By Robert M. Goldberg on 1.22.10 @ 6:07AM
Liberals who argue the masses would come to love the health care
reform they currently hate.
In the hours after Scott Brown's victory -- despite his
campaigning against Obama care -- liberal healthcare
commentators were urging Congressional Democrats to push on with
a healthcare bill that used deep cuts in Medicare and a
presidentially-led effort to reduce patent protection for
breakthrough medicines to pay for a $60 billion tax break for
unions only. Ignoring Brown's huge upset victory and the fact
that half of those who voted for him cited his stance on
healthcare reform as the reason they did so, they are now arguing
that the election results was not a referendum on health reform because, as one reporter told
me, "those living in Massachusetts may already be enjoying the
benefits that a universal health
care bill could provide."
The strategy of pushing health care through even though
people don't understand the proposal and are suspicious of its
impact and government because of the way it was, uh, crafted, is
a product of the dismissive arrogance of such commentators as the
New Republic's Jonathan Cohn. He argues that once the benighted
masses are forced to live under the new order, they will awake to
celebrate the benefits they failed to perceive over the past two
years of health care debate.
Cohn
claims that reform "will make a
huge difference in people's
lives -- and, quite likely, the evolution of
the American social welfare
state. You'll be sparing financial or physical hardship
for thousands of Americans every year, while delivering peace of
mind -- and safer, higher quality medicine--to literally millions
of others. You'll be saving the American economy and, along the
way, helping people to stay healthy."
To support his thesis that people will like the product
even if they don't understand it and hate how it was made, Cohn
holds up Massachusetts as the model for that shining health
clinic on the hill and claims massive support for the reforms in
that state. He cites a September 2009 Boston
Globe/Harvard School of Public
Health poll, where 58 percent of respondents said they
supported the state reforms while 28 percent said they
opposed.
Cohn failed to note that in the same poll, most said they
didn't think the law has had much of a direct impact on their
lives. There are two reasons for that. First, before the
Massachusetts law was passed 90 percent of people in the state
had healthcare coverage. Second, unlike the congressional
proposals, no one was forced to give up their healthcare coverage
because of a state mandate.
Cohn also ignores another poll result: 43 percent said the state
could not afford to keep the law as it is today and 40 percent
said it could.
People have a reason to be concerned. Much like the
congressional proposal 60 percent of the people covered under
MassHealth were Medicaid eligible. Further, the state
received additional federal money to cover the cost of
subsidizing the cost of low-income people. As with the
bills in Congress, the initial cost of the entitlement was
hidden.
Further, the cost estimates of the proponents were wildly
off. In 2006, MIT economics professor Jonathan
Gruber predicted that the amount
of money in the "free care pool" would be sufficient to
pay for reform legislation without requiring additional funding
or taxes. He was way wrong. By 2008 even after the federal
government kicked in $1.5 billion the health care costs in the state were rising at
an annual rate of 10 percent, and the state budget deficit was $1.3 billion in
large part because of the added entitlement.
Incidentally, Gruber is being paid hundreds of thousands of
dollars by the Obama administration to make similar assurances
about the federal health plan.
However, expanding coverage did not translate into
increased access. Medicaid reimbursements are half of those in
the private sector. Major nonprofit hospitals are shutting down
across the state and primary care docs are not taking Medicaid
patients because of the lousy reimbursement.
According to the Boston Globe, "The
wait to see primary care doctors in Massachusetts has grown to as
long as 100 days, while the number of practices accepting new
patients has dipped in the past four years, with care the
scarcest in some rural areas."
Yet here is the lesson Cohn
says Democrats should learn from Scott Brown's successful
run: "…deliberating over health care
reform is messy, unattractive, and unpopular. But health
care reform itself is popular once the deliberations are
finished." Right. And Curt Schilling is an Yankee fan.
Americans want affordable, understandable health care
reform. To respond to that demand, legislators should stop
listening to "experts" who shaped the health care bill and excuse
the deals needed to ram it through.
The Massachusetts election was the liberals' Waterloo. If
they listen to Cohn, government-run health care will become the
liberals' domestic Vietnam.
topics:
Health Care
