Obama concedes his is a health-care rationing plan.
Wise guy liberal talk show hosts and writers of impassioned letters to the editor have been lecturing me with the argument that Obama and his Democrats are not remotely planning any sort of government health-care rationing in their socialized medicine plan, which is going to save so much money that they are now scrounging around for the biggest tax increase in U.S. history to pay for it. But Obama has now made fools out of all of them with the release last week of his White House report, “The Economic Case for Health Care Reform” (.pdf), produced by his Council of Economic Advisors (CEA).
Read the document, and you will see that it envisions a complete government takeover of America’s health care in great detail. Wise, all-knowing, government bureaucrats in Washington will identify exactly what health care in each locality in the entire country is waste, and eliminate it. They will determine whether the treatments and health care your doctor has prescribed for you are right, and the best of the alternatives, and they will control his practice through their payment policies and regulations, forcing him to follow what they in their all-knowing wisdom think is best. Worst of all, they will decide whether the health care your doctor thinks you need is “cost-effective,” meaning they will decide whether the cost of your health care is worth it, to them.
Listen to Obama, and you will hear him say almost every day that his health reforms are going to save America and its economy by reducing health costs. The CEA report explains exactly how and why he is going to do that. They don’t use the word, of course, but nevertheless it is all overwhelming, government, health-care rationing, meaning you and your doctor lose control and choice over your health care, and centralized, government bureaucrats in Washington decide what health care you get and when. Think about it, and you will realize that in the government-run system Obama envisions, there is no other way to achieve the cost reductions he is talking about than through extensive government health-care rationing, meaning denying you the health care you want.
Indeed, the CEA report says 30% of American health care is waste, which government bureaucracy is now going to eliminate. That is a lot of health care to deny you. Doctors and hospitals who don’t think this downsizing is going to affect them, and their freedom to control and run their own practices, are whistling past the graveyard. Wake up, and you will realize that in Obama’s Brave New World, you are going to be the targets, just like the bank executives are today.
The Government Doesn’t, Can’t, and Won’t Know
The economists who wrote the CEA report on health-care reform start by assuming first that the government is omniscient. They don’t say that, but that assumption jumps out of every line.
For example, the report says the government is going to sharply reduce health costs by
Looking systematically at what works and what doesn’t in order to provide more high value care and less care that is of low value. For many types of medical conditions, a patient may have a choice of several methods or treatments, each having different benefits or risks. Systematic examinations of the merits of different treatments and dissemination of the results of these examinations to patients and providers is one mechanism for promoting high value health care.
You will notice in reading Obamaspeak on health policy a distinct lack of nouns. Just who is going to look systematically at what works and what doesn’t? And just who is going to conduct those “systematic examinations of the merits of different treatments?” And will whoever that is really know what works and what doesn’t for 300 million patients across America, and “the merits of different treatments”? The answer to the first two questions is a centralized government health-care bureaucracy in Washington. Intelligent readers might think the answer to the last question is “No,” or maybe “Hell, no!” But the answer is really, “Of course not, wake up and smell the coffee before it is too late.”
The CEA report says at the beginning that “up to 30 percent of health-care costs (or about 5 percent of GDP) could be saved without compromising health outcomes.” Achieving that result to slash the federal deficit, increase GDP ultimately by 8%, and reduce unemployment is going to require a lot more than “dissemination of the results [of the above] examinations to patients and providers [as] one mechanism for promoting high value health care.”
No, a more promising mechanism for enforcing what the government decides works and what doesn’t is found in another policy for controlling costs in the CEA report:
Reorienting the financial incentives of providers toward value rather than volume. Payment systems….should reward providers who deliver care that adheres to evidence based guidelines and should not pay for preventable medical errors.
This is supposed to solve a problem identified earlier in the report:
Provider Incentives. Most provider payment systems are fee-for-service, which creates financial incentives for doctors and hospitals to focus on the volume of services that they deliver rather than the quality, cost, or efficiency of care delivery. In general, payment systems do not reward higher quality and value. In some cases, they reward poor quality of care by paying for the costs associated with additional medical care necessary to fix errors that could have been prevented.
In other words, the government will enforce its decisions as to what works to provide high quality care and what doesn’t through the payment system for doctors and hospitals. Those who follow the government’s decisions get paid well, and those that don’t don’t. They will be lucky to get paid at all.
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Mr. and Mrs. American Spectator Reader, let P.J. O’Rourke talk sense to your kids.
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It won’t take long for conservatives to scratch this presidential wannabe off their 2008 scorecard.
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