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Washington, Not The Individual, Gets Control In President's Plan

March 11, 2010

By David Gratzer

On Wednesday in Missouri, President Obama delivered his 37th speech promoting his health reform proposal, despite sustained opposition from inside and outside his own party. Previous arguments didn’t sell.

In early 2009, he couldn’t convince fiscal conservatives with his pitch that “health reform is deficit reduction.” In late 2009, middle America wasn’t persuaded that 2,000 pages of statutes were necessary to cover pre-existing conditions. Early in 2010, the president tried the “it’s time to get it over with” line — and Scott Brown was elected senator from Massachusetts.

The latest spin: Health reform is all about control. Specifically, your control. In the president’s words: “The proposal I put forward gives Americans more control over their health insurance and their health care by holding insurance companies more accountable.” Does it really?

At his press conference last week, the president said his proposal gives individual Americans “the same kind of choice of private health insurance that members of Congress get for themselves.” Well, it’s the same kind of choice, but it’s not the same choice.

The White House recently confirmed that there will be no national health exchange in the proposal, only individual state exchanges. So you’ll only get to choose from within your home state — a choice most Americans already have. Members of Congress, though, can still choose plans offered by insurers from across the nation.

The president’s plan pays for a trillion dollars in subsidies, new Medicaid benefits and new community grants, in part by cutting benefits from Medicare Advantage, a program designed to give seniors more choice.

While this may or may not make fiscal sense — critics argue that Medicare Advantage is a giveaway to insurers, supporters counter that health outcomes are better and seniors are more satisfied — millions of elderly Americans will have less personal control over their care than before.

Even before inauguration, White House budget director Peter Orszag championed a Medicare panel, designed to recommend whether the federal program will cover expensive drugs, devices and treatments, with an eye on saving money.

The president’s proposal includes such a panel, and it’s still charged with cutting billions of dollars in services. Fewer treatment options mean less flexibility for your physician — and surely, less control over your own health care.

The president’s latest proposal explicitly protects state benefit mandates. On Jan. 29, he insisted: “We’ve got to do so with some minimum standards, because otherwise what happens is that you could have insurance companies circumvent a whole bunch of state regulations about basic benefits or what have you.”

Not only do mandates limit choice for consumers, but they tend to drive up the cost of coverage. They are very popular — with certain health-provider lobbies that gain from these regulations.

Take Massachusetts, where everyone is required by law to have insurance that includes in vitro fertilization, substance abuse rehabilitation and (depending on who’s counting) between 34 and 50 other services. It’s one reason health insurance premiums in the state are nearly 50% higher than the national average. It’s as if the law forced every family buying a house to install a hot tub, a swimming pool and a second garage.

If you’re a middle-aged Boston mother of two young boys, you shouldn’t be forced to pay for in vitro fertilization coverage, just as a family of devout Mormons living in Springfield shouldn’t be required to have rehab in their policy.

Under the president’s proposal, you’ll pay more, since it adds new federal mandates on top of the state ones — in other words, less personal choice (and control).

Finally, ObamaCare forces you to have insurance whether you can afford it or not, or pay a penalty. While there’s a good argument to be made that we should all be insured, it’s understandable why people opt out of the overregulated, overheated insurance market.

A young healthy person in New York may not want to pay $300 a month for coverage when he doesn’t even see his family doctor. Of course, we could try and entice him into the market, with more flexible and better- priced options. ObamaCare, however, tries force: pushing him to get a policy full of mandated services he’ll never need.

Who gains control under the president’s proposal? The people in Washington, who will oversee what services are covered by your insurance and at what price, who will “guide” clinical decisions through a Medicare panel for your doctor and who will regulate countless other aspects of health care with, literally, dozens of new committees and agencies.

Is it any wonder that, after 37 speeches, the Obama hasn’t managed to close the deal, despite all the talk about Americans getting more control over their own health care?

Original Source:



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