Politics & Policy

Three Strikes against Obamacare

Barack Obama promises that if the Democrats’ health-care plan is passed, Americans will enjoy wider and better insurance coverage without: 1. being forced out of their current insurance; 2. being subject to government rationing, including the outright denial of life-saving care; 3. spending themselves and future generations into deeper debt. The Democrats’ program deserves to be rejected because conditions 1, 2, and 3 are not going to be met — and because the Democrats know it and are doing their best to hide that fundamental and important fact from the American people.

This isn’t a question of conjecture or of competing interpretations of complex CBO calculations. Just as Democrats have misled Americans about whether their health-care plans will force taxpayers to subsidize abortion or shunt money into the pockets of illegal aliens, they deny these three facts — Americans will lose their current insurance, will be subject to rationing, and be will encumbered with debt — but that denial does not overrule reality.

The most noisome fact for most Americans is that the legislation coming out of the Democratic caucus will force many families out of their current insurance plans. Estimates suggest that nearly 90 million Americans will lose their current insurance under the Democrats’ vision and very likely will be forced into a government-run program. True, current insurance plans are “grandfathered” into the new system — but only for five years. (Doubt it? Consult Section 202(b)(1) of the House bill, page 91.) After that, the Democrats’ mandates will force families and employers to select only those plans that conform to Washington’s demands — which is to say, to the demands of the insurance-industry lobbyists who will end up determining the criteria. In states that have similar mandates, we already have seen how that shakes out: Inexpensive catastrophic-care plans are forced out in favor of expensive, bloated packages that legislate coverage of everything from infertility treatment to personal counseling. There’s nothing wrong with those things, but not everybody in the country needs to be forced to buy coverage for them — and they certainly shouldn’t be forced out of their current insurance plans on that account. And will your new Washington-approved plan include your current doctor, or reflect your current needs? Who knows?

But that’s not the only way Americans will lose their current insurance coverage. Those who receive relatively expensive high-benefit coverage through their employer will very likely find themselves dumped into the government-run and government-subsidized “public option,” which will give businesses an incentive to offload health-care costs onto the taxpayer. The Democrat-controlled CBO estimates that 15 million will be sucked directly into Medicaid — not Medicare, mind you, but Medicaid, the perennially dysfunctional program for the poor, entirely operated by the government. And older Americans who receive private coverage through Medicare Advantage will certainly lose that option, since the Democrats’ plan will gut the program.

That’s a lot of angst and upset for a bill that, according to its own supporters, will only raise insurance coverage from 83 percent of the population to 96 percent.

Which brings us to the second count on this indictment: Moving the insurance-coverage rate from the mid-80s to the mid-90s is a worthy goal, if not a dramatic one. But even modest as it is, when combined with the Democrats’ extensive menu of mandates and subsidies it surely will bring an influx of patients into the health-care system, increasing demand without doing anything to increase supply. (Indeed, the Democrats’ new regulations and price controls will restrict the supply of both private insurance and health-care services.) Unless Speaker Pelosi is empowered to repeal the laws of mathematics, that means higher prices for health-care services. But Democrats promise to “bend the cost curve.” What they mean, of course, is that they will ration care, both through the outright denial of care to patients in government-run programs and by using price controls to deny payments to physicians and hospitals, and thereby to deny care indirectly. This is precisely the arrangement that sends thousands of Canadians and Europeans flocking into the United States every year seeking care that is denied to them in their home countries, where political necessities trump medical necessities, as they inevitably do in a government-run system.

Finally, President Obama promised that health-care reform would not add “one thin dime” to the federal deficit or impose new taxes on the middle class, but the most honest estimates of the program’s cost is $1.3 trillion. There may be modest cuts, true — but, given that our government operates in habitual deficit, that still means either $1.3 trillion in taxes on somebody or $1.3 trillion added to the national debt. Neither option looks very attractive. Democrats habitually promise to confine tax hikes to “the rich,” but economist Greg Mankiw calculates that Obamacare will represent something on the order of a 23 percent implicit tax rate on families of modest means. Pelosi’s bill includes an 8 percent payroll tax, which in reality will come right out of the pockets of working Americans.

We call that three strikes: taking away Americans’ current insurance plans, replacing them with a system of government rationing, and burning through more than a trillion steadily depreciating U.S. dollars to get it done.

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