The National Right to Life Committee on Thursday released a new report, “The Affordable Care Act and Health Care Access in the United States.” Burke Balch, director of the Robert Powell Center for Medical Ethics there talked with National Review Online about it.
KATHRYN JEAN LOPEZ: What is the National Right to Life Committee doing opposing Obamacare? That’s got to be a question on people’s minds who do not quite see the law as you do. Shouldn’t NRLC be pro-health-care reform?
BURKE BALCH: There are, of course, many ways to reform health care — some better than others. The wrong way, embodied in Obamacare, is to limit the health care Americans can receive. Since its inception, the National Right to Life Committee has been as committed to protecting the vulnerable born from euthanasia as to protecting the unborn from abortion, and we have recognized that when the government denies people life-saving medical treatment against their wishes, that is a form of involuntary euthanasia. That is why, while consistently advocating positive measures to protect access to life-preserving medical treatment, as well as to assisted feeding and hydration, the National Right to Life Committee fought the rationing in the Clinton Healthcare Plan in the 1990s and why it is fighting the rationing in Obamacare now.
LOPEZ: You put out a press release that says: “Obamacare is bad medicine for America.” If I’m an American fatigued by all this opposition to the president’s law, why should I read on?
BALCH: Ask yourself three questions:
1. Should the federal government limit what private citizens are allowed to spend on health care to save the lives of their family members?
2. Should the federal government limit how much life-saving medical treatment doctors are allowed to give their patients?
3. Finally, despite all the talk about Obamacare, did you know it does both of these? If not, read on!
LOPEZ: How does the “Excess Benefits” tax work and why is it of concern to the National Right to Life Committee?
BALCH: If your employer pays for your health insurance, any amount above a government-set limit will be taxed at 40 percent; the intent is to deter employers from offering pricey insurance. Remember the problem with the alternative-minimum income tax? Originally designed to target a few wealthy individuals who used tax deductions to avoid paying any tax, because of “bracket creep” it snared more and more middle-class Americans as inflation brought their nominal incomes above the trigger point for it. Only in 2012 was that trigger point permanently indexed to inflation.
The “Excess Benefits” tax will have a similar effect. The trigger point for it is indexed to the Consumer Price Index, but not to medical inflation, which since 1990 on average has annually exceeded the CPI by 3.3 percent, as documented on our website. Because that difference “compounds” like interest in the bank, by 2011 the medical inflation index stood at almost 1800, compared to a bit over 200 for the CPI index.
That means that over time, the value of employer-paid health insurance, adjusted for medical inflation, will shrink drastically, placing ever-greater downward pressure on the diagnostic tests and medical treatment that will be covered for life-threatening illness and injury.
LOPEZ: But the “excess benefits” business doesn’t come into effect until 2018. Why is this a priority for you now?
BALCH: As Politico has reported, “[The consulting firm] Towers Watson found that more than six out of ten employers said the fear of triggering [it] would influence their health-care benefit strategies in 2014 and 2015 . . . [E]mployers are . . . concerned that they’ll get busted for offering fairly standard plans.”
LOPEZ: What’s your beef with the exchanges and what people have access to there?
BALCH: It’s been widely reported that in many exchanges most or all of the available health-insurance plans have very narrow panels of health-care providers you can use, excluding top specialists and highly rated health-care centers, and in some cases forcing beneficiaries to go many miles away to get hospitals or doctors that will take their plans. But there’s been little attention to a key reason for this: A little-noticed provision in the law excludes from the exchanges plans offered by insurers who allow consumers to pay what the government deems an “excessive or unjustified amount” to save the lives and preserve the health of their family. It is as though the government set up marketplaces for automobiles, and only allowed people to buy subcompacts — “protecting” them from paying “too much” and buying a mid-sized car or minivan.
LOPEZ: Isn’t it only practical that a federal plan would place limits on what doctors can do?
BALCH: Not necessarily. To assist those who genuinely need help paying for health insurance, sliding scale subsidies could be provided to be used toward the cost of health insurance, and then we could rely on free-market competition to strike a balance between the costs and benefits of health care, without the government putting artificial constraints on what people are allowed to pay and doctors and insurers are allowed to provide.