Tuesday, October 29, 2013

Inconsistencies and Contradictions

The people who say this “health care reform” legislation will not work do not know what they are talking about. The people who say that it will work also do not know what they are talking about. The problem is twofold. First, the legislation is so convoluted and complex that no one can know everything that it actually does. Second, even in it’s most basic form it is an experiment. The policy prices emerging from the smoke and the hall of mirrors are guesses, and only time will tell if they will prove workable.

This “reform” was doomed from the start, because while everyone wanted it, no one was willing to pay anything or sacrifice anything to get it. The government was unwilling to increase its budget to accomplish it. People who already had insurance were unwilling to give that up. People on Medicare were not willing to see changes made to that program. Voters were unwilling to be taxed to pay for it. People who wanted insurance didn’t want to have to pay to get it. We all know the stake that medical providers, drug companies and health insurance companies had in this issue.

And so we have a “health care reform” which is filled with inconsistencies and contradictions. Government is by nature coercive, but this mess is gratuitously so. It forces businesses to sell a product to one group of persons on which it will lose money, and balances that by forcing another group of persons to buy a product which they neither want or need to buy. The claim is that one will balance the other, but no one has the slightest idea whether that is actually so or not. It may be nothing more than an urban myth.

When forcing an individual to buy a product which he cannot afford, the government pays a large portion of the premium, but it does so by "savings in Medicare," which means less medical care for old people, and by a tax on medical devices, which means higher prices for those devices and higher costs for medical care. So we're reducing care and increasing costs for one group who needs medical care to pay the premiums for another group who is being forced to buy coverage they don't need.

The claim is that reductions in Medicare will be borne by the providers and not by elderly people, which means that providers being paid by Medicare will provide the same or more care for the elderly while charging billions of dollars less. And pigs will fly, but not on this planet.

And the supposition is that a tax on medical devices will “reduce expenditures for” medical care. It may indeed mean that we will use fewer devices, because the cost of those devices will increase as a result of imposing a tax on them, but that is a far different proposition than “reducing the cost of” medical care. If the stated goal of the reform had been to reduce the amount spent on health care by reducing the amount of health care delivered, the “health care reform” movement would have been one hell of a lot less popular than it is.

Instead we get the claim that the “reform” is going to raise standards for insurance and deliver better health care for lower insurance premiums, which defies logic. Millions of people are having their “bare bones” policies cancelled as we speak because those policies do not meet the new standards, and are being told that they can sign up for new policies that do meet those standards at much higher premiums, so we know already that insurance companies are not going to deliver more benefits with lower premiums. Why is anyone surprised?

At every turn it looks like we are providing more care one place by providing less care somewhere else and pretending to lower costs here by raising costs somewhere else. And given that there was no willingness to pay or sacrifice anything to achieve reform, how could it be anything other than that sort of trade off?

No comments:

Post a Comment