September 23, 2010
ObamaCare: Will Someone Please Kill It Before It Kills Us?By Deane Waldman
Will a Republican-controlled Congress repeal HR 3590 before it destroys U.S. health care and depresses the U.S. economy even further?
Coming into the midterm elections, public anger and frustration -- while generally anti-Congress and anti-Beltway -- is specifically aimed at those in power, those who promised they would change things for the better. There is a high probability that the Republicans will regain control of the House and a lesser chance of the Senate. Will they do what is necessary for our country and repeal the massive boondoggle called ObamaCare? I doubt it, but one can hope.
A boondoggle is a "work or activity that is wasteful or pointless but gives the appearance of having or adding value." That is a perfect description of HR 3590, disingenuously titled the Patient Protection and Affordable Health Care Act and colloquially known as ObamaCare. The Act cannot do what its title promises. In fact, it achieves exactly the opposite what the president said it would do.
In early 2009, President Obama started a national dialogue on health care, saying that the cost spiral was unsupportable and we needed to deal with it before it destroyed us. True, and what does his plan do? It adds at least $1 trillion to the price of U.S. health care. (A recent estimate places additional spending at $2.7 trillion.) Is that what the president calls "reigning in unsupportable costs"?
Our nation is an economic doldrums, the most painful manifestation being unemployment, currently at 9.6%. The pundits, the politicians, and the public all seem to agree that what we need is private-sector job creation. ObamaCare includes penalties (you can call them what they really are: taxes) that increase the cost of doing business. Just ask AT&T, John Deere, or Medtronic, each of whom has publicly announced their increased costs due to ObamaCare, costs that are forcing them to lay people off.
Finally, there is unfunded but mandated health care: the legal obligation of most hospitals to provide care even if a patient has no insurance. I trust you have noted the glaring silence on whether or not ObamaCare will provide health insurance coverage for illegal U.S. residents.
According to the CBO (January 2009), the number of uninsured Americans is 45+ million, yet the president speaks only of 30 million. Thus, he neatly sidesteps the issue of the cost of care for 15 million illegal residents while leaving in place mandates that require hospitals to provide that care for free. To keep their doors open, they must over-charge insured patients to make up the mandated loss.
So when we desperately need to reduce costs, HR 3590 increases spending and requires hospitals to cost-shift. When we desperately need to increase jobs, HR 3590 suppresses entrepreneurship and puts people out of work. Just like Atticus Finch does in To Kill a Mockingbird, if you see a rabid dog threatening your children, wouldn't you shoot it?
The "care" part of ObamaCare proves that it has rabies. The Bill offers insurance and implies that having insurance means getting care. People deliver care, not insurance policies. Before HR 3590 was passed, we had a shortage of doctors and nurses. Now (presumably), 30+ million more people will have health insurance. Who will "deliver" that care?
ObamaCare adds six whole new agencies and thousands of new bureaucrats to the government payroll but not one new doctor or additional nurse. Worse, the Bill cuts Medicare payments by over $500 million. This directly translates to cutting services because doctors simply cannot afford to care for Medicare patients.
And then there are the infamous "death panels," as claimed by the Republicans and put down by the Democrats with a condescending smirk. HR 3590 creates "Cost Cutting Commissions." These are federal agencies that determine which medical treatments are cost-effective and which are not. The latter will not be paid for and thus will be unavailable to the general public. What if you personally need medical care that is deemed "not cost-effective"?
Recently, Great Britain's NHS (National Health Service) -- the model that Dr. Don Berwick, Director-Designate of Medicare, wants to bring here -- determined that such therapies as kidney dialysis after 55, heart surgery after 65, and hospice care are "not cost-effective." You cannot get them in Great Britain unless you can pay privately. Is this not effectively a death panel for a 56-year-old kidney patient and a 66-year-old heart patient -- who, by the way, will not have end-of-life services either?
As they say in the game of bridge, let's review the bidding. HR 3590 will:
ObamaCare is a rabid dog. Someone needs to kill it. A Democrat-dominated Congress certainly will not. If control shifts to the Republicans in November, will they do what is necessary? Your guess is as good as mine, but I am not optimistic. Meanwhile, Congress is spending billions expanding the federal bureaucracy that is good at doing only one thing: consuming dollars that we do not have.
PS. If by some miracle Congress actually does what is right and repeals HR 3590, that still leaves us with a "broken" health care system. We need to begin real reform rather than the travesty that is ObamaCare. "Uproot U.S. Healthcare" shows how we can create what we need. I have asked Republican leadership to consider a true cure for health care, but so far, they have nothing to offer in place of Band-Aids and sedatives.
Deane Waldman M.D., MBA is the author of "Uproot U.S. Healthcare" and Professor of Pediatrics and Decision Science at University of New Mexico.