“I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans,” Obama wrote. “This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”Logic dictates that a government operated health plan would be able to charge less than one operated by the private sector. Even if all other things were equal since the government plan would not have to make a profit, the public run company would have a built-in competitive advantage enabling them to undercut the private companies out of business.
The President says the government would not force a change, but of course just like they can do today, a company can force a change. Now follow the logic out, if the government plan doesn't have to make a profit, and if all other costs are the same, it can charge less. So which way do you think companies will go? If You have a group of competitors and one has virtually unlimited resources and does not have to make a profit, how long before the competition is struggling for customers.
Eventually you will end up with ONE insurance company named Uncle Sam. And when your good Uncle Sam wants to save some money, he will start making bureaucratic, rather then medical decisions about your health. Mom wont get that treatment to save her life because it is expensive, or Uncle Sam will determine when to pull the plug on grandma. How am I so sure? Because there has NEVER Been a Government-run Health Plan That Did Not Ration Care.
Does that mean there will be some sort of Death Committee saying that Joe Smith is going to die? NO! But there will be a set of guidelines that say which treatments can be given to which people. As far as I know, there is no language in any of the bills that call for the guidelines. But there will have to be rationing, and the only way to save money is to reduce care, and it is our seniors who need the most care. Its as simple as that. Obama care is not going to murder your grandmother, but the effect is going to be exactly the same:
Obama's Senior Moment
Why the elderly are right to worry when the government rations medical care.
Elderly Americans are turning out in droves to fight ObamaCare, and President Obama is arguing back that they have nothing to worry about. Allow us to referee. While claims about euthanasia and "death panels" are over the top, senior fears have exposed a fundamental truth about what Mr. Obama is proposing: Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.
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Far from being a scare tactic, this is a logical conclusion based on experience and common-sense. Once health care is a "free good" that government pays for, demand will soar and government costs will soar too. When the public finally reaches its taxing limit, something will have to give on the care and spending side. In a word, care will be rationed by politics.
Mr. Obama's reply is that private insurance companies already ration, by deciding which treatments are covered and which aren't. However, there's an ocean of difference between coverage decisions made under millions of voluntary private contracts and rationing via government. An Atlantic Ocean, in fact. Virtually every European government with "universal" health care restricts access in one way or another to control costs, and it isn't pretty.
The British system is most restrictive, using a black-box actuarial formula known as "quality-adjusted life years," or QALYs, that determines who can receive what care. If a treatment isn't deemed to be cost-effective for specific populations, particularly the elderly, the National Health Service simply doesn't pay for it. Even France—which has a mix of public and private medicine—has fixed reimbursement rates since the 1970s and strictly controls the use of specialists and the introduction of new medical technologies such as CT scans and MRIs.
Yes, the U.S. "rations" by ability to pay (though in the end no one is denied actual care). This is true of every good or service in a free economy and a world of finite resources but infinite wants. Yet no one would say we "ration" houses or gasoline because those goods are allocated by prices. The problem is that governments ration through brute force—either explicitly restricting the use of medicine or lowering payments below market rates. Both methods lead to waiting lines, lower quality, or less innovation—and usually all three.
A lot of talk has centered on what Sarah Palin inelegantly called "death panels." Of course rationing to save the federal fisc will be subtler than a bureaucratic decision to "pull the plug on grandma," as Mr. Obama put it. But Mrs. Palin has also exposed a basic truth. A substantial portion of Medicare spending is incurred in the last six months of life.
From the point of view of politicians with a limited budget, is it worth spending a lot on, say, a patient with late-stage cancer where the odds of remission are long? Or should they spend to improve quality, not length, of life? Or pay for a hip or knee replacement for seniors, when palliative care might cost less? And who decides?
In Britain, the NHS decides, and under its QALYs metric it generally won't pay more than $22,000 for treatments to extend a life six months. "Money for the NHS isn't limitless," as one NHS official recently put it in response to American criticism, "so we need to make sure the money we have goes on things which offer more than the care we'll have to forgo to pay for them."
Before he got defensive, Mr. Obama was open about this political calculation. He often invokes the experience of his own grandmother, musing whether it was wise for her to receive a hip replacement after a terminal cancer diagnosis. In an April interview with the New York Times, he wondered whether this represented a "sustainable model" for society. He seems to believe these medical issues are all justifiably political questions that government or some panel of philosopher kings can and should decide. No wonder so many seniors rebel at such judgments that they know they could do little to influence, much less change.
Mr. Obama has also said many times that the growth of Medicare spending must be restrained, and his budget director Peter Orszag has made it nearly his life's cause. We agree, but then why does Mr. Obama want to add to our fiscal burdens a new Medicare-like program for everyone under 65 too? Medicare already rations care, refusing, for example, to pay for virtual colonsocopies and has payment policies or directives to curtail the use of certain cancer drugs, diagnostic tools, asthma medications and many others. Seniors routinely buy supplemental insurance (Medigap) to patch Medicare's holes—and Medicare is still growing by 11% this year.
The political and fiscal pressure to further ration Medicare would increase exponentially if government is paying for most everyone's care. The better way to slow the growth of Medicare is to give seniors more control over their own health care and the incentives to spend wisely, by offering competitive insurance plans. But this would mean less control for government, not more.
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It's striking that even the AARP—which is run by liberals who favor national health care—has been backing away from support for Mr. Obama's version. The AARP leadership's Democratic sympathies will probably prevail in the end, perhaps after some price-control sweeteners are added for prescription drugs. But AARP is out of touch with its own members, who have figured out that their own health and lives are at stake in this debate over ObamaCare. They know that when medical discretion clashes with limited government budgets, medicine loses.
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