googlef87758e9b6df9bec.html A Sure Word: Obama’s Address

Wednesday, September 9, 2009

Obama’s Address

OK, I admit it, the guy can speak. He has a gift for oratory that’s rarely seen. When he talks about the 3 basic goals of his plan (“It will provide more security and stability to those who have health insurance. It will provide insurance to those who don't. And it will slow the growth of health care costs for our families, our businesses, and our government”), who can argue with those? But it’s when you pause and think about some of the details of how he intends to accomplish his goals that we see that things just don’t add up.

Think about this: Obama said his plan “it will be against the law for insurance companies to deny you coverage because of a pre-existing condition,” Insurance companies “will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime,” AND “We will place a limit on how much you can be charged for out-of-pocket expenses.” Now, add to this the fact that we’re also going to insure another 30-40 million people who don’t have insurance now. Oh, and I forgot that he will require insurance companies “to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies.” How is it possible for an insurance company to do all of these things and it NOT cost more money? How can they add millions of people to the insurance rolls (including people with preexisting conditions), guarantee unlimited lifetime or annual medical care, and charge patients less out of pocket costs to boot?

The simple answer is that it’s mathematically impossible to add so much without raising the cost of insurance. So where is the extra money coming from to pay for all this? One way is supposedly by offering a not-for-profit, government-run exchange that competes with insurance companies. The theory being that competition always drives down costs. Well, I am a believer in capitalism and competition typically does reduce costs; however, the competition should exist in a free-market – that is, one where there is little control or regulation from the government. That’s hardly the case here. Furthermore, it’s extremely difficult for for-profit companies to compete with not-for-profit companies – especially when the not-for-profit company is the one regulating the for-profit companies!

Another area of savings is supposed to “eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies — subsidies that do everything to pad their profits and nothing to improve your care.” First off, large companies already strive to reduce fraud and waste. It’s not as though they haven’t thought of this already. And there’s nothing magical about a government mandate that would help them find more areas to cut. But secondly, if hundreds of billions of dollars in waste and fraud exist in Medicare now, why are they waiting for health care reform to correct it? Why not just eliminate it now? I guarantee you he would have Republican support for it.

But besides the absurd notion that all of this reform can be done without adding to the cost of insurance or to the deficit, I object to the moral argument there even needs to be sweeping health care reform. In his speech, Obama said, “One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.” But in that same speech, he also said, “Now, even if we provide these affordable options, there may be those — particularly the young and healthy — who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers. The problem is, such irresponsible behavior costs all the rest of us money.” In my opinion, compelling people to “act responsibly” is antithetical to rugged individualism.

Obama said, “under my plan, individuals will be required to carry basic health insurance — just as most states require you to carry auto insurance.” Of course, states which do require individuals to carry insurance only require liability insurance; I am perfectly free to risk my own life and property – I just don’t have the option to risk other peoples lives or property. But besides that, how does Obama reconcile his belief in “rugged individualism” with his belief in compelling individuals to act at the expense of their own liberty for the benefit of society as a whole? The contradiction is glaring.

Oh, and I noticed how the President has carefully changed the wording of his guarantee that people can keep their existing coverage if they’re happy with it. He now said, “nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.” Isn’t that interesting? Nothing “requires” you to change. That means your employer might decide it’s more expensive to insure you than to not insure you and pay the government fine instead. He’s not “required” to do it but he might still do it and you end up on the government plan whether you wanted to or not. Again, how is this reconciled with personal liberty?

The one area of the speech that piqued my interest is when Obama said, “Finally, many in this chamber — particularly on the Republican side of the aisle — have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.” Of course, I noticed the stoic expressions on the faces of Biden and Pelosi as he said this. I doubt Democrats would allow that into any bill they voted for. But regardless of that, I doubt Obama is serious about it anyway. His statement might be paraphrased, “I don’t think tort reform would do anything but, if it makes you happy, I’ll have someone look into it.” There was certainly no promise that tort reform would be a part of final bill in Congress.

So, in short, we have a government usurping it authority to impose on us another entitlement we can’t afford and don't want. There’s Washington for you.

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