The High Cost of Health Care

As Democrats and Obamabots try to remake the health care system in the face of bitter opposition (45% of doctors say they will quit their practices or retire early), the federal public option for the elderly is preparing to cut benefits. This should be part of the debate, but of course it is not.

Supporters of the health care revision tell us that its $1 trillion price tag won’t add a dime to the national deficits. But the reality is any program that expands Washington’s reach into health care will cost far more than the rosy projections we’re hearing. History shows that the bureaucracy always spends far more on programs than the Beltway experts say it will.

One program that has spun wildly out of control is Medicare, enshrined as an entitlement in 1965 over the opposition of many in Congress because they could see what was coming. Actuaries projected its cost for 1990 as $10 billion. Yet actual outlays were $107 billion. Now the program is spending more than it is taking in through the payroll tax that is supposed to fund it, leaving Washington with only two options: ration Medicare or raise taxes.
Don’t make the mistake of thinking that brilliant minds in Washington will figure out a way to avoid rationing before it becomes necessary. Those heads are busy looking for places to slash right now. Medicare, for instance, is considering cutting $1.4 billion in benefits beginning on January 1st, 2010. If the new schedule is adopted, the reductions will be in fees paid to cardiologists and oncologists.
At the same time that fees for heart and cancer physicians will be trimmed by 10%, fees paid to family doctors, who can do for little heart and cancer patients, will be boosted by 8% and reimbursements paid to nurses will rise 7%. The Administration believes that moving the fees toward primary care will be a boost for preventive care which recent studies have been shown to provide no significant savings.

There are two points to take away from this mostly ignored news. One, any scheme passed by Congress and signed into law will cost taxpayers dearly. Two, the government will have to ration care because it cannot possibly pay for a nation of 305 million going on a billion demanding free medical care.

If rationing is adopted, it will have a direct effect on patients, particularly those who are suffering from two of the most serious illnesses. Heart and cancer specialists, who will be expected to accept Medicare reimbursements that are less than some procedures cost, are already reporting that they will either close their practices or limit care. Some will simply stop treating Medicare patients. Welcome to the new brave world of rationed medicine!
Anyone who believes Washington can improve health care by increasing its involvement is not thinking clearly. Its solutions tend to create bigger problems. Yes, a government takeover may improve care for a small segment of the population. But it will be far worst for everyone else. – adapted from an IBD editorial.
In looking for cost savings the government has overlooked the most obvious source for such savings: illegal aliens, legal immigrants, and their progeny who account for a disproportionate share of the uninsured and who use emergency rooms are their primary providers. What if we started demanding that emergency room patients produce evidence of citizenship as soon as possible after their condition is stabilized or sooner if a relative is available to provide that evidence? What if we required the hospitals and emergency rooms to place an automatic call to ICE by pushing a button with a pre-recorded message like, “We are treating a patient who has been unable to produce evidence of citizenship. Please arrange for immediate pick up and deportation as soon as the medical problem is under control.” What if the hospitals and emergency rooms also required the patient to identify the employer of the family breadwinner so he could be billed for any unreimbursed costs? What if they also had a mechanism for billing the countries of origin for all costs of treatment, hospitalization, detention, and repatriation? There is a good possibility of billions of saving to be had with these administrative arrangements. Obviously, Obama is not interested in savings from this quarter or he would be saying, “Why didn’t I think of that?”