Monday, June 08, 2009


Not only will the new program become the default coverage for the uninsured, but Democrats intend to game the system to precipitate—or if need be, coerce—an exodus . . . of private insurance. Soon enough, that will be the only “option” left. -- The Wall Street Journal, April 13, 2009

A new report from the President’s Council of Economic Advisers warns that the increasing cost of health care is not sustainable. The Congressional Budget Office estimates that individual and corporate income taxes would have to rise through 2050 by 90 percent even without “public option,” the new middle-class entitlement.

The CEA Report, titled, The Economic Case for Health Care Reform, mentions among its solution: People should get used to less medical care. Betsy McCaughey, long-time critic, argues that a superior way is to reduce government’s share of the costs, which will not be done by ousting the private health-care insurers through the new radical public option.

President Obama wants the health-care insurance bill passed right away, and two bills are scheduled to be heard in the Senate this month. Unfortunately, that will give little time for readers to absorb The Wall Street Journal’s April 13 editorial, “The End of Private Health Insurance.”

The President and others argue illogically that health care will be less expensive if everyone is covered, an argument used to make the case for mandating health-care insurance. Massachusetts in 2006 adopted mandating. By nearly universal agreement, the law is a failure and not a good model for the country, though it is the model for Senator Kennedy’s bill.

High among the controversial issues list is single-payer. It is defined as a “single government-backed insurance plan that would pay for all Americans’ medical costs.” But suddenly, without warning, single-payer has been whisked off the table, to the consternation of supporters. The official reason? It’s “too radical.”

“This public option would be the most radical change in the way American health care is financed—and thus provided—in at least 44 years, and maybe ever,” says the WSJ.

Opponents see single-payer as a government bulldozer kicking private insurance companies out of the industry.

Another explosive issue is whether health-care insurance should be mandated. Massachusetts mandates “universal” health-care insurance for individuals, but it is universally seen as a failure, even though it is being used as the model in Senator Kennedy’s bill

Massachusetts’s mandate on individuals is a windfall for the insurance industry, which is “holding us hostage,” according to resident and single-payer proponent Marcia Angell, former editor of the New England Journal of Medicine.

If there is mandating, it should be only a last resort, according to Professor Stuart Butler. He advocates starting out with “automatic enrollment,” where people are signed up unless they actively decline. Part B of Medicare is voluntary, and through automatic enrollment, about 96 percent of eligible seniors are enrolled. The point is to try individual responsibility as the default option before sending the cops around to enforce the mandate, urges Butler.

Programs that work, writes Grace-Marie Turner of the Galen Institute, are incentive-based. She cites a survey by Deloitte’’s Center for Health Solutions that found that the cost of consumer-directed health plans increased by only 2.6% in 2006 among 152 major companies, which is one-third the rate of increase among traditional plans.

Senator Kennedy has his bill all ready for adoption. It creates the public option —the new government-sponsored health insurance plan -- which would compete with private insurers. It does not include cost estimates or discuss how to pay for the expansion.

Massachusetts had one of the highest rates of insured at the outset of the program, which is costing heavily. One problem is that Massachusetts kept in place the same expensive mandates that had made private coverage expensive.

Massachusetts’s universal health care was to insure everybody by forcing everybody into either private programs or expanded government programs, using both tax hikes and subsidies. Subsidies include families earning up to 500 percent of the poverty level or $110,000.

Opponents see the goal of public option as getting rid of the private insurance companies and putting the government as the single-payer in the position of command and control of the industry. Senator Bennett in an eloquent speech on the Senate floor last week pointed out that if a bill includes private as well as public insurers, it will be arranged so that ultimately the public will be the only player. Public option seems to be designed to rid the industry of its private companies.

What does the public think? One poll found the single-payer option last of eight choices, with 49 percent in favor, 47 percent against. One-third of those who favor public-payer would be against it if were the opening of a single-payer system.

The Wall Street Journal April 13 editorial concludes,

"Republicans, especially those in the Senate who want to cut a deal on health care, should understand that a public option is the beginning of the end of private health insurance."

By Natalie Sirkin
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