Monday, November 23, 2009

The Spirit of WFB

(Sorry for the small size. For a larger version see the Weekly Standard's blog site - 11/22).
These data were first revealed in Friday's New York Post and then re-presented on the Weekly Standard website yesterday. There's a reason the Post is John Derbyshire's favorite newspaper. (Well, besides the gossip columns). Those paragons of journalistic integrity, The New York Times and The Washington Post were probably too busy fact checking Sarah Palin's book to investigate this latest massive deception by the Democrats. Anyway what the graph shows is that the $849 billion price tag for the Senate's health care bill is based on ten years beginning in 2010. The plan doesn't start paying out until 2014, so a true 10 year cost, calculated from 2014-2023, is $1.8 trillion, more than twice Harry Reid's phony number. CEOs get thrown in jail for using accounting gimmicks like that. And $1.8 trillion is just the baseline projection. Remember that initial estimates of federally funded health care plans like Medicare and Medicaid were small fractions of their ultimate cost. Take that $1,800,000,000,000 and multiply it by 4 or 5 to get a more realistic price tag. And that's just the cost for the feds portion. The states are going to have to dish out much more in Medicaid payments for the proposed expansion of that program.
So what do we get for this exorbitance? Jeffrey Flier, dean of Harvard Medical School (WSJ - 11/18) says that the Massachusetts experiment offers some insight.

...currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.
There are important lessons to be learned from recent experience with reform in Massachusetts. Here, insurance mandates similar to those proposed in the federal legislation succeeded in expanding coverage but—despite initial predictions—increased total spending.
A "Special Commission on the Health Care Payment System" recently declared that the Massachusetts health-care payment system must be changed over the next five years, most likely to one involving "capitated" payments instead of the traditional fee-for-service system. Capitation means that newly created organizations of physicians and other health-care providers will be given limited dollars per patient for all of their care, allowing for shared savings if spending is below the targets. Unfortunately, the details of this massive change—necessitated by skyrocketing costs and a desire to improve quality—are completely unspecified by the commission, although a new Massachusetts state bureaucracy clearly will be required.
Yet it's entirely unclear how such unspecified changes would impact physician practices and compensation, hospital organizations and their capacity to invest, and the ability of patients to receive the kind and quality of care they desire. Similar challenges would eventually confront the entire country on a more explosive scale if the current legislation becomes law.

If passed, the bill won't take effect for three years. 2013. (Strange coincidence - it's the year after 2012, when the physician-in-chief will be up for re-election). The Democrats are trying to ram this through now, before American voters can digest the bills' particulars. It's not working. The latest Rasmussen poll shows support down to 38% with 56% opposed. That might not matter. Reid, Pelosi and Obama are probably willing to sacrifice temporary control of Congress to achieve that holy grail of socialism - permanent government control of health care. This will be an interesting test of our democratic process. There are two powerful competing forces at work. The Democrats with complete control of the legislative and executive branches versus millions of individuals "standing athwart history, yelling 'stop!'"

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