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Critical Condition

NRO’s health-care blog.

The $100,000 Obamacare Policy



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Nearly everyone agrees on the major goals of legitimate health-care reform: reducing costs and reducing the number of uninsured — without reducing the quality of care.    Polls show that Americans’ number-one health-care concern — by far — is the first of these: lowering costs. But the proposed Democratic health-care overhaul would instead raise health costs. It would also inject the federal government into the historically private relationship between patient and doctor. By a margin of about two to one, Americans think that their quality of care would decline rather than improve as a result. Raising costs and lowering quality would seem to be two rather major shortfalls in any effort at “reform.” And such figurative shortfalls would be matched by a literal one: The Congressional Budget Office says that, unless doctors’ pay under Medicare is cut by 25 percent and never raised back up, the proposed Senate bill would increase deficits by $286 billion in its real first decade (2014–23).    However, all is not lost. The Democrats’ version of “reform” might at least reduce the number of uninsured. But to what degree, and at what cost?   According to the Census, there are 28 million uninsured Americans (46 million, minus 9 million non-citizens, minus 9 million Medicaid beneficiaries whom the Census admits were falsely tallied as uninsured). The CBO is adding 5 million to that figure because of the recession (fair enough) but isn’t accounting for the Census’s admitted Medicaid undercount, so it is erroneously listing the number of uninsured as 51 million — inflating the true number by about 20 percent.   In addition, the CBO isn’t meaningfully factoring in the increased incentive that young, healthy people would have under the proposed legislation to dump their insurance and pick it up again only if they are already sick or injured — raising everyone else’s premiums as a result.   But let’s suspend disbelief and pretend that there really are 51 million uninsured people in America and that almost no one would take advantage of the opportunity to wait until they need insurance to buy it if they could. Under these generous and fanciful assumptions, the CBO says that the proposed legislation would reduce the number of uninsured by 31 million by 2019. The CBO says that 28 of these 31 million would become newly insured between the start of 2014 and the end of 2016, and that little further progress would be made thereafter. But let’s make another charitable assumption and assume that another 8 million could somehow become newly insured in the next decade (2020–29), for a total of 39 million in all. (As the CBO notes, not all of these newly insured would be Americans.)   So, what would be the price tag? The CBO projects that the proposed legislation’s costs over these two decades — from insurance coverage expansions alone – would be $3.9 trillion. So, even under this most generous set of assumptions regarding success in lowering the number of uninsured, the legislation’s cost for every newly insured person would be . . . an even $100,000.    Let’s call this the $100,000 Obamacare policy — courtesy of your wallet, via the Democratic Congress and White House.



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