Thursday, November 5, 2009

What's Wrong with Obamacare?

Why do conservatives and Republicans oppose health care reform?

(A brief summary for sharing with your friends.)

When millions are without health insurance and far too many people are driven to bankruptcy by their medical bills, why do Republicans want to maintain the status quo in health care?

The answer is simple: They don't.

First, do no harm.
Our health care system, for all it's wonders, has some serious problems. We need to fix them. We must also preserve what is good in the process.

Conservatives, Republicans, and many independents and even Democrats oppose the bills in Congress right now, and the principles laid out by Pres. Obama, because they will not preserve what is good in our health care system, and they probably won't even fix what's wrong.

Universal Health Care and Single-Payer
The goal of health care reform in its simplest form is "universal health care." We want everyone to have access to whatever they need.

Unfortunately, Democratic leadership prefers a single-payer system to accomplish this. That, ultimately, is what conservatives oppose.

But no bill currently in Congress calls for a single-payer system, and the President has specifically said he thinks that's an unwise approach, so why are conservatives determined to focus on this phantom menace?

Because Mr. Obama, many of his advisers, and many Congressional Democrats have said 1) they want to get to a single-payer system ultimately and 2) their current proposals are designed to lead us to a single-payer system.

Trojan Horse
How would this happen? An insurance exchange, co-op, or public option could be designed so only those truly in need of help can get in. But if a single-payer system is your goal, you can open it up so that other people can move into the government system.

If you want to maintain the private system, you make the public option (or co-op or whatever) charge reasonable market rates and use only those premiums to pay medical bills. But if you want to move to a single-payer system, you allow the public option to charge less than private insurers and have taxpayers cover shortfalls — undercutting the private insurers and running them out of business.

Any safeguards created today to prevent a public option from destroying private insurance can be removed later. Congress is famous for last minute, unrelated bill riders that no one knows about until it's too late. It would only take a few of these for a "safe" public option destroy the private insurance market.

The Problem with Single-Payer
So what's wrong with that? Would it be so terrible to have a government run health care system like the ones that are so successful in Canada and Great Britain?

They're not successful!

Britain, Canada, France, and all the rest have had the same experience — the system runs out of money and requires a fresh infusion of taxes again and again. In the end, they can't keep costs under control and just need more and more money.

The US government is already beyond broke. Can we really afford a single-payer system?

Cost Control
Of all the issues in our health care system, there is one that must be addressed. We have to rein in health care costs. It's not enough to just get everyone insured if the price of insurance keeps climbing. We can't simply cap the price of insurance or they will simply shut down.

We have to reduce the rate of health care inflation. Nothing that has been proposed by the Democrats will do that.

Most of what they've proposed will actually make things worse: Changing to a single-payer system will cause demand for medical care to increase while incentives to practice medicine decrease. The same number of doctors, possibly less, will be seeing many, many more patients.

At the same time, attempts to control health care costs by paying less for drugs or limiting who can get them will make investing in new medicines unprofitable.

In the end, quality of care will go down. And they know it.

The "Success" of Medicare
But we've had single-payer-ish systems in the US for years. Isn't Medicare a good example of how successful a government health care program can be?

Medicare is nothing we want to imitate. It's going to run out of money in the near future, and that's when it already pays less than it actually costs to treat patients. Putting everyone in such a program would destroy our health care system.

Medicaid, the VA, and the Indian Health Service are no better.

Which One?
Given the rousing success of the above programs as well as Social Security, FEMA, Cash for Clunkers, TARP, et cetera, ad nauseum, which government program is such a resounding success that you can point to it and say, "I want health care to run like that?"

The alleged goal of the various public options is to create competition in the health insurance industry. In many states, there are very few health insurance companies. This supposedly allows them to charge high premiums. A public option, proponents claim, will give people another option, thus lowering the cost of health insurance.

But these states only have a few insurance companies because of government regulations. And people may only buy insurance in their state by law. It would be a simple thing to allow people to buy health insurance across state lines; that would instantly add hundreds of competitors to these states with only two or three insurance companies. That's far more, and better, competition than adding one government program.

Besides, a competition with a public option will never really be fair. The government sets the rules, can demand whatever reimbursement rates it wants, and can always add taxpayer money if the program runs out. The private insurers can only compete as long as the government wants them to. Again, one midnight rider is all it would take to turn the whole thing on its head.

It's like me trying to play HORSE with Lebron James. If he wants to handicap himself, I might be able to make a decent showing. But if he decides to stop holding back, he's going to blow me away. That's not a competition.

In health care, it's a ticking single-payer time bomb.

Individual Mandate
As bad as the single-payer system is, it's hardly the only reason to oppose the current health care reform legislation. The individual mandate is a "glaringly unconstitutional" attempt to force people to buy health insurance.

Supporters claim this is no different than requiring people to buy auto insurance. Huh? Auto insurance laws require people to protect other people while they exercise the licensed privilege of driving. We do not need a license to breathe.

It's also just poorly done. In the Bauchus bill, at least, the fine for not having insurance is cheaper than buying it. It's almost as if they prefer folks pay the fine. That's no way to achieve universal coverage.

The Democratic health care reform proposals offer nothing in the way of meaningful or effective reform. And they're going to cost an insane amount of money. $1 trillion to extend health coverage to a few million people?

Size and Scope
And that's really the thing. We can insure everyone without a massive restructuring of our health car system. You only need a 2000 page bill if you're trying to slip something by the electorate. And for every little feature they intend to slip into those 2000 pages, another unintended consequence they neither want nor predict will manifest. Simplicity is our friend.

So why do conservatives oppose ObamaCare? Because it wants to do too much, will accomplish too little, and will cost far more than we can afford.


Jon said...

Excellent article; this sums up in clear and concise terminology exactly why Obamacare is a bad idea. I posted the link to my Facebook page, so hopefully more people will have a chance to read it.

ChrisB said...

Thanks, Jon, that was exactly what I was going for. Glad you found it useful.

Anonymous said...

Just one question to the "mother with two kids" who originated this blog - do you and your family have health insurance?

ChrisB said...

Yes, but Obamacare is a bad law whether I do or not.

Anonymous said...

Lots of opinion. No facts.

ChrisB said...

No facts? You mean other than that most senior Dems are on record saying Obamacare was intended to push us into single-payer? Or that everywhere this has been tried it has resulted in higher health care costs and lower service?

Anonymous said...

I'm from Canada. Our system is great. I would be bankrupt under your present system. You have already lost,its law, I am proud of Obama for standing up to corporate greed

ChrisB said...

"You have already lost, its law..."

You sound like an American liberal, not a Canadian one. In this country, no law is set in stone. Bad ones (and for that matter, good ones) can be undone -- and they are all the time.

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