President Obamas point person on health care isnt his point person on health care after all. These days, wherever youd expect to see Kathleen Sebelius the respected former Governor of Kansas and newly appointed Health and Human Services Secretary youll probably see the forty-year old Peter Orszag instead. If youre starting to wonder why the President doesnt sound like the Barack Obama you remember, its because hes starting to sound almost exactly like Mr. Orszag, the Presidents budget director.
Mr. Orszag is in many ways the father of the strange contradiction within the Presidents health agenda. President Obama wants to expand government health care and increase government health regulation. At the same time, the White House hopes to cut trillions in future government health costs or “bend the curve,” to use Mr. Orszags most quotable phrase. The President believes in this impossible agenda because he believes in Mr. Orszag, who spent two years as the highly regarded Director of the Congressional Budget Office.
Mr. Orszag is a proponent of the “game changer” a big idea that will result in big savings. “Yes, we can” has become “yes, Washington can.” Take the latest government-centered policy solution touted by the White House. Its called “IMAC,” or the Independent Medicare Advisory Commission, which will have the authority to ration new drugs, tests, and technologies. IMAC will be a new Washington bureaucracy with an “independent” mandate, founded on the fiction that an expensive treatment must be by definition a waste of money.
The Democrats insist they dont want British health care. Weve seen this approach before as it turns out, in Britain, which has employed the IMAC philosophy for more than a decade. There, the Orwellian super-committee is called NICE, the National Institute for Health and Clinical Effectiveness. Courts and patient petitions have forced NICE to repeatedly reconsider its decisions to reject treatments. NICE spent two years restricting a drug to treat blindness arguing that patients could get by with only one good eye. NICE rejected cancer drugs even after certifying their effectiveness solely because they were too expensive.
While Democrats argue they dont want Canadian health care, Canadas counterpart to IMAC is the secretive Common Drug Review, or CDR. The CDR has rejected several orphan drugs without public debate, ignoring the fact that these drugs are often the best or even the only treatment for certain diseases.
While Mr. Orszag believes a health politburo can solve the cost-inflation problem, this strategy has failed elsewhere. Britains annual health inflation rate was 7% over general inflation for much of this decade. Despite drug price controls and the CDRs draconian decisions, Canadas health-care system faces cost inflation rates of 5 - 7%. The United States considers adopting a “game changer” that failed patients and taxpayers elsewhere.
Its not as though Mr. Orszag isnt smart or sincere. Hes brilliant and principled. But ideology is the driver here. The Administrations solution to the rising-cost problem: bring federal budget decisions and a doctors treatment recommendations as close together as is politically possible.
Indeed, Washington isnt simply their solution to the question of, say, reducing drug costs. Its their solution to everything: Private insurance premiums are too high, so the solution is public insurance; thanks to state-based insurance markets and regulations, local insurance markets arent competitive enough, so the preferred Orszag solution is a federally-managed insurance market to simulate what a market would do if it were actually allowed to exist.
The problem with that philosophy is best seen in a favorite talking point of Mr. Orszags coincidentally a favorite talking point of the Presidents. Both rightly point to the Cleveland Clinic and the Mayo Clinic as models of efficient, quality care. The President even visited Cleveland recently to emphasize that point. Left unsaid is the fact that innovative doctors in the American heartland founded and built both organizations from the ground up, not the top down. Neither Mayo nor the Cleveland Clinic came about as the result of a federal insurance company, a federal health exchange, or the work of a federal rationing committee, yet these are the policies that dominate the ObamaCare package.
Peter Orszag doesnt seem like the type who would enjoy standing in a hospital room to get between a doctor and a patient. But hes convinced the President to support health-care policies that will have exactly the same effect.
Original Source: http://townhall.com/columnists/DavidGratzer/2009/08/20/you,_your_doctor,_and_peter_orszag