Tag: health system

Would ObamaCare Improve Public Health? Probably Not.

George Avery is an assistant professor of public health at Purdue University.  In today’s Daily Caller, Avery rebuts claims that the Obama health plan would improve public health:

The idea that health care contributes significantly to population health is both intuitively appealing and untrue….

In fact, federal “reform” often hurts the public health system. Both public health and health care experts have criticized Medicare and Medicaid, enacted by Congress in 1965, for changing the focus of health care practitioners from prevention to treatment….

Requiring all Americans purchase health insurance, which the current bills hope to do, would not address the underlying socio-economic issues at the root of most public health problems….

Indeed, access to health care can help individual patients, but can also aggravate some public health problems…. High rates of surgical intervention increase the risk and spread of drug resistant infections like MRSA.

Avery is the author of the Cato Institute briefing paper, “Scientific Misconduct: The Manipulation of Evidence for Political Advocacy in Health Care and Climate Policy.”

Good News: Health Care Express Slows

Health care “reformers” (meaning those who want to effectively nationalize America’s medical system) have long understood that their best hope in the new political environment is to ram through legislation with the claim that it is an emergency and won’t wait.  The longer the American people think about the increased cost, decreased choice, and other negative impacts of a a government takeover, the less likely they are to support it.

Thankfully, the government health express has slowed noticeably in recent weeks.  Even supporters are coming to doubt that legislation can be approved before Congress goes home in August.  Reports Politico:

Health care reform proponents are growing pessimistic that they can meet President Barack Obama’s August target for passing a bill — saying the next four weeks must fall together perfectly, without a hitch or a hiccup.

The number of weeks that’s happened recently? Zero.

A series of setbacks has made the task of completing floor votes in both chambers virtually insurmountable, given the plodding pace of the Senate. The official line from the White House and the congressional leadership is it’s possible, but privately, there are a dwindling number of aides who would put money on it.

And without a deal by August, the ripple effects could start to endanger the prospect of health care reform this year altogether — chief among them, the closer it gets to the 2010 midterm elections, the harder it will be to get members to make the toughpolitical decisions needed to vote on a bill.

This is good news.  The U.S. health system needs fixing.  But the more rushed they are, the less likely policymakers are to do the right thing.  We need a medical system that is more responsive to consumers and market forces rather than to political forces and government dictates.

Sen. Kennedy’s Budget-Breaking “Reform” Bill

It appears that the Obama administration has decided to disown the venerable Senator.  No wonder.  The Congressional Budget Office estimated the ten-year cost of Sen. Kennedy’s bill at $1 trillion, but admitted that its analysis was incomplete. 

Now the consulting group HSI Network, LLC comes foward with an estimate of $4 trillion:

The Senate Committee on Health, Education, Labor and Pensions (HELP) have proposed a health reform bill called the Affordable Health Choice Act (AHC) that seeks to reduce the number of uninsured and increase health system efficiency and quality. The draft legislation was introduced on June 9th, 2009. The proposal provided adequate information to suggest what the impact would be of AHC using the ARCOLA™ simulation model. AHC would include an individual mandate as well as a pay or plan provision. In addition, it would include a means-tested subsidy with premium supports available for those up to 500% of the federal poverty level. Public plan options in three tiers: Gold, Silver and Bronze are proposed in a structure similar to that of the Massachusetts Connector, except that it is called The Gateway. These public plan options would contain costs by reimbursing providers up to 10% above current reimbursement rates. There is no mention of removing the tax exclusion associated with employer sponsored health insurance. There is also no mention of changes to Medicare and Medicaid, other than fraud prevention, that could provide cost-savings for the coverage expansion proposed. Below, we summarize the impact of the proposed plan in terms of the reduction on uninsured, the 2010 cost, as well as the ten year cost of the plan in 2010 dollars.

HELP Affordable Health Choices Act

  • Uninsurance is reduced by 99% to cover approximately 47,700,000 people
  • Subsidy - Tax Recovery = Net cost:
    • $279,000,000,000 subsidy to the individual market
    • $180,000,000,000 subsidy to the ESI market with
    • Net cost: $460,500,000,000 (annual)
    • Net cost: $4,098,000,000,000 (10 year)
  • Private sector crowd out: ~79,300,000 lives

HSI figures that a lot more people will take advantage of federal health insurance subsidies, driving costs up far more than indicated by the CBO figure.  (H/t to Phil Klein at the American Spectator online.)

Of course, no one knows what the bill would really cost in operation.  But the history of social insurance and welfare programs is sky-rocketing expense well beyond original projections.  Go back and look at the initial cost estimates for Medicare and Social Security, and you will run from the room simultaneously laughing and crying.

Health care reform would be serious business at any moment of time, but especially when the country faces $10 trillion in new debt over the next decade on top of the existing $11 trillion national debt.  And with the $100 trillion Medicare/Social Security financial bomb lurking in the background, rushing to leap off the financial cliff with this sort of health care legislation would be utterly irresponsible.

Len Nichols Is Wrong: This Debate Is about Socialized Medicine

Over at “The New Health Dialogue Blog,” my friend Len Nichols writes:

I am disappointed to hear the health reform conversation devolve once again into a contrived debate about a single payer, government-run health system. This is an old dispute about “socialized medicine” and one that has already been settled in the minds of a critical mass of policymakers.

A couple of things strike me about his post.

First, this debate is obviously about socialized medicine, and to argue anything else is absurd. We have a president who advocates single-payer. That president just held a health care summit to which he invited other single-payer advocates, but not a single free-market advocate. As I explain in this paper, all the bluster about “public-private partnerships” is an intellectually dishonest smokescreen. Nichols and other members of the Church of Universal Coverage hate the term “socialized medicine” not because it inaccurately describes their policies, but because it accurately describes their policies and rankles a large segment of the American public. Rather than adjust their policies, they are trying to convince the public that policies generally considered socialist really aren’t.

Second, this “old dispute” obviously has not been “settled in the minds of a critical mass of policymakers.” If that mass of opinion were truly critical, then (by definition) the fact that some are crying “socialized medicine” wouldn’t bother Nichols at all.

I think I’ll shoot my friend an email and invite him to speak at a Cato Institute policy forum where we can discuss whether President Obama is trying to move us closer to socialized medicine.