Friday, September 11, 2009

When Santa Clause Came to Washington

Be thankful we're not getting all the government we're paying for.
--Will Rogers


All men having power ought to be distrusted to a certain degree.
-- James Madison in The Federalist

Obama's address to a joint session of Congress in support of health care was a strange mix of lofty rhetoric, questionable claims, and thinly disguised partisan attacks while calling for “civility” from those who disagree with him. But four items came through loud and clear in speech: 1) no one knows exactly what “the plan” is, 2) no one knows what “the plan” will cost, 3) no one knows how “the plan” will be paid for, but 4) “the plan” will cost the taxpayers nothing and only a fool would turn down something for nothing.

For those who still haven't caught on, let me summarize the main argument: the government run Medicare program, the nation's main budget problem and forecast to eventually absorb all the government's resources, is fraught with fraud and abuse and ever escalating costs so to fix this problem we need an even bigger, more comprehensive, more complex government run health care program that will cover millions more people, compete against for-profit insurance companies on a zero-profit basis, and eliminate the fraud, waste and abuse and slow down the cost increases of the smaller, more focused Medicare program. Huh? Am I the only one struggling with the paradoxes of that argument? It begs the joke this new bureaucracy is sure to have the compassion of the IRS, the speed of the post office, and the efficiency of the emergency response to Katrina. But I'm not writing to make that argument. I'm writing to say the claims for cost savings, elimination of fraud and waste, and efficiency gains are blatantly false, and the claim that over 30 million more people (or whatever the number du jour is) can be insured by the government at no additional cost to the taxpayers is delusional. This health care plan will end up costing significantly more than what we are being promised to the point of bankrupting the country, and our politicians already know this.

How can I make these claims when the health care plan is just vaporware at this point? Don't I trust politicians? Don't I want to believe in hope and change? I let history do the talking for me. In 1966, Medicare cost $3 billion, at which time the politicians estimated the 1990 costs to be $12 billion. By 1990, Medicare cost topped out at $107 billion, only 9 times more than predicted by the best and the brightest. Today's Medicare tab is rapidly approaching $500 billion. The only sure thing is that the cost of the proposed health care plan will be significantly more than what was promised Tuesday night, and could very well endanger the financial health of the country.

Instead of creating the world's biggest bureaucracy to manage US health care, let's try the easy, low-risk things first, like making health insurance tax deductible for individuals, allowing insurance companies to compete across state lines, allowing individuals to use tax deductible health savings accounts, expanding use of retail clinics (http://www.time.com/time/health/article/0,8599,1919754,00.html) and nurse managed centers, and putting price point decisions back into consumer's hands instead of third parties. I'm growing tired of all these solutions that require solutions that require solutions that require solutions, etc. How about some real reform for a change?


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