The cost-control provisions of the recent House and Senate drafts are thin to nonexistent. In effect, they amount to nothing more than hopes and exhortation. The reform will most likely broaden coverage with individual and employer mandates, restrictions on the ability of insurance firms to deny coverage, and creation of a new insurance exchange for individual purchasers — all along the lines of Massachusetts’ plan. But it will leave the structure and incentives that drive costs largely unaddressed. Overall, as in Massachusetts, health reform is going to substantially increase outlays, not cut them.
The administration’s own budget mentions (but fails to pay for) extra spending of more than $1 trillion over the next 10 years. Yet the White House is pressing for this reform because, it keeps telling us, controlling health care costs is such an overriding national priority.
Maybe the politics of this is very shrewd — assuming that the administration can continue to get away with the sleight of hand. Poll after poll shows that health reform is popular because voters are indeed worried mainly about rising costs. The problem of the uninsured comes farther down respondents’ list of concerns because most Americans have insurance and are satisfied with the services they receive. A key theme in presenting the reform policy is that households happy with their insurance will see no change: For most Americans, things will carry on as before. But one of the things that won’t change, if nothing changes, is the trend of rising costs.
You know, the more it gets out that the emerging Obama plan will do nothing to curb the rising costs of health care, the more trouble the plan–which many consider to be unstoppable–will encounter. And there is no reason why the plan should not encounter trouble, given how badly flawed it is.
On a related matter, the American Medical Association has come out against a public insurance option in any health care reform plan, based on the reasonable concern and objection that public options will allow for the private insurance market to be cut out, thus restricting patient choice and ultimately increasing costs. The AMA’s well-placed objections will only serve to stiffen the resistance against the Obama Administration’s vision of reform . . . which probably is why the Administration and is Democratic allies are telling Democratic lobbyists to strong-arm their clients into refusing to deal with Republicans in any way when it comes to crafting a bipartisan reform package.
Interesting. After having spent so many years denouncing Tom DeLay, Democrats are now working to be just like him. I trust the Democrats will no longer feel they have the high ground to denounce the K Street Project ever again, now that they have made it clear that they offer DeLay nothing other than the sincerest form of flattery.