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Critical Condition

NRO’s health-care blog.

Give Me Liberty, or Give Me Obamacare



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Remember back in June, in President Obama’s major address to the AMA, when he said the following? “No matter how we reform health care, we will keep this promise. . . . If you like your health-care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.” In the six months since, there seems to have been a change.

 

Obamacare would require Americans to buy government-approved health insurance. It would make it illegal to offer choices in insurance plans beyond the handful of very similar ones that the government would allow. It would become illegal to offer new and innovative plans. Under any of the government-approved plans, it would become illegal to pay your doctor directly for more than a certain percentage of your care. Higher deductible, consumer-driven plans would be severely altered or eliminated. By law, a greater percentage of money would have to be paid in insurance premiums, rather than directly for care. Competition and choice would diminish tremendously. One-size-fits-all conformity would rule the day. 

 

At its core, what Obamacare really means is a loss of freedom.

 

Obamacare would significantly diminish Americans’ freedom to control the fruits of their own labors and to spend them as they choose and as they think best. The Congressional Budget Office (CBO) reports that American taxpayers would be on the hook for approximately $2.5 trillion for Obamacare in its real first ten years in operation (2014 to 2023) — about triple the false number of $871 billion that the Democrats are spreading. As the CBO conveys, $871 billion only covers the cost of insurance coverage expansions, which is only a portion of the bill. Furthermore, less than 2 percent of the costs for what the Democrats are calling the bill’s “first-ten-year costs” would hit prior to the fifth year of that period.  So the Democrats are really giving the six-year costs — for insurance coverage expansions alone — and calling them the ten-year costs for the whole bill. Either the Democrats know this and are being deliberately deceitful, or else they don’t understand their own bill and are in over their heads even more than it appears.

 

In exchange for our significantly reduced freedom to contract with others in the manner of our own choosing, and our significantly reduced freedom to control the fruits of our own labor, one would hope that we would at least enjoy a corresponding drop in health-care costs. Instead, the Office of the Chief Actuary at the Centers for Medicare and Medicaid Services (CMS) says that health-care costs under Obamacare would rise in relation to current law, becoming 21 percent of the gross domestic product (GDP) by the end of 2019 in comparison to 17 percent today. Remember when President Obama said that we couldn’t continue spending 17 percent of our GDP on health care? For that matter, remember when President Obama talked about the crucial need to bend the health-care cost-curve down, vowing flatly that he wouldn’t sign a bill that did otherwise? The CMS Chief Actuary confirms that both the House and Senate versions of Obamacare would bend the cost-curve up.

 

The CBO also reports that, in its real first twelve years in operation (2014 to 2025), Obamacare would transfer $1.0 trillion from American taxpayers to private insurance companies. Ever wonder why insurers back Obamacare — even though they would no longer be free to control their own product-line? The answer is plain: Obamacare would mandate that Americans buy insurers’ product. And to make that mandate more feasible, it would transfer a trillion dollars of Americans’ earnings to insurers over a dozen years. That trillion dollars would be funneled through the government and used to help individual people comply with the mandate, but the money would be required to be spent on insurance, and it would therefore end up in the hands of insurers.

 

The Democrats are not only making disingenuous claims about the costs of their proposal, they are making similarly disingenuous claims about its effects on the deficit. Democrats claim that this massive expansion of government would somehow reduce the deficit.  But the CBO says otherwise. The CBO says that unless Democrats follow through and cut doctors’ pay under Medicare by 21 percent next year and never raise it back up, the bill would increase the deficit by over $200 billion in its real first decade. How many people think that the Democrats would really cut doctors’ payments by a fifth? Certainly the Democrats know that they won’t, and yet they are shameless enough to pitch Obamacare as deficit-neutral, despite the CBO’s plain findings to the contrary.

 

And yet this is just the beginning of the increased deficits. According to the CBO, the Democrats would siphon over $1 trillion out of Medicare and related federal programs in the real first decade of their health-care overhaul. Simply put, they would siphon $1 trillion out of Medicare and spend it on Obamacare. Across the last year, the White House’s own budget director, Peter Orszag, has repeatedly and rightly emphasized that Medicare and Medicaid (the latter of which would be expanded dramatically under Obamacare) are already barely-solvent, that their effects on future budget deficits will “swamp” the effects of all other federal programs combined, and that the key to being able to afford them in the future is to bend the health-care cost-curve down. Now the administration is pulling out all stops to try to pass a health bill that would bend the cost-curve up, and is planning to pay for it, in large part, by looting $1 trillion out of a Medicare program that its own Budget Director has made clear is the last place that we should be looking for money to spend elsewhere. Not surprisingly, the CBO openly mentions the possibility that Obamacare could “reduce access to care or diminish the quality of care” for Medicare beneficiaries.

 

When a “health-care reform” bill would deplete Medicare funds, drive up health costs, and dramatically reduce choice, competition, and personal freedom in health care — while funneling $1 trillion from American taxpayers to insurers (who would now be almost entirely under government control) — one starts to suspect that the motivation is something other than health-care reform. It is. The motivation is to replace millions of private choices with a command-and-control model in which health-care decisions and health-care resources are centrally administered and allocated by the federal government — under the ultimate command, at least initially, of Barack Obama. The motivation is simple and can be reduced to one word: power. And it doubtless has the American Founders, who dedicated their lives to securing liberty, spinning in their graves.

 

 – Jeffrey H. Anderson, the director of the Benjamin Rush Society, was the senior speechwriter for Secretary Mike Leavitt at the U.S. Department of Health and Human Services.

 



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