What was it like to go to a doctor in America 60 years ago?<\/p>\n
The family doctor couldn\u2019t offer high-tech diagnostic tests or treatments, mind you. But neither would you find the office full of employees negotiating on telephones with Medicare, Medicaid, or private insurers, trying to determine what treatments would be \u201ccovered,\u201d and what percentage of the doctor\u2019s real costs the \u201ccoverage\u201d would pay.<\/p>\n
Charges would seem quite low, by today\u2019s standards. Many doctors treated \u201ccharity cases\u201d for free, though that was their own decision. Most Americans paid their modest bills on the spot, or arranged their own, ad hoc, \u201ctime payment\u201d plans.<\/p>\n
What was it like trying to buy a telephone in America, 60 years ago?<\/p>\n
You couldn\u2019t. Most telephones — largely identical, heavy black desk sets — were owned by a monopoly enterprise which only rented them to consumers. You couldn\u2019t even unplug a phone and move it to another room — you had to call one of the company\u2019s \u201cinstallers\u201d to do such work. A \u201cmobile\u201d or \u201ccellular\u201d phone? What\u2019s that?<\/p>\n
Today, no one complains about a lack of choice or technical innovation in telephones. Because the old monopoly was broken, hundreds of suppliers now compete for consumer dollars by offering smaller and lighter portable phones with ever greater capabilities, at prices so low even children carry personal telephones — in a choice of colors.<\/p>\n
There\u2019s no ponderous phone-subsidizing bureaucracy threatening to bankrupt the nation, called \u201cPhonicare\u201d or \u201cPhonicaid.\u201d The free market works great, providing a service it\u2019s now hard to imagine doing without. Furthermore, we\u2019re free to go \u201cphoneless\u201d any time we choose.<\/p>\n
On the other hand, American medical care over the past 60 years has come under increasing government regulation, control, and economic dominance, thanks to the welfare-state schemes called \u201cMedicare\u201d and \u201cMedicaid,\u201d which were supposed to make medical care \u201cmore affordable\u201d for the poor and elderly.<\/p>\n
Each of these schemes has overrun its intiial cost estimates, not by a mere 10 percent or 20 percent, but by a factor of 10 to 20. In company with \u201cSocial Security,\u201d their costs will soon dominate the entire federal budget.<\/p>\n
Now, \u201cOptimists say\u201d the $848 billion \u201chealth care reform\u201d package drafted by Senate Majority Leader Harry Reid, D-Nev., \u201cwould eventually reduce both private premiums and the swelling cost of government health care for the elderly and poor,\u201d reports Lori Montgomery of the Washington Post.<\/p>\n
\u201cPessimists,\u201d on the other hand, \u201cfear the initiative would leave Washington struggling to pay for a new $200-billion-a-year health program even as existing programs require vast infusions of cash to care for the aging baby-boom generation,\u201d the Post reports.<\/p>\n
By imposing new taxes now, but phasing in \u201cbenefits\u201d only over a period of years, the Reid bill is rigged to fool federal 10-year cost analysts into believing it will shave \u201cless than 2 percent from deficits projected to top $9 trillion over the next decade.\u201d After that, the Congressional Budget Office figures its impact on federal deficits projected to balloon to roughly 14 percent of the economy by 2035 would be minimal.<\/p>\n
\u201cThe hope that health-care reform would take care of our budget problem has evaporated,\u201d admits Isabel Sawhill, a fiscal expert at the Brookings Institution.<\/p>\n
Furthermore, the budget-balancing act assumes Congress won\u2019t later renege on imposing new taxes and spending cuts. \u201cMany budget experts also worry that lawmakers may not have the stomach to keep the new taxes and spending cuts intended to pay for the package,\u201d The Post reports. \u201cRepublicans are already planning to offer an amendment to strike more than $400 billion in proposed Medicare cuts from the package, a move that would blow a huge hole in financing for the bill.\u201d<\/p>\n
In merging bills drafted in committee, meanwhile, Sen. Reid \u201csignificantly watered down\u201d two of the most important \u201ccost-containment\u201d provisions: an independent commission to automatically restrain Medicare spending, and a tax on high-cost health insurance policies that was opposed by the labor unions. (For the record, taxing the rich is not \u201ccost containment,\u201d any more than it \u201creduces your food budget\u201d to rob a convenience store so you can afford to keep eating steak.)<\/p>\n
This is like watching a skilled carny operator shift the three walnut shells, in hopes we can find the one that contains the pea. Problem is, the fellow palmed the pea way back at the start.<\/p>\n
White House Budget Director Peter Orszag insists the legislation \u201ccreates a feedback and continuous improvement loop that will allow us to learn as we go,\u201d while insisting that \u201cDoing nothing is guaranteed to fail,\u201d since — without change — health care costs are poised to swamp the federal budget.<\/p>\n
Leaving aside how much confidence is instilled by the admission that the administration plans to \u201clearn as they go\u201d after being handed trillions more dollars — kind of like buying a new Cadillac, handing the keys to your 13-year-old, and saying \u201cGo out and learn the drive, son!\u201d — the final statement is simply not true.<\/p>\n
The costs of each American\u2019s \u201chealth care\u201d can\u2019t do a thing to the federal budget. If the costs exceed what each American can afford to pay, they will — they must — simply boycott the more expensive treatments till prices come down, as always happens when supply exceeds demand.<\/p>\n
(For the record, the same thing would happen if the government stopped subsidizing low-interest student loans. College attendance would drop; the colleges would then trim costs and reduce their tuition and fees to recapture some of that business.)<\/p>\n
No, what threatens to \u201cswamp the federal budget\u201d is the arrogant assumption that the federal government can and should \u201ccover\u201d all the medical costs anyone chooses to run up.
\nWhat Washington should be doing is reining in or planning to privatize Medicare and Medicaid. Instead, they plan to make all medical care \u201cfree\u201d for everyone, and promise us it won\u2019t cost a thing.<\/p>\n
If you believe that, let\u2019s go to the nearest ATM and draw out your life savings. Then, I\u2019ll bet you can\u2019t figure out which walnut shell holds this little pea …<\/p>\n","protected":false},"excerpt":{"rendered":"
What was it like to go to a doctor in America 60 years ago? The family doctor couldn\u2019t offer high-tech diagnostic tests or treatments, mind you. But neither would you find the office full of employees negotiating on telephones with Medicare, Medicaid, or private insurers, trying to determine what treatments would be \u201ccovered,\u201d and what […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[18,20],"tags":[],"class_list":["post-380","post","type-post","status-publish","format-standard","hentry","category-economics","category-medicine"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/pWqFl-68","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts\/380","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=380"}],"version-history":[{"count":2,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts\/380\/revisions"}],"predecessor-version":[{"id":384,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts\/380\/revisions\/384"}],"wp:attachment":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=380"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=380"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=380"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}