16th
The Kennedy Bill
President Obama’s oft-repeated refrain when it comes to health care reform, offered again on Thursday, has been, “If you like your health care plan, you will be able to keep your health care plan.” But the Obama-backed Kennedy health-care bill, recently introduced in the U.S. Senate, belies that promise. For it would so radically overhaul the health care system, no health plan would be untouched. Meanwhile, health care costs will only continue to climb under the bill’s provisions.
The most obvious way that Obama’s promise is disingenuous is for those whose “health plan” is outside the current system. If your health plan is to stay healthy, eat well, exercise, and pay out of pocket for medical care, well, no, you can’t really keep that health plan. You will be forced to pay either an insurance company or the federal government and enroll in one of their prescribed plans. Or, barring that, you will be fined and taxed at an amount to be determined not by Congress, but unilaterally by the Obama Administration or its successor, liable to be increased at any time. This is the kind of health-care reform that is so universal, you’ll get it whether you want it or not.
And you won’t be able to enroll in just any health-insurance plan. A new clique of federal magistrates appointed by the Secretary for Health and Human Services – the “Medical Advisory Council” – will determine which plans are qualified. So, if you don’t want to enroll in a health plan that covers, say, abortions, impotence drugs such as Viagra, or psychiatric drugs such as Prozac, you are out of luck if the Council decides those are vital services. Thus, you will have to pay higher premiums for services you may never use, subsidizing those who do. And Congress will have veto power over the Council’s decisions, making that process even more political.
The legislation itself already sets out pretty broad parameters for what kinds of health care plans will be legal, and which won’t. For instance, insurers will be forbidden from basing insurance premiums on risk factors. If this holds, there will be no exceptions even for positive lifestyle choices. Though you’ll consume fewer medical services, you won’t be eligible to receive a discounted premium for exercising or for avoiding tobacco.
The idea of nationally mandated health insurance is based on the state-based universal health insurance model of Massachusetts, pushed into law a few years ago by then-Governor Mitt Romney. As a precursor of things to come, the prognosis is not good. The primary reason health care costs have been rising the last several decades is because the tax system has favored employer-backed health plans, which disconnect individuals from the costs incurred by too-frequent or too-expensive procedures and pharmaceutical regimens. In the 1960s, half of health-care costs were paid out-of-pocket by individuals; today that number is just 10 percent. High-deductible, low-premium individual health plans are a way to circumvent this problem while still allowing individuals to obtain necessary medical care.
Yet Massachusetts’ version of the proposed Medical Advisory Council, the Massachusetts Connector Authority, has already deemed these sort of plans “unqualified,” capping individual deductibles at $2,000 – lower than some plans offered nationally. This is one reason insurance premiums in Massachusetts are already approaching 400% of the national average. Facing similar pressures from the health industry, the new Council is likely to act in a similar fashion. But perhaps a Massachusetts-style tripling or quadrupling of health premiums is anticipated by the plan’s authors. After all, they propose subsidizing households with incomes as high as $100,000.
This proposed reform is so all-encompassing and socializes so much risk, with so few incentives for individual cost control, that health care costs will doubtless continue to climb. The present legislation has one provision that might seemingly combat that trend – a new “public option,” essentially a new government-backed insurance company aimed at competing with private insurers on price. Yet in that scenario, a very real danger exists that the public plan will use taxpayer subsidies to drive many private insurers of business, establishing a government monopoly through the backdoor. If cost-cutting occurs at that point, it will be the sort that is dictated by federal advisory councils, with little room left for the unique needs of individual patients. With a circumscribed set of options, many patients will be left with a health care plan they don’t like, but one they’ll have no choice but to keep.
