While health reform passed, modifications likely
While I have profound disagreement with what President Barack Obama and the Democratic congressional leadership did with passage of the Patient Protection and Affordable Care Act, their moment of jubilance is understandable. It was a significant legislative accomplishment.
I, too, advocated large-scale reform of our nation’s healthcare sector. Were the outcome mine to choose, however, reform would have focused on the real problem: cost. Solving the cost problem paves the way for expansion of coverage to follow.
Advocates of the new law say once everybody is insured, we can begin dealing with the cost of care. Count me as skeptical on this one. Their assumed 10-year estimates suggest that half the funds needed for health reform will be secured by reducing Medicare growth by a halftrillion dollars. This will not happen—it never does. I have personal experience in this category. As HHS secretary, I annually delivered budgets to Congress that contained a mere fraction of the Medicare reductions that this law now demands. These proposals were met with vehement opposition from members of Congress, including claims that I lacked compassion and common sense. If a Democratic-controlled Congress wasn’t willing to make the hard decisions when the cuts were much smaller, why would the outcome be different now?
Here is the reality. Half the funding for the health reform bill will come from new taxes and the rest will be added to the national credit card for the next generation to pay. The buy-today, pay-tomorrow mentality is a time-honored congressional tradition, especially when it comes to health entitlements. Putting it on the next generation’s credit card is an all-too-familiar scenario.
I agree that pre-existing conditions should be eliminated from the issuance of health insurance. However, there are smarter ways to do it. The act will produce unintended consequences galore. Actually, I’m not sure the consequences are unintended. It may be more accurate to call them undiscussed consequences.
With the combination of pre-existing conditions, medical-loss ratio, community rating and weak individual mandates, the health reform bill has guaranteed an exit of capital from the health insurance business. Their legislative language, in combination with the populist rhetoric against anything resembling capitalism, causes me to wonder if there was anything unintended about it. The act was drafted by legislators who openly advocate for the government becoming the insurance system, and if the bill is implemented, as passed, they will succeed.
Another aspiration I share with drafters of the health reform bill is for every American to have access to affordable insurance. However, the new legislation contemplates a different role for government than I envision.
Government’s role should be limited to organizing, not owning, the healthcare system.