Health Care Reform - Questions That Must Be Answered - Part I

One thing far too many people promoting national health care reform have overlooked has been the actual economics of the main proposal (HR3200). In their minds the numbers will come into alignment if we all just wish hard enough and keep our fingers crossed. But taking a look at the economics with a (hopefully) dispassionate eye reveals some disturbing issues that have been ignored, either by design or through ignorance. (I, being the kind of guy I am, am willing to give the proponents the benefit of doubt and assume it's from ignorance.)

Whenever government gets involved, and particularly the federal government, costs go up. It is inevitable. Our own history has shown again and again that is the case. Why does anyone doubt that it will happen again if government takes a broader role in health care? All anyone needs to do is look at what's been happening in Massachusetts, where their preview of nationwide health care reform has done nothing but increased costs and wait times. Can anyone say that won't happen across the board if Obama gets his way?

So before there's any progress on such reform, proponents cannot defy the economics of that reform and what it really means. Too many parts of the most well known health care reform bill – the aforementioned HR3200 – ignore the economic impacts, which in turn will lead to the failure of the reform measure while at the same time damaging or destroying the existing medical care infrastructure. That's no way to 'fix' the problem.

A few 'lowlights' of what we can look forward to if HR3200 should pass:

Massachusetts reduced its uninsured population by two-thirds — yet the cost would be considered staggering, had state officials not done such a good job of hiding it. Finally, Massachusetts shows where "ObamaCare" would ultimately lead: Officials are already laying the groundwork for government rationing.

The most sweeping provision in the Massachusetts reforms — and the legislation before Congress — is an "individual mandate" that makes health insurance compulsory. Massachusetts shows that such a mandate would oust millions from their low-cost health plans and force them to pay higher premiums.

The necessity of specifying what satisfies the mandate gives politicians enormous power to dictate the content of every American's health plan — a power that health care providers inevitably capture and use to increase the required level of insurance.


Those requirements can increase premiums by 14 percent or more. Officials further increased premiums by imposing new limits on cost-sharing.

Over time, as mandates eliminate low-cost options and price controls eliminate comprehensive options, both the Massachusetts and Obama reforms will march consumers into a narrow range of health plans.

As goes choice, so goes quality. Statistics on waiting times for specialist care in Massachusetts read like a dispatch from Canada. In 2004, Boston already had the longest waits among metropolitan areas. By 2009, waits had generally shortened in other metro areas (average wait: less than three weeks) but lengthened in Boston (average wait: seven weeks), according to the Merritt Hawkins survey.

Some may argue that the national version of this program won't suffer from the problems seen in Massachusetts, but anyone with even a little knowledge of history will understand that the problems with a national program will be far worse. In the end it will benefit no one but the government. Disincentives for health care workers will make sure the quality and quantity of health care available will fall, particularly after the more gifted and dedicated workers are finally driven out by frustration and stress. It's already started in Massachusetts and has been an ongoing problem in the UK.

One does not promote better health care by penalizing those giving exceptional care. But that's exactly what this latest version of socialized medicine will do.

I always thought the way to ensure more 'equality' when it came to any issue, be it economic, political, or medical, was to raise everyone up to a higher level, not pull everyone down to the lowest common denominator. That's what health care reform as proposed will do, making sure everyone but the most wealthy (and members of the ruling elite) will receive exceptional care. The rest of us will be left with an ever declining quality and quantity of health care because reform made it inevitable that it would be so.

If nothing else such a move should be considered criminal because it looks like just what it is: racketeering. And we must remember racketeering has a long, fruitful history in Chicago.

Another problem with health care reform is that viable, workable plans are being ignored. It could be because the plans are being proposed by people other than those belonging to the 'right' party. Never mind that they might actually work as compared to ObamaCare.

One would thing the Democrats would pay attention to some of those plans, particularly those put forth by knowledgeable health care professionals, like Dr. Arthur M. Feldman:

As a cardiologist and the administrator of a large practice that includes general internists and specialists, I spend much of my time trying to figure out how to provide care for a growing number of uninsured or underinsured patients. I also have to battle billion-dollar private insurance companies that don't adequately cover patients with preexisting illnesses and often deny coverage for necessary treatments.

On a basic level, I'm with the president: Our health-care system needs to be changed so that all of my patients, and all citizens, have access to the care they need. But I don't agree with how he wants to fix things. Most of my colleagues and I strongly oppose the health-care reform bills that Congress will take up again this week. The proposals leave enormous gaps unfilled.

Before President Obama addresses a joint session of Congress on Wednesday, I hope he will consider these 10 major reasons why I -- and doctors like me -- worry that the legislation on the table will leave us worse off.

1.Private insurance companies escape real regulation.
2.We urgently need tort reform, but it's nowhere to be seen.
3."Prevention" won't magically make costs go down.
4.Reform efforts don't address our critical shortage of health-care workers.
5.We need more primary-care physicians -- but we also need specialists.
6.We have to streamline drug development and shake up the Food and Drug Administration.
7.We can't fund health-care reform by cutting payments to doctors.
8.We can't forget about research.
9.Cutting reimbursements could shut some hospitals down.
10.We need to improve the quality of care.

Each of Dr. Feldman's points bear looking into. (In his article linked above, each of his ten points are explained in detail.) Failure to address these issues will cause health care reform to be a dismal failure, creating both medical and economic chaos. Of course, I always thought health care reform was supposed to make things better, not worse. But if Congress does not abandon its ill-advised course of action in this regard, we will all be worse off for no other reason than they made it be that way.

More to follow in Part II.....

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