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Follow the Bouncing Buck: The Year's Highlights in Blame Shifting
· Wednesday, December 29, 2010
Two weeks ago, writing in The Washington Post, Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sebelius argued that Americans must be forced to buy government-approved medical coverage to prevent "unfair cost-shifting" by uninsured patients. They neglected to mention that the federal government mandates such cost shifting by requiring hospitals to treat all comers, regardless of their ability to pay.
Holder and Sebelius also misleadingly implied that the individual insurance mandate is aimed at addressing uncompensated care, which according to the Henry J. Kaiser Family Foundation represents less than 3 percent of health care spending.
The main reason ObamaCare compels people to buy insurance is not so they can pay their own bills, but so they can pay other people's bills. Since the new system requires insurers to cover everyone while forbidding them to charge sicker policyholders more, it needs to conscript people who hardly use health care so they can subsidize the expenses of people who use it a lot.
The Obama administration's refusal to acknowledge that coercion begets coercion when the government meddles in the health care market was one of the year's most memorable examples of blame shifting. Here are a few more:
Tiny Toy Terror. This month, with help from the Center for Science in the Public Interest, Monet Parham, "a mother of two from Sacramento" (who happens to work for the California Department of Public Health), filed a class action lawsuit against McDonald's, complaining that the fast food chain "uses toys as bait to induce her kids to clamor to go to McDonald's and to develop a preference for nutritionally poor Happy Meals."
In the spirit of former Federal Communications Commission Chairman Kevin Martin -- who once declared that "you can always turn the television off and, of course, block the channels you don't want ... but why should you have to?" -- Parham concedes that she can say no to her kids, but she resents the necessity.
"As other busy, working moms and dads know," she says, "we have to say 'no' to our young children so many times, and McDonald's makes that so much harder to do."
Four Loko Madness. The Food and Drug Administration banned the fruity malt beverage in November amid a moral panic about a product that grandstanding politicians denounced as "a plague," a "witch's brew" and "a death wish disguised as an energy drink." Alarmist press coverage blamed Four Loko for making people break into homes, crash stolen vehicles, shoot themselves and contemplate murder.
Mooting the Messenger. President Obama called Citizens United v. FEC, the January decision in which the Supreme Court lifted restrictions on political speech by corporations, "a green light to a new stampede of special interest money in our politics." Later, he pre-emptively blamed the ruling for letting "shadowy groups with harmless-sounding names" trick people into voting against Democrats. Obama thereby ignored the ways in which his big-government policies, including stimulus spending, bank and automaker bailouts, and expanded federal control of health care, simultaneously invited special-interest lobbying and alienated voters.
Government-Guaranteed Drug Dangers. This year, drug warriors repeatedly warned the public about hidden hazards in psychoactive substances sold by unscrupulous traffickers, including a veterinary medicine used to cut cocaine and the obscure chemicals that supply the high in quasi-legal alternatives to pot and speed. They never acknowledged their own role in creating such hazards by enforcing drug bans that make quality unreliable and drive people to potentially dangerous substitutes.
Scope or Grope. The Transportation Security Administration invited travelers to blame Umar Farouk Abdulmutallab, the Nigerian accused of trying to blow up an airplane by igniting explosive powder sewn into his underwear, for the ritual humiliation of routine full-body scans backed up by newly aggressive pat-downs. But the new scanners probably would not have discovered Abdulmutallab's underwear bomb because they are bad at detecting thinly packed, shape-hugging explosives. The specious excuse suggests TSA officials are determined to cover their butts while making us show ours.
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Jeff
We conservatives like to argue free market principles on the health care debate. The problem is, health care has never been a free market.
Our prior system was a hodgepodge of bleeding hearts being manipulated by special interests. It's disingenuous to argue for libertarian principals defending a system that's so dysfunctional.
No, I don't think the government will do a better job than health insurers. The kludge that recently passed was so much worse that I suspect the only winners will be lawyers who are left trying to decipher the law while patients die.
The solution is two fold. First we need people to start paying their own way. As long as people are left to game the system inefficiencies will eat up much of the money.
Second we need a rough match of the number of payers to the number of payees. As long as the AMA is monolithic, by limiting the number of doctors, we need a single payer system.
Either break up the AMA or go to a single payer system. Breaking up the AMA moves us to a true free market (more efficient). Letting the government take over moves us in a socialist direction (less efficient, but more robust).
Posted December 30, 2010 at 6:27:11 PM
sunforester
Jeff, the AMA doesn't limit the number of doctors. The AMA is simply a trade association - the number of doctors in this country is limited only by the individuals who willingly choose to get their license and practice medicine.
Market incentives power the number of doctors; whenever the health care system makes it more onerous to be a doctor in this country, the more established practitioners decide to retire early or move to Australia. A tough health care reimbursement system also incentivizes young people to forego medical school and take up a career that is more rewarding. The AMA can't possibly do a thing about this.
If you want more doctors in this country, allow them to make a good living. That used to happen in this country, but Obamacare will guarantee that doctors will be highly regulated and poorly compensated. If it makes you feel any better, nurses are leaping into the vacuum - if you don't mind far more simplified and less advanced diagnosis and medical treatment, Obamacare is for you.
You are correct in that bleeding hearts have made a mess of our health care system by mandating care to all who walk into an emergency room, without providing any means to pay for them except leaving the hospitals to shift the burden to the other patients who do pay.
Bleeding hearts in a wide number of states also demand certain medical services and benefits to be available for all, with the tab to be picked up by those who are already paying for their own care. Just like our tax system, relatively few people are paying the medical bills for everyone - Obamacare makes this disaster official and far more widespread.
You are also correct in that people should pay their own way, but that is a tricky proposition at best. Now that health insurers are mandated to accept any child to age 26, the first numbers are coming in for us to see how popular opening the floodgates are for all that allegedly pent-up demand.
Guess what? Only 1 or 2 percent more families than last year are paying premiums for their children's health insurance that insurers cannot refuse. All this shows is that a mandate to insure does not guarantee coverage. You can lead the horse to water, but you can't make him buy health insurance as long as it is his choice. Obamacare deals with that by removing any choice altogether.
Breaking up the AMA won't give us more doctors or make the health care market more efficient. The government taking over puts us squarely into an Orwellian socialist system - far from making our health care system more robust, it degrades and squanders our resources. We need to dump Obamacare and start over without all the bleeding heart desires to give away free medical care that is by no means free.
Posted December 31, 2010 at 6:53:55 PM