American Elephants


Here’s Why ObamaCare Has to Go! by The Elephant's Child

You may remember this chart which lays out the reach of ObamaCare. [Click to enlarge, then use your mouse to drag it larger]. It shows the reporting lines and lines of responsibility. There are supposedly something like 100 new agencies involved, each with many employees, all of whom receive salaries and benefits. Yet Obama has claimed that it will be less costly than our present health care system, and our costs for insurance will go down— described as “bending the cost curve down.” This, of course, is preposterous. It will be many times more expensive.

We have a lot of misconceptions about the whole health care debate.  First of all, it is not about our health care, it is about insurance. The only interest in actual health care is how to cut expenses. In the case of ObamaCare, it means eliminating the highest expenses which are for old people in the last years of their lives, and for those who serve no useful purpose, the demented, the completely disabled. They want to get rid of the expensive nuisances.

Obama’s health care advisors were uniformly great admirers of Britain’s National Health Service. Even in Britain, those who can afford it have private insurance and go to private doctors and hospitals. James Delingpole offers us some advice.  Surely you have noticed that all of those who are so enthusiastically trying to force us into ObamaCare have excluded themselves from any necessity to participate

Much is made of international comparisons. The United States, we are told spends way more than other countries, therefore we spend too much. Trouble is they try to make these comparisons based on purchasing power parity, and summing up of transactions.  For uncomplicated dental fillings, reimbursement data underestimate total costs by 50% in nine European countries. Countries account for long term care and out-of-pocket spending differently. The accounting treatment of overhead and capital costs also varies. According to the National Center for Policy Analysis (NCPA), an OECD project to harmonize national accounting methods began in 2000, but even when methods are harmonized, the choice of a price adjustment method can alter hospital cost estimates by as much as 400%.

The U.S, compares more favorably when real resources are measured rather than monetary accounts. Per capita, the US uses fewer physicians, nurses, hospital beds, physician visits and hospital days than the median OECD country. The average annual rate of growth of real per capita US health care spending is slightly below OE average over the last decade and over the last four decades.

The US infant mortality rates vary a factor of two or three to one across racial and ethnic groups, a cross cities, and across states for reasons that seem to have little to do with health care. The big difference seems to be in national differences in the definition of a live birth.

We spend more on prescription drugs, do more tests, have more major diagnostic equipment, and a better rate of survival for cancers, less pertussis, measles and Hepatitis B, 36% of cases of high blood pressure are controlled. We have short waits for cataract surgery, prompt coronary bypass, rapid hip replacement. We know about waiting times in other countries, but we don’t know about the people who live with pain or poor sight.

Much has been made of the uninsured — but most uninsurance is transitory, while people are between jobs. A major part of the uninsured are uninsured by choice. Obama has made much of bankruptcies caused by medical debt, but the claim conflicts with four decades of economic research. The label “medical bankruptcy” was applied if out-of-pocket medical bills exceeded $1,000, even though out-of-pocket expenses of the average US household were $2,182 in the year studied. Recalculating the study’s data, they concluded that only 17% of the sample had medical expenditure bankruptcies.

Can the free market work in health care? NCPA points out that:

In cosmetic surgery, virtually all payments are out-of-pocket and transparent package prices covering all services are the norm. Even though technological progress is frequently assumed to increase health care costs, the real price of cosmetic surgery has declined over the past 15 years, despite substantial technological progress and a six-fold increase in demand. In corrective vision surgery, out-of-pocket payments and package prices are the norm, and the real price has declined by 30% over the past decade. Price transparency is absent in virtually every other kind of surgery.

Many are now demanding that since Republicans are urging repeal of ObamaCare, the Republican candidate should be able to explain in a sentence or two just what his plan is. It took 2074 pages to enumerate the Patient Protection and Affordable Care Act, and it is reported today that lawyers have already drafted 13,000 pages of regulations for the new ObamaCare tax law.

Scholars at the Heritage Foundation, the American Enterprise Institute, the National Center for Policy Analysis, the Cato Institute, the American College of Physicians, The Pacific Research Institute, and many other think-tanks, foundations and individuals have been working on ideas since Hillary Care. And they have a lot of impressive ideas: tort reform, cross-state border insurance, health savings accounts, Paul Ryan’s plan for direct subsidies for buying health insurance is promising. Above all, they are not looking for power, they are looking for a free-market solution that both gives you care for your own health and that of your family, but preserves your individual freedom.

When a third party (your insurance company) pays for your medical care, there is no incentive to try to hold down costs. Incentives matter. The Medicare Drug Benefit is unique as a government program in that it has come in costing less than estimates because of the incentives to use generic drugs and keep costs down when possible. Republicans believe in incentives because they work.

They started with wrong assumptions; their goals—which seem to be about control of the people—are reprehensible; the results of their sloppy work will do all sorts of damage to the country, and the monumental tax increases may well bankrupt the country. These people are somewhat wanting in economic expertise.




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