By Jeb Bradley NH Senate
Listening to the supporters tout the benefits of federal health care reform during the day long debate, I was struck by the saying ‘if it sounds too good to be true – it probably is. For 219 Democrats who voted for passage, it sounds wonderful: access to health care improves, the patient-doctor relationship is strengthened, insurance premiums drop, and deficits decline.
219 Democrats may be true believers or "incentivized" into voting yes, but the American people clearly do not believe this happy talk. Just as noteworthy, Americans witnessed a totally partisan vote for passage, and significant bi-partisan opposition.
Let’s examine the Democratic spin.
Access to health care -- does it deteriorate or improve? Physicians are already reluctant to accept Medicare and Medicaid patients because of low reimbursement rates. Over $500 billion of Medicare cuts only exacerbates this trend. 32 million people will be newly insured – nearly half covered by Medicaid. How the current medical establishment can absorb 32 million new people without creating long waits is an unanswered question. Ominously, the New England Journal of Medicine recently wrote that one third of physicians “will want to leave medical practice after health reform is implemented.”
For anyone imbued with the hope that access to healthcare will improve consider this: the Mayo Clinic announced in January it will no longer treat Medicare patients at one of its facilities in Arizona as the Clinic considers whether to drop coverage for 500,000 more Medicare patients it currently serves. This should not be a surprise as government-run health care in Canada and England has excruciatingly long waits. Where exactly will Americans go when they can’t get life saving treatments at home?
Will medical decisions be made by doctors and patients? Consider the following: a health czar will determine the parameters of health insurance policies, approve insurance rates, and the extent of reimbursement for medical service. Government mandates and bureaucracy will only lead to fewer patient choices as government controls increase.
Insurance premiums will increase despite the President’s promise that American families would save $2500. The Congressional Budget Office (CBO) has estimated that insurance premiums will be 10% to 13% higher as a result of the bill. The Center for Medicare and Medicaid Services – the people who actually run these programs and the CBO have both estimated that overall health care spending will increase as a result of the reform.
The real world however, is more instructive than any prediction. Massachusetts mirrors provisions of the federal legislation, in particular the requirement to buy insurance. They have the highest health insurance costs in the nation, major budget problems, and Governor Patrick has proposed price controls. The rest of the country will learn soon enough. Massachusetts already has – it's no accident that an overwhelmingly Democratic state elected Republican Scott Brown primarily because of his opposition to the national healthcare legislation.
Supporters claim the deficit will drop, accomplished through nearly $600 billion of new taxes and over $500 billion of Medicare cuts and accounting shenanigans. Tax hikes will be immediate while the majority of the new spending does not occur for four years. That’s how Democrats miraculously reduce the deficit.
Congress also deferred over $200 billion for physician reimbursement under Medicare so this legislation appears – for now – to be budget neutral.
The real world is again instructive. When Medicare was first implemented in 1965 the annual projected costs were $9 billion by 1990. Instead its costs were nearly $70 billion and the unfunded future liability for Medicare is now a staggering $37 trillion. With deficits as far as the eye can see—what is really at risk is the health of our nation’s financial system and our children’s future.
Health care reform is necessary. That's why we should develop better high risk pools to resolve coverage denial for pre- existing conditions. We need to allow across state border health insurance purchasing to create competitive markets that will lower costs for business and individuals. We need to change the tax code to give individuals the same preferential treatment as businesses. Most importantly, we need to let individuals be in charge of their own care so they can make their own choices when utilizing services. Lastly, tort reform could curtail $80 to $150 billion of defensive medicine costs making health insurance much more affordable. All these measures will significantly improve access to affordable health care --- without a government takeover.
If health care reform was everything its supporters claim -- why in the world did they need a second piece of legislation fixing the first legislation an hour after they passed it? If the legislation is so good – why will the IRS need to hire nearly 17,000 agents to enforce it? And if the legislation was so good then why do its supporters seek to exempt unions from the new tax on so-called "cadillac" health plans the rest of us will pay?
Carol Shea-Porter and Paul Hodes may drop by New Hampshire in April to campaign for their election in November. They should start thinking now about how to explain to constituents that their vote is unfortunately no April Fool's joke.