The Obama administration and their allies in the progressive
community have a problem when it comes to selling their brand of
health care reform. While they argue that we'll be able to reduce
health-care spending and improve quality by having the government
intervene and provide subsidies for everybody to get insured,
they
cannot name a single example at the state level where this
has worked. In fact, the opposite has been the case. The most
prominent example is Massachusetts, which implemented a plan
similar to the one proposed by Obama during the campaign, but has
seen costs explode. As the New York Times
reported yesterday, "government and industry officials agree
that the plan will not be sustainable over the next 5 to 10 years
if they do not take significant steps to arrest the growth of
health spending."
Anticipating that opponents of the Obama health-care agenda will
use Massachusetts as an example of the failure of government run
health-care, the progressive Institute for America's Future has
come out with a new report
arguing that the reason why costs are skyrocketing in
Massachusetts is actually that the system relies too heavily on
the private sector.
For the uninitiated, both the Massachusetts and Obama plans are
similar because they are based on subsidizing individuals to
purchase government-designed health care plans on a
government-run exchange. The difference is that President Obama
and most Democrats want to include a Medicare-like governtment
plan in the national exchange with the idea being that it would
keep private insurers honest since they will have to "compete"
with the government plan. The reality is that since the
government will be running the exchange and setting the rules of
the game, it will be able to steer people toward the government
plan. Thus, it's a clever way of having the government take over
the health-care system incrementally while saying they're for
"choice" and preserving the free market.
In a conference call this morning, Diane Archer, the author of
the Institute for America's Future's report, said that the
Massachusetts plan has run into problems because it relied too
heavily on private insurance and it didn't address costs.
"Even with regulation, we cannot count on the private insurers to
deliver people the care they need," Archer said. "They must --
it's their business model -- put profits before people's health
care, and that's what they do."
Her solution is to create a government plan, to ration care, and
have the government tell doctors and patients what types of
treatment they should seek for given ailments. Of course, she
doesn't quite put it that way.
Instead, she says things such as, "I completely believe that we
need to have comparative effectiveness in the mix, protocols, and
that we begin to pay in a very transparent way to test, to
analyze and to implement systems that pay for services that are
effective and cost effective."
She endorsed the idea set forth by Tom Daschle for a Federal
Reserve-like panel of experts that would issue guidelines on the
cost effectiveness of given treatments and drugs. She said it
might be something akin to Britain's National Institute for
Health and Clinical Excellence, or NICE, which recently concluded
that it was worth $22,750 to extend somebody's life for six
months.
The one silver lining of the Massachusetts health care fiasco is
that it demonstrates the absurdity of the idea that more
government intervention into health care is going to control
costs, so it makes sense that in an act of political jujitsu, the
left is trying to shift blame to private insurers. Unfortunately,
they are aided in this task by the fact that Mitt Romney and his
conservative apologists have insisted on identifying MassCare as
"free market" reform.
If you really wanted to drive down costs in Massachusetts or
anywhere else, the solution is not more government, but actual
free market reform. A good example would be eliminating mandates
requiring that insurance companies cover certain treatments, so
that all people, young or old, healthy or sick, can purchase the
type of coverage that they actually need. Is it fair to force a
young male to purchase a more expensive insurance policy that
covers in vitro fertilization?
