Sunday, January 24, 2010
The Healthcare Trap
Five days before Scott Brown became the Republican who slayed the healthcare dragon, I wrote (A Perfect Storm?) that many Democrats were secretly wishing Brown would win so they could bow out of healthcare gracefully and still blame the Republicans for its failure. It didn't take but a few hours before the good-ship Healthcare was listing badly. Two days after the election Nancy Pelosi said she didn't have the votes for the Senate bill. The truth is the Democrats never had a bill that could pass and it took a year of trying to con the public into thinking they did before their vision of Single Payer collapsed. The President took this news poorly and said he was going to continue to push for it anyway. The point is that opponents of government health care must be vigilant and not fall into the trap of supporting options that continue adding the building blocks of government care. Both the moderate and extreme wings of the Democratic Party agree they have been fighting for national healthcare for more than sixty years. They started with Roosevelt and added Medicare twenty years later. Now every citizen over 65 must join the system. In the Clinton years they tried again for government healthcare. They failed, but they added children in the form of CHPS. So now they have adults over 65 and children under 18. The next building block is the Expansion to 55. It was offered by a little-known Representative or Senator as a potential option during the debate. It is an extremely interesting way to, as Solomon said, to "cut the baby." By expanding Medicare to include those above 55, they increase the size of the program by locking in another group of payers and at the same time; reduce the pool of potential customers for competitive healthcare services. Throw in some tort reform, open competition and liability limits and before you know it you have a compromise that both sides can accept. It'll be a regular "Lord of the Flies" bonfire with Republicans and the Democrats all dancing to the joys of cooperation, bipartisanship and re-election. Therein lays the trap. It permits an increase in the size of the government's involvement in something they should assist but not control. What the healthcare system needs to be more equitable is less government interference. Whatever savings may exist in government control is aggravated by the bureaucracy needed to extract those savings. That is just another way of saying it cost more when the government becomes part of the equation. Thinking people, whether they are liberal, moderate or conservative, recognize the wisdom of keeping government involvement in healthcare to a minimum. The failures of Medicare and Medicaid, which have almost $50 trillion in unfunded liabilities, and the substandard care that is part of the Social Medicine legacy, are proof enough that cost control, efficiency and innovation do not exist in government programs. Do not be fooled when the President makes a Healthcare push in his State of the Union speech this week. He and the Democrats will continue to pursue Single Payer until they are convinced it can never pass.