Robert Samuelson has a must-read on healthcare “reform” in today’s Washington Post. He explains that unless we control costs first, universal healthcare will be a long-term burden for America.
The health-care conundrum involves a contradiction that the administration steadfastly obscures: In the short run — meaning four to eight years — government cannot both insure the uninsured and rein in health spending. Here’s why. The notion that the uninsured get little or no care is a myth: They now receive about 50 to 70 percent as much health care as the insured. If they become insured, they would use more health care, possibly as much as today’s insured. That would increase both government and private health spending, depending on how the insurance is provided.
Until health-care costs are better controlled, expanding insurance coverage will be expensive. The president talks endlessly about the need to limit spending and eliminate waste. These are worthy goals. But changing the way medical care is delivered and paid for would take years and involve disruptive and unpopular measures. Patient co-payments might increase; networks of doctors and hospitals might displace individual practices; the tax exclusion for employer-paid health insurance might be curbed. Obama downplays the obstacles. His “reform” isn’t likely to compel needed changes, partly because it’s not clear what will work.
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The administration had to make choices; it could emphasize expanded insurance coverage (”access”) or cost control, but not both. It chose coverage, embracing the long-standing liberal grail of “universal” insurance. Millions of Americans would receive more health care, though how much their health would improve is uncertain (the administration can’t logically argue that much health care is wasteful and also that the uninsured will automatically benefit from more of it). Many with insurance would gain the peace of mind that they won’t lose it.
But what helps many Americans as individuals may hurt society as a whole. That’s the paradox. Unchecked health spending is depressing take-home pay, squeezing other government programs — state and local programs as well as federal — and driving up taxes and budget deficits. The president has said all of this; he simply isn’t doing much about it. He offers the illusion of “reform” while perpetuating the status quo of four decades: expand benefits, talk about controlling costs. The press should put “reform” in quote marks, because this is one “reform” that might leave the country worse off.