The Only Health Care Cost Control Idea the Democrats Have Ever Had
April 8, 2010, 9:18 am
I think this article makes it clear that, no matter what the rhetoric, the only health care cost control idea Obama and the Democrats ever had was saying “no” to care. Whatever one calls this (managed care, rationing, death panels) it is really not that much different from what insurance companies have been doing for years. And it is a real irony that Democrats passed this legislation feeding off anger of voters with insurance companies saying “no”, when their plan really depends on the government saying “no” even more often (or else there won’t be any cost savings).
The author argues that information is important for patients to make better decisions:
When patients are given information about potential benefits and risks, they seem to choose less invasive care, on average, than doctors do, according to early studies. Some people, of course, decide that aggressive care is right for them — like the cancer patient (and palliative care doctor) profiled in this newspaper a few days ago. They are willing to accept the risks and side effects that come with treatment. Many people, however, go the other way once they understand the trade-offs.
They decide the risk of incontinence and impotence isn’t worth the marginal chance of preventing prostate cancer. Or they choose cardiac drugs and lifestyle changes over stenting. Or they opt to skip the prenatal test to determine if their baby has Down syndrome. Or, in the toughest situation of all, they decide to leave an intensive care unit and enter a hospice.
I agree, but I would go further — information and incentives are important. And the absolute most important bit of information when it comes to cost control is price, and patients under Obamacare have absolutely no incentive to give a sh*t about price even if they were informed of it. Exactly the opposite of the incentives I have had since I took on a high-deductible health care policy several years ago.
Update: Brad Warbiany discusses the proposed IPAB and its powers to shape health care spending in the context of Congress as an addict trying to control its impulses. However, I think Brad underestimates the power of the board to be captured. What will result is rulings for more coverage of procedures with powerful lobbies, offset by less coverage of procedures with weaker lobbies, irrespective of the science. Just look at the diseases the NIH and NSF gives grant money for — the grants have nothing to do with the science of where research could be most productive and everything to do with diseases that have large and powerful constituencies.
Update #2: Isn’t it interesting to see the NY Times, after arguing for months that Obamacare was not about rationing, is now admitting that rationing is the key to success.
It reminds me of this that I wrote a while back:
I have decided there is something that is very predictable about the media: they usually are very sympathetic to legislation expanding government powers or spending when the legislation is being discussed in Congress. Then, after the legislation is passed, and there is nothing that can be done to get rid of it, the media gets really insightful all of a sudden, running thoughtful pieces about the hidden problems and unintended consequences of the legislation.
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caseyboy:
Update # 2 – concerning the media getting after it after it is too late to stop. I could not agree more. They don’t want to interfere with the progressive agenda, but once pieces are in place they feel they must do some critical reporting to maintain some semblance of “objectivity”. For the most part they are a corrupt group of elitists who feel they know what is best for the rest of us.
On a different front I was surprised when the OMB released a statement that our current deficit spending is unsustainable. Hmmmm? You think that might bit of information might have been useful in the debate over Obamacare? Another instance of “CYA” for the history books.
April 8, 2010, 11:36 am
Ironman:
It’s worse than you think – the new incentives are such that for many, it will make more sense to drop their health insurance altogether, and only buy it when actually needed, then drop it again as soon as possible if it should no longer be needed. It’s an interesting method of rationing….
April 8, 2010, 12:09 pm
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Methinks:
Mesa,
This is exactly how they dealt with Social Security during the Roosevelt administration. The politicians swore up and down that it’s not a tax.
When it was challenged in the Supreme Court, the government lawyers argued that it Social Security is a general tax and the money collected under that general tax can and will be used to fund any number of government whims.
I think they don’t care if the mandate is struck down or not. They’ll just replace it with a tax and argue for single payer. They’ve got the citizens of this country in a vice. This was the intention and they don’t much care how exactly it plays out because in the end, they got what they wanted – more power and more centralized power while the citizenry has less disposable income, thus less freedom and more dependency on the politicians.
They aren’t even pretending anymore. They stopped pretending when Obama and Nancy Pelosi made it clear that they couldn’t give two shakes of a rat’s ass what the vast majority of the population wanted. They were getting their way. The constitution is meaningless.
April 8, 2010, 7:03 pm
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