The Health Care Follies Continue

I don't know if the health care reform bills are going to die on the operating table or not. But Dr. Howard Dean, of all people, wants to administer euthanisia, in this editorial at the Washington Post...

If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.

Listen to that man -- he's a doctor! Ruth Marcus, who blogs for the same paper where Dean's editorial appeared, wants to know if Dean has lost his mind. Lady, did you watch his scream speech in 2004?



Seriously, all joking aside, I have no idea if this is the first person putting a nail in the coffin of Obamacare, or if it's just one irrelevant angry old guy complaining about the damn kids on his lawn. I don't think much of Howard Dean, but folks on the left almost nominated him to be the Democratic Presidential nominee, before deciding that John Kerry was the more intelligent choice (when viewed in hindsight, they clearly should have gone with Dean -- we would have gotten far more entertainment). Robert Gibbs also whacked Dean today, although I'm not sure if Ben Smith's spin that this shows Obama's independence from the liberal Dem establishment will actually work since (a) it's beyond stupid to claim he didn't have the support of labor, when SEIU endorsed him over Clinton, (b) the liberal Dems in the blogosphere spent most of 2008 writing about Obama like he's God, and (c) Obama's absence from the debate until now is equally likely to help push the theme that he likes to vote present and never makes a decision until push comes to shove.

Getting to the point, however... there's two important graphs regarding health care reform that should be considered. The first one is this one...



The longer it takes the Democrats to pass a bill, the longer that graph stays out there. As Jim Geraghty notes, it's hard to believe that huge government bureacracies will provide for lower costs...

I wonder how many senators could continue to claim the plan will work smoothly under the influence of, say, sodium pentathol. For starters, the aim of the legislation is to bring more patients into a system that already lacks enough general practitioners.

A poll of doctors by Investors Business Daily suggested that 45 percent of doctors would consider quitting if the bill passed. Let's presume that's an exaggeration by a factor of four. That would still mean that 11 percent of the nation's doctors would hang up their stethoscopes.

The plan is to cut costs by eliminating "unnecessary" tests, but the recent reaction to the recommendations about mammograms suggests that the public is wary about sudden redefinitions of what constitutes "unnecessary."

The plan is to cut waste, fraud, and abuse . . . of course, you don't need thousands of pages of legislation to do that, and we've been hearing that promise for as long as we can remember.

Perhaps you do need thousands of pages of legislation to cut costs and fraud, but no one's explained why it's necessary, and how it would. People fear that cost savings coming from a government program are as fictional as Santa Claus. You can explain that technology will let you cut some costs, but do people really believe making health care more accessible will make it less costly (particularly when tort reofrm seems to be ignored as part of the package)?

The other graph is this one...



That graph is why no deficit hawk can support this administration right now. Now, again, President Obama has tried to sell the plan as one that would cut costs. He did last night with Charlie Gibson, making this statement...

And last point I'll make on this: If we don't pass it, here's the guarantee, that the people who are watching tonight, your premiums will go up, your employers are going to load up more costs on you. Potentially they're going to drop your coverage, because they just can't afford an increase of 25 percent, 30 percent in terms of the costs of providing health care to employees each and every year. And the federal government will go bankrupt, because Medicare and Medicaid are on a trajectory that are unsustainable, and this actually provides us the best chance of starting to bend the cost curve on the government expenditures in Medicare and Medicaid.

So anybody who says that they are concerned about the deficit, concerned about debt, concerned about loading up taxes on future generations, you have to be supportive of this health care bill, because if we don't do this, nobody argues with the fact that health care costs are going to consume the entire federal budget.

Now, it might be easier to believe the President if he hadn't blasted the deficit with a $787 billion stimulus bill. But you can't sell this to deficit hawks when you have no credibility, and you can't sell the plan as one that won't change anything for people who have health insurance (especially seniors) when they hear you saying that we have to cut costs in the current system. You have to choose to be honest with people -- either say it may cost more, but it's worth it, or say that we need to reform the system because the costs related to it are far too great. Saying both makes you look duplicitous. Probably because you're being duplicitous.

If I had to place a bet, I'd still say the bill will probably pass. But it won't be good for Democrats, and it won't be good for the country.