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Tuesday, August 18, 2009

Lots More Reasons why ObamaCare isn't Popular

Pete DeCoursey has an interesting column on Capitowire (subscription) about why people oppose ObamaCare. He hits the main point correct – most people are satisfied with their coverage ( in a forthcoming study, we note that 85% of Americans have insurance, and 80% are satisfied with their current coverage), but he misses on a number of statements.

That is what public rationing of health care has done in Canada and Germany and Britain: even out the health care of the non-wealthy. The wealthy can still afford to game the system, but in most of Europe and Canada, if you're not wealthy, you get the same health care. Here, more than half the non-wealthy get vastly better health insurance and health care than the rest, because they work for big or generous employers.
False – In Europe, Canada, Australia and others, the rich (and often non-rich) buy health care outside the government system, often coming to America to do so. In Canada, it is illegal (at least until the Canadian Supreme Court ruled that this denies individuals their right to quality health care) to do so, but the law is ignored as nearly everyone buys private care out of pocket. In France, Michael Moore’s favorite ‘universal’ health care system, 90% buy private coverage above and beyond the government program.
So you occasionally read about someone in England or Germany or Canada having to wait so long for a long-shot, expensive, life-prolonging treatment that by the time they come up on the list, they have died or can no longer survive the treatment.
But more often, people wait and then they get their service, and they pay less than we do.
The number of horror stories from Europe and Canada are greater than you suggest, and on routine treatments, not just “long-shot” care. There are countless examples, like the guy who pulled his own teeth with pliers while waiting for a dentistry or the story from Britain today that access to in-vitro fertilization will depend on where you live. There are there are many more such stories at BigGovHealth.

And as for the US paying more, it is partly because we are a much wealthier nation, and health care appears to be a superior good, so we are willing to pay more or our income on our health (not to mention the fact the US funds virtually all research and development in health care and pharmaceuticals).
So who makes the decision of what is covered and what isn’t right now? Employers and insurers.
Wrong again. Government has a heavy hand in this. Pennsylvania has 52 mandates of services/treatments/providers that must be covered in every health care plan. States have regulations about how insurers can charge and what products they may offer. Of course, these mandates drive up the cost of insurance, and naturally the number of uninsured.
First of all, it wouldn’t save us any money, because the fact is, the president and Congress are going to cover more than businesses and insurers watching profit margins will. Running for re-election every two or four years would tend to make you want that national policy to cover more than a Mother Hubbard dress.
If that were true, then Medicare and Medicaid would provide greater coverage than private insurance—in fact, they cover far less (hence those who can afford to—wealthier individuals on Medicare—buy supplemental coverage). These program also pay doctors and hospitals less for the same services, hence many doctors are refusing new Medicare and Medicaid recipients. This underpayment results in cost shifting, which drives up the cost of private insurance further.

DeCoursey is right when he states that every plan must ration – but the question is who should make that choice. It is not merely a question of “reform” vs. the status quo, but there are reforms we are pushing and that have been introduced in Congress and the state House to give patients – not government, employers, or insurance companies - more control over health care decisions, while preserving the quality of coverage most Americans enjoy.

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