Jewish World Review Dec. 26, 2002 / 21 Teves, 5763
Debra J. Saunders
Hazardous to your health
IN A WORLD that makes no sense, the Bush
administration announced last week that it was
reducing Medicare payments to doctors by 4.4
percent starting in March 2003 -- that's after a 5.4
percent cut this year. Doctors' costs haven't
decreased, frustrated federal officials admitted.
Doctors will get less because of a nonsensical
Medicare rate formula set by Congress. "When the
economy slows down, payment rates will decrease,
under the formula," an official, who wished to not be
Here's what makes less sense. Even as Medicare
policies threaten the ability of seniors to find doctors
and receive promised health care, that is, even as
Medicare is having trouble delivering on its
commitments, some politicians -- try former Vice
President Al Gore and California state Sen. Sheila
Kuehl -- want the government to make more
commitments it can't keep.
They call it "single payer" -- a universal health care
package that promises to move the country's 41
million uninsured residents out of emergency rooms
and into the health-care community.
They should call it "more promises destined to fail."
Look at Canada's single-payer -- and allegedly
universal -- health-care system that has left 900,000
citizens of Ontario without a primary care physician.
They call that care?
Why would a system that promises to treat everyone
leave so many families without a family doctor?
Money. It costs money to take care of sick people
and money to keep people from getting sick.
There was a time when people understood this
simple concept and paid for doctor visits and
medicine; insurance provided coverage for serious
problems. But managed care introduced the idea to
consumers that they shouldn't have to pay anything
but a nominal fee for their doctor visits; other
providers followed suit. Politicians now promise to
pay drug benefits for seniors even as they're shorting
doctor payments. It's all part of the Holy Grail of
health care in America -- getting someone else to
In Canada, the government pays, so the government
devises ways to pay less. The shortest route: Less
In the United States, parties play pass-on with
health-care costs. Seniors want Medicare to pay for
their health care; many want to expand benefits to
cover prescription drugs. Medicare shortchanges
providers who must pass on unpaid costs to
consumers. When the pass-ons grow too big to be
absorbed, the rhetoric to get other entities to pay
gets ratcheted up -- remember, this stuff is supposed
to be free -- and politicians promise more benefits
while their policies eventually will net less care.
Ed Colloff, an internist at Kaiser Permanente in
Redwood City, notes that seniors have complained
that Kaiser raised its co-payment fees in response to
last year's Medicare payment cuts. They have to
understand, Colloff noted, one problem: "Kaiser can
no longer afford to subsidize the government."
And while patients complain about higher health-care
costs, they rarely recognize that the higher costs
deliver better care and an enhanced qualify of life.
In Washington, everyone knows there's a problem,
but there is too little incentive to fix it. Besides, when
you get to the point where you can't pass on the
costs, you can still pass on the blame.
It's especially helpful when the public blames, not
those who fail to deliver, but those who fail to promise
big. Tell voters that you support single payer, and
that's supposed to be a sign that you care. Tell
voters you want to promise only as much care as the
government can afford, and you're mean-spirited.
Few will give you credit for trying to keep taxpayers
who already have good medical coverage from
becoming a Canadian-style statistic.
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© 2000, Creators Syndicate