Lie #1: President Obama wants to euthanize your grandma!!!
Lie #2: Democrats are going to outlaw private insurance and force you into a government plan!!!
Lie #3: President Obama wants to implement Soviet-style rationing!!!
Lie #4: Obama is secretly plotting to cut senior citizens' Medicare benefits!!!
Lie #5: Obama's health care plan will bankrupt America!!!
In a recent speech the President said that doctors are paid more for amputating the limb of a diabetes victim than they are paid for keeping that same patient healthy to prevent the amputation. He got to the heart of something important in the reform debate that I don’t think he realized. Much of the debate is about the intentions of the government rather than the incentives that such a sweeping bill would create.
Obama does not want to euthanize your grandmother, but he did recently question whether his own grandmother should have received a hip replacement near the end of her life. What he was addressing is that the government is not going to be able to conquer the scarcity of resources. No one can. The difference in the government plan is that a civil servant will decide who gets what instead of an insurance adjuster.
Democrats are not going to outlaw private health insurance. That’s what doomed the 1993 plan. But the incentives in the bill will make many corporations decide to end their own health insurance plans because those plans will become more costly with the reform. Many corporations are longing for the government to take this expense off their ledgers, so in some ways the reform is corporate welfare.
The President does not want to implement Soviet style rationing. But someone is still going to have to manage scarce resources and people won’t all get what they want even if they are paying a greater amount of the taxes to create such a plan. Cancer survival rates are higher in American than in Canada and Great Britain because it’s more likely here that you’ll get timely treatment under the current system.
Medicare is growing broke without any nefarious plan from Obama. In fact, the way the government has mishandled Medicare should give anyone pause that national health care won’t find the same problems.
One thing that the President will not address is the lottery lawsuits that are causing so much of the health care expense in this country. There are places in America with inadequate OBGYN doctors because the malpractice insurance is too costly for a small town practice. Great Britain has a loser pays system and that keeps the frivolous suits from coming before a judge. Here attorneys can make litigation so expensive that insurance companies will settle cases because it would be more cost-prohibitive to win.
Rather than trust the intentions of any politician we need to ask whether the incentives of a reform plan are likely to create unintended consequences that are worse than the current problems. And likewise we should ask what incentives a health care bill should have to ensure that we’ll get the results that we the taxpayer desire. Neither is being addressed in the debate. It's become a sporting event in the media.