Monday, July 27, 2009

Team Obama's Moving Goalposts and Shifting Goals Obscure Real Healthcare Issues...

Obama says first that he wants everyone to be covered. Then he says, no, the real reason he wants reform is to reduce costs. Then, no, it isn't that, it is about access. He and his team keep shifting goals and focus on the healthcare debate. All that does is keep misperceptions alive and keep us from really tackling the issue. Robert Samuelson delves deeper:
If you listen to President Obama, his "reform" will satisfy almost everyone. It will insure the uninsured, control runaway health spending, subdue future budget deficits, preserve choice for patients and improve quality of care. These claims are self-serving exaggerations and political fantasies. They have destroyed what should be a serious national discussion of health care.

Instead of a serious discussion, we are presented with utopian panacea. We are given this notion of a false nonchoice, that we can have it both ways. And these assumptions are based on myth:
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.

So here we shoot down at least two myths. One, that the poor and uninsured don't receive treatment. And two, that insuring everyone is going to save money. It won't. It can't. It is a lie.
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.

That's the way it is with liberals. Who cares if it won't work, it will make us feel better that we tried, that we meant well. Where does the road paved with good intentions lead again?
Evaluations of proposals reflect this reality. The Congressional Budget Office judges that the legislation in the House would, through expanded Medicaid and subsidies for private insurance, reduce the uninsured from 46 million in 2007 to 17 million in 2019. But the cost would be $1 trillion over a decade; of that, $239 billion would add to the budget deficit. Worse, the costs would rise faster than the sources of financing, including a tax on the wealthy. In 2019, the projection's last year, the deficit would be $65 billion. Assuming that the deficit rises 4 percent a year, the cumulative shortfall in the second decade would total about $800 billion.


Now we are talking real money, folks. The ChiComms are really going to be mad when they see this, about how our deficits will rise and how this will affect their investment in our country, since they hold most of our debt. Gee, you would think Obama would give us fact, not fantasy. But not so:
But Obama sees all blue sky. "Here's what reform will mean for you," he said at a recent rally. "It will mean lower costs and more choices and coverage you can count on. Health insurance reform will save you and your family money," he said. (Note: Except for subsidies, it's doubtful families will experience savings anytime soon.) And later: "We'll also change incentives so that our doctors and our nurses can finally start providing patients with the best care and not just the most expensive care. And if we do that, then reform . . . will lower our deficits in the long run."

Contrast Obama's reassuring rhetoric with this exchange at a congressional hearing between Sen. Kent Conrad (D-N.D.), chairman of the Senate Budget Committee, and Douglas Elmendorf, head of the CBO.

Conrad: "From what you have seen from the product of the committees that have reported, do you see a successful effort being mounted to bend the long-term cost curve?"

Elmendorf: "No, Mr. Chairman. In the legislation that has been reported, we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs. . . . The (cost) curve is being raised."


Anyone else want to listen to more of Obama's bedtime stories? In the next one, Hillary the Huffer gets North Korea to give up weapons by giving the Frog Prince Kim Jong Il a Kiss......
Check out the whole thing for a reasonable discussion on the perils and pitfalls of Obamination Care.