the proposals put forth so far by Democrats, and supported by President Obama, have the unique gift of satisfying virtually no one. ObamaCare, inasmuch as there is such a thing, is bound to disappoint you, no matter what you'd like to see in health care reform.
If you think you'd get free health care, you wouldn't. Instead, you'd be forced to buy health insurance, under threat of prison and enforced by the IRS. If you prefer spending your money on a better apartment over health insurance, and then taking your chances of going bankrupt if you get really sick or in a bad accident, you would no longer have such a choice.
If you think you'd get to keep your current insurance, that would only be possible if that same policy continues to be offered by whoever is providing it now. If your employer pays for your health insurance, you have no guarantee whatever. In fact, your employer would be incentivized to change or drop your coverage. Government would mandate what insurance must cover, meaning a comprehensive, low-deductible plan for everyone. If your current plan provides "catastrophic" coverage with a high deductible, get ready to shell out another $10,000 per year for family coverage. Say good-bye to Health Savings Accounts, too.
If you think ObamaCare would save you money on your current plan, it wouldn't. There is nothing in the proposed legislation that promises to reduce health costs in any significant way. There is nothing in it to reform medical torts (lawsuits) and therefore minimize the costs of "defensive" medicine (unnecessary tests or surgeries, etc.). The added bureaucracy would add new layers of cost. And there would be plenty of new taxes and fees to make sure you'd be paying more, on top of your insurance premiums.
If you think ObamaCare would stave off the bankruptcy of the government, it wouldn't. In fact, it would hasten it. It would not save the government money; it would cost it more. One trillion dollars more over 10 years.
If you think you would start getting some immediate help from it, you wouldn't get anything immediate at all, except taxes. (Not that help would come later, either.) The health care changes would not become effective until 2013 at the earliest, or after President Obama's current term is over. However, the new taxes enacted by the legislation would start taking effect immediately.
If you think a "public option" is required to provide competition among health insurance providers, it isn't. Obama is selling it as a way to provide market competition. But at best, it would add one more choice, and a lousy one at that. (Obama himself said it would be like the Post Office compared to FedEx and UPS.) A simpler and cheaper option is to allow health insurance to be bought across state lines. That would not only add hundreds of insurance plans to the competition, it would save the government money -- $7.4 billion over 10 years. But Obama refuses to even consider it.
If you think ObamaCare would insure everyone, the CBO estimates it would leave about 36 million people uninsured even after full implementation. If you think ObamaCare would at least reduce the number of uninsured, I hope you're not thinking too big. Because 95% of us, insured or uninsured, would have the same status then as now. The other 5% would become insured, but mostly by being forced to buy their own insurance.
You might wonder why Congress exempted itself from health care reform. Congresspersons and their families would continue to get the Cadillac coverage they've had up to now. Congress is the only group of people who can genuinely rest assured that they won't be required to change health providers under this legislation.
If you think you'd get a Canada-like system, you wouldn't. In fact, President Obama said it is his critics who claim that would happen. So if you like a single-payer, government-run system, this isn't it, at least not any time soon. It is true that ObamaCare would provide incentives to kill off existing private health insurance and would insert a public option to be the only survivor. But the evolution to single-payer would take years, require new legislation and involve years of declining choice and quality in health care in the mean time.
That leaves two small groups who might have something they like in ObamaCare: Congress, who would get the same great coverage they get today, at taxpayer expense; and people who are so in love with single-payer, government run health care that they are willing to let the whole system falter and ultimately collapse so that their dream might come true in perhaps 20 years or more. The Communist Party falls under the latter category.
So I guess ObamaCare does offer something beneficial for two small groups of people: Congress and communists. I don't know about you, but I'm in neither category.
Randall Hoven can be contacted at randall.hoven@gmail.com or via his web site, randallhoven.com.
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