Critical Condition

Please Read the Bill, Mr. President

During his speech before a joint session of Congress last week, President Obama addressed voter skepticism about his health-care overhaul. The fact remains that tens of millions of Americans are still concerned about his plan and its ultimate impact on the cost, quality and accessibility of health services nationwide.

President Obama’s biggest problem is that the widespread concern over his $1 trillion reform plan is real, organic, and legitimate. Now that we’ve had a week to digest the president’s remarks, let’s pull back the facade, open up House bill H.R. 3200, and take a look at five reasons why the American people are right to feel apprehensive:

Government-run plan: President Obama reiterated his assertion that creating a government-run insurance plan will spark competition with the private sector, giving consumers more choices for better and cheaper care. The reality is that it will be nearly impossible for private insurance entities — which already are heavily regulated — to compete with the government. The new 10,000-pound gorilla will be able to fix dictate prices to doctors, hospitals, drug companies, and other providers (see page 121 to start). That’s why so many believe that the introduction of a government-run plan will force many Americans to lose access to the health insurance they prefer today.

Keeping the plan you have if you like it: Is it true, as the president insists, that all Americans will be able to keep the health insurance they already have? On page 15, as part of Section 101, the government gives itself the power to declare what qualifies as acceptable health insurance. While Democrats highlight a provision in the next section titled “PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE,” when you read the fine print a different story emerges. Subparagraph (a)(1) says that, for you to keep your insurance, your insurer can’t enroll anyone new into your plan. Meanwhile, subparagraph (a)(2) says the insurer can’t change the terms, conditions, or benefits of your plan. But if you have employer-based insurance, subsection (b) of this section says that, in reality, you only get to keep your current plan for, at most, five years if it fails to conform to all the new federal requirements.

Rationing: The president and many Democrats still claim that our new health-care system won’t feature the kind of rationing seen in countries like Canada and the United Kingdom. Yet when given the opportunity to add language to prevent the newly established Center for Comparative Effectiveness Research (beginning on page 501 with Subtitle A of Title IV of the bill) from rationing health-care services on the basis of cost (as a similar commission in the United Kingdom already does), Democrats rejected the amendments during committee markup.

Without such safeguards, this government board will get in the way of doctors and patients, and it decide on its own which treatments are necessary.

Illegal aliens: President Obama’s speech echoed congressional Democrats’ claims that illegal aliens will not receive benefits under the bill. They cite as evidence Section 246 on page 143, which says that “nothing . . . shall allow” illegal aliens to receive benefits. However, nothing in the bill requires anyone to verify that a person is in the United States legally before disbursing taxpayer-funded health care. Past experiences with Medicaid prove that lax enforcement mechanisms will enable illegal aliens to receive benefits. This is no trivial matter; even Democratic Sen. Max Baucus has acknowledged that the problem must be fixed.

Cost: President Obama has asserted that his health-care plan will not add to the deficit. Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, says otherwise: “The legislation significantly expands the federal responsibility for health-care costs . . . The way I would put it is that the [cost] curve is being raised.” The CBO estimates that the bill will increase the deficit by $239 billion in the first 10 years. Even this is misleading, though, since the tax increases in the bill start immediately while the new spending is delayed. Once the spending really kicks in, the bill adds over $60 billion a year to the deficit.

The notion that health-care reform has foundered because of Republicans is flatly false. Some of President Obama’s most ardent critics are moderate Democrats. The president would be better served by taking a closer look at the content of the bill and by starting to work with Republicans to find solutions that are more acceptable to the American people. He may not get another chance.

Eric Cantor (R., Va.) is Republican whip in the U.S. House of Representatives.

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