Today Robert Samuelson describes how the recent health care debate hasn’t informed Americans—it’s misinformed them, and the solutions being peddled by the President and Democrats in Congress would exacerbate existing problems with the health care system. He writes:
One job of presidents is to educate Americans about crucial national problems. On health care, Barack Obama has failed. Almost everything you think you know about health care is probably wrong or, at least, half wrong. Great simplicities and distortions have been peddled in the name of achieving “universal health coverage.” The miseducation has worsened as the debate approaches its climax.
There’s a parallel here: housing. Most Americans favor homeownership, but uncritical pro-homeownership policies (lax lending standards, puny down payments, hefty housing subsidies) helped cause the financial crisis. The same thing is happening with health care. The appeal of universal insurance — who, by the way, wants to be uninsured? — justifies half-truths and dubious policies. That the process is repeating itself suggests that our political leaders don’t learn even from proximate calamities.
How often, for example, have you heard the emergency-room argument? The uninsured, it’s said, use emergency rooms for primary care. That’s expensive and ineffective. Once they’re insured, they’ll have regular doctors. Care will improve; costs will decline. Everyone wins. Great argument. Unfortunately, it’s untrue.
A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency room use remained higher than the national average, reports an Urban Institute study. More than two-fifths of visits represented non-emergencies. Adult respondents to a survey said it was “more convenient” to go to the emergency room or they couldn’t “get (a doctor’s) appointment as soon as needed.” If universal coverage makes appointments harder to get, emergency room use may increase. …
Though it seems compelling, covering the uninsured is not the health care system’s major problem. The big problem is uncontrolled spending, which prices people out of the market and burdens government budgets. Obama claims his proposal checks spending. Just the opposite. When people get insurance, they use more health services. Spending rises. By the government’s latest forecast, health spending goes from 17 percent of the economy in 2009 to 19 percent in 2019. Health “reform” would likely increase that.
Samuelson argues that the key to reforming health care to control costs is to change incentives. Rep. Paul Ryan makes a similar argument in his oped in the Washington Post. He highlights the many ways the Democrats proposal fell to address the systems most fundamental problems (and would create new problems with new job-killing mandates and by driving costs higher), and makes the case for an alternative approach. He describes alternative legislation that he and other Members have introduced:
The Patients’ Choice Act takes on the discriminatory and inflationary tax exclusion, delinking the tax benefit from employers and attaching it to individuals through universal tax credits. The tax exclusion for employer-provided health coverage subsidizes insurance instead of health care, hides the true cost of coverage and disproportionately favors the wealthy at the expense of the self-employed, the unemployed and small businesses. Health-care economists across the political spectrum and reform-minded Democrats such as Sen. Ron Wyden identify the backward tax treatment of health care as a problem that must be addressed….
This year I re-introduced my own proposals to tackle our entitlement crisis head-on. My plan, “A Roadmap for America’s Future,” fulfills the mission of health and retirement security, lifts our crushing burden of debt, and spurs economic growth and job creation. In stark contrast to the vision being pushed by the majority in Congress, my plan unapologetically seeks to apply our nation’s timeless principles — our Founders’ commitment to individual liberty, limited government and free enterprise — to today’s challenges. It does so in a way that honors our historic commitment to strengthening the social safety net for those who need it most.
If this debate had actually been about health care, we could have worked together to get a grip on costs, make quality care more accessible, address exclusions for preexisting conditions and realign the incentives of insurance companies with those of patients and doctors. Yet this process — including its embarrassing conclusion — demonstrates that the debate has never been about health-care policy but, instead, paternalistic ideology.
This is the debate that Americans need, and deserve, to have about our health care system. Will Members listen to their constituents and scrap this big-government power-grab so they can actual consider ways to make our health system better? We will find out this week.