I watched Wednesday night’s ABC News special hosted by Diane Sawyer and Charlie Gibson, broadcast from the East Room of the White House and featuring an audience-driven Q&A session with President Obama. To their credit, ABC allowed audience members to ask a number of relevant and tough questions. The President handled the questions well, although in most cases he did not provide much in the way of specifics in his answers.
Here are a few observations of mine, in no particular order:
1) The selling point for ObamaCare seems to be “the worst thing we can do is to do nothing,” which is the exact same hard sell line Obama used to push his stimulus plan. Congress bought into the stimulus, and yet, $787 billion dollars later, unemployment is worse that President Obama’s worst-case “do nothing” scare prediction. It appears that the Obama Administration is not trustworthy when it comes to economic predictions.
The President says that without government intervention, health care costs will continue to rise 6% – 8% per year, or will double every ten years, and more and more people will be left uninsured. He believes that government intervention is the best way to stop this trend. He recognizes that certain private organizations like the Mayo Clinic have successfully kept quality of care high, while significantly lowering costs. But he does not believe that, industry-wide, the free market can provide enough incentives to make voluntary cost cutting an attractive option.
He never satisfactorily explained why health costs are rising at such a fast rate. I believe that understanding why costs are rising (and being able to offer a straight-forward explanation, which is best proof that you really understand a problem) is crucial before you propose solutions.
2) President Obama is optimistic that reallocation of existing health spending, combined with efficiency programs and effective cost reduction plans, will offset most of the cost of ObamaCare. Considering how badly his economic and financial advisers have bungled their economic forecasts, I don’t share the President’s optimism.
3) President Obama is serious about outlawing coverage limits for preexisting conditions. He said that insurers would make less money per insured, but overall the industry should still be profitable. Another prediction that the President is “sure” of. The problem here is that a public, government funded and managed insurance system doesn’t have to worry about showing a profit. It can absorb whatever regulations Congress imposes simply by asking Congress for more money. But a private insurance company can’t do that. If government regulations ruin the profitability of private insurance companies, you can be sure that the next “solution” will be a series of government bailouts and take-overs of private insurers that will eventually produce a single nationalized health care system.
4) President Obama is serious about encouraging more people to enter the medical field as primary caregivers, such as primary care physicians, nurse practitioners, and nurses. He believes that affordable and readily available primary medical care is the key to having a healthier nation. To this end, he seems to want to create some kind of financial parity between what specialists earn and what primary care physicians earn. He is concerned about the debt load that medical students accumulate during their schooling, and is troubled by the fact that (apparently) many medical students choose specialty medicine in order to earn more money to pay off their debts. (At least that is the impression I got from the direction of the discussion.) The President did not offer any specific solutions for these problems.
He also stressed that under his plan, doctors would not be “working for the government,” they would still be self employed. But if your sole source of income is government-regulated payouts from a Central Bureau of Medical Efficiency (or whatever it would be called), what is the difference?
5) Finally, President Obama’s efforts to explain how government management would both save money and result in a higher standard of medical care failed to establish even a basic level of confidence for me. There was a lot of discussion about efficiency standards, eliminating unnecessary tests, compensating doctors based on successful treatments rather than on the number of procedures they perform, and relying on science to determine the most effective treatment options. But all of these measures essentially boil down to statistics and bean counting — neither of which embodies the proper ethos to serve as a governance tool for medicine.
I won’t disagree with the fact that even now, and even with private health care, there are limits to what can be done and what insurers can afford to pay. But as long as there is hope, and as long as private money is available for whatever treatments doctors or patients wish, the government should not be allowed to force limits on those treatments.
Supporters of government-managed health care argue that the government can provide higher quality medical care because the government can do a better job of eliminating waste, which largely consists of overly expensive and unnecessary medical procedures. Yet such a program necessarily requires the government to put a dollar value on human life. Capitalists are generally considered “evil” if they value human life based on profit motives (remember the Ford Pinto?). But is empowering the government to value human life based on cost-cutting and statistical efficiency any real improvement?
More on this from Conservative Nation — a must-read if you want to know what the “reformers” pushing a public health insurance option are really interested in achieving.