Tuesday, August 11, 2009

Obama's health care proposal is only more of status quo and will only make matters worse.

Washington Post economics' columnist Robert Samuelson did a story on Obama's health care plan now in Congress, "Obama's Health Care Will Make it Worse."

Samuelson says Obama isn't doing what he said he would -- change the status.
Obama took a pass. He simply claims that his plan will do things it won't. What he's offering is an enlarged version of the status quo that, as he says, is already unsustainable.
Samuelson adds:
...open-ended reimbursement by government and private insurance has ballooned health spending despite repeated pledges to "contain" costs. For example, health payments for individuals rose from less than 1 percent of federal spending in 1965 to 23 percent in 2008.

Obama would perpetuate this system. No president has spoken more forcefully about the need to control costs. Failure, he's argued, would expand federal budget deficits, raise out-of-pocket health costs and squeeze take-home pay (more compensation would go to insurance). All true. But Obama's program would do little to reduce costs and would increase spending by expanding subsidized insurance. The House legislation would cut the uninsured by 37 million by 2018, estimates the Congressional Budget Office. The uninsured get care now; with insurance they'd get more.

"You'd be adding a third medical entitlement on top of Medicare and Medicaid," says James Capretta, a top official at the Office of Management and Budget from 2001 to 2004.

What would a debate over controlling health care costs really look like?
For starters, we wouldn't be arguing about how to "pay for" the $1 trillion or so of costs over a decade of Obama's "reform." Congress wouldn't create new benefits until it had disciplined the old. We'd be debating how to trim the $10 trillion, as estimated by CBO, that Medicare and Medicaid will spend over the next decade, without impairing Americans' health. We'd use Medicare as a vehicle of change. Accounting for more than one-fifth of all health spending, its costs per beneficiary, now about $12,000, rose at a dizzying average annual rate of 8.5 percent a year from 1970 to 2007. (True, that's lower than private insurers' rate at 9.7 percent. But the gap may partly reflect cost-shifting to private payers. When Medicare restrains reimbursement rates, hospitals and doctors raise charges to private insurers.)

Medicare is so big that shifts in its practices spread to the rest of the delivery system. But changing Medicare, and through it one-sixth of the U.S. economy, requires more than a few demonstration projects of "comparative outcomes" research or economic incentives. What's needed is a fundamental restructuring. Fee-for-service medicine -- Medicare's dominant form of payment -- is outmoded. The more doctors and hospitals do, the more they get paid. This promotes fragmentation and the overuse of services.

We should move toward coordinated care networks that take responsibility for their members' medical needs in return for fixed annual payments (called "capitation"). One approach is through vouchers; Medicare recipients would receive a fixed amount and shop for networks with the lowest cost and highest quality. Alternatively, government could shift its reimbursement of hospitals and doctors to "capitation" payments. Limited dollars would, in theory, force improvements in efficiency and effective care.

We're not having this debate. To engage it would require genuine presidential leadership, because, admittedly, these proposals would be hugely controversial. Medicare recipients -- present and future -- would feel threatened. Existing doctor-patient relationships might be disrupted. Spending limits would inspire fears of short-changed care. Hospitals, doctors and device manufacturers would object.
I think the answer, and Samuelson only mentions it in passing and indirectly, is restoring market forces to the health care system, e.g. vouchers for one. Government will have to stop offering everybody something for nothing. More government control and regulation will only make matters worse, e.g. rationing, less access to medical care for those with serious conditions, reduced quality of care, etc.

10 comments:

Elaine said...

Doesn't it get old to lead with fear and scare tatics?

Health care reform and or universal health care is pro christ and the fact that your against it is a sin.

I will pray for your greedy black souls.

Minnesota Family Council said...

Elaine,

If health care reform is "pro-Christ," and opposition to it is a "sin," then, by your own logic, you are "colonizing" and forcing your religious beliefs and "behavior" on other people.

Elaine said...

health care reform is pro christ.

and that is a reason for me to support it.

The fact that it also gives to ALL other religions, or non religous backgrounds makes it just morally correct period.

My opinion is that to not back it is immoral and is based on greed, and personal political reasoning.

The way it is expressed is with fear tatics



The first step is to take care of our own people in our own nation, all color all creed all behaviors and give care to them.

Elaine said...

here are facts... these things have have happened and proof that the only backing to anti health form is your political agenda.

* James Dobson, founder of Focus on the Family, opens his pre-recorded message with this opening salvo: "The health care bill being advanced by congress is the abortion advocates' dream come true."

* Charmaine Yoest, president of Americans United for Life, equates the health care plan to "a stealth agenda to impose FOCA ."

* Tony Perkins, president of the Family Research Council, made claims that are sure to be challenged by abortion rights advocates that the proposed health care reform will be a bailout bill for abortion clinics and groups like Planned Parenthood.

Blog mole said...

Elaine, Have you ever heard of spell-checker? Your views and inability to spell correctly indicate to me that you are ignorant. "Speak the truth in love". You are not speaking the truth nor are you saying it in love.

Claude said...

forget love lets talk numbers.

85% of People in Canada are happy with health care.

Elaine said...

I will not resort to insults. I do not hate anyone and I feel that the MFC has the right to their opinions and behavior even if I disagree with them and I have the right to think that that particular behavior is not right.

I want a country that gives to everyone and where everyone has health care coverage. I also believe that we as citizens should supply it.

I believe its pro christ like as well.

Troy said...

Vouchers don't work for education, they won't for healthcare. Can we find any more outdated "ideas" to pass for Republican discourse?

britney said...

Even i believe it..
___________________
Britney
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Elaine said...

vouchers are a ration idea so again your hypocritical in your own thoughts and comments