“If you think health care is expensive now, wait until you see
what it costs when it’s free!”
As Congress prepares to consider health reform, P. J. O’Rourke’s
famous quip provides an important context to the debate. President
Obama and Democrats in Congress have proposed a government-run
health care plan that would “compete” against private health
coverage. Estimates have suggested that such “competition” would
encourage employers to reduce costs by eliminating their health
benefits for employees. As a result, as many as 119 million
Americans will lose their coverage, forcing most of them into the
government-run plan. In his budget, the president proposed nearly
$1 trillion in new spending as a mere “down payment” to fund this
“free” health care gimmick.
The truth is, government-run health insurance takes away
citizens’ freedom, forcing them to accept a government decree about
intensely personal health decisions. At a time when Medicare faces
unfunded obligations of nearly $86 trillion, dumping more than half
of all Americans with private coverage into a government program
will dramatically jeopardize our fiscal future. To make matters
worse, it will take away citizens’ freedom to choose their
doctors—and the freedom to choose, with their doctors, the
treatment option that best meets their health needs.
Democrats have admitted both their desire for government to
control health carew and the effect of such control on ordinary
Americans. A provision in the recent “stimulus” bill will spend
$1.1 billion for comparative effectiveness research. While few
would dispute the wisdom of scientific research comparing the
medical benefits of various treatment options for a given ailment,
Democrats have shown a strong desire to use such research to
examine the cost-effectiveness of medical treatments—as a precursor
to government rationing of care. In fact, a draft committee report
produced by the Democratic majority noted that “more expensive
[treatments] will no longer be prescribed” as a result of rationing
sparked by effectiveness research.
Peter Orszag, President Obama’s new budget director, was candid
about the impact of government control on health care when he cited
studies in a 2007 report noting that “patients who might benefit
from more expensive treatments might be made worse off” if the
government rations access to costly—but potentially life
saving—care. In other words, the true cost of “free” government-run
health insurance will be a loss of freedom for millions of
Americans who will be forced to give up their freedom to choose
medical treatments that will actually work for them.
Here’s how one Michigan mother expressed her exasperation with
the government-run Medicaid program: “You feel so helpless
thinking, something’s wrong with this child and I can’t even get
her into a doctor….When we had real insurance, we would call and
come in at the drop of a hat.” This mother’s helplessness in a vast
government bureaucracy is the antithesis of freedom—lack of freedom
to choose one’s doctor resulting in a lack of access to care.
Our nation needs health reforms that expand Americans’ freedom.
Removing the current inequities in the tax code that force
individuals whose employers don’t offer health coverage to use
after-tax dollars to buy insurance—and pay 30 to 50 percent more as
a result—would put coverage within reach for millions of Americans.
Allowing individuals to purchase health insurance across state
lines would increase consumer choice while expanding insurance
coverage for as many as 12 million individuals. Just as important,
these options would ensure that doctors and patients, not
government bureaucrats, make important health care decisions.
While Democrats argue that a government-run plan is more
“efficient,” I strongly believe that the nationalized plan would
look a lot like Medicaid does today—cheap, broken, and
government-rationed coverage that most Americans do not want. The
American people want to keep their health care freedom—and
Republicans need to respond to their call.
