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Jewish World Review
Oct. 27, 2009 / 9 Mar-Cheshvan 5770
Government by Holiday Inn Express
You've seen those commercials in which an airline pilot, or surgeon, or
nuclear engineer is giving expert advice only to acknowledge eventually
to this nonplussed listeners that while he is not actually a
fill-in-the-blank, he did stay at a Holiday Inn Express last night. Do
you ever get the feeling that we are getting Holiday Inn Express
Does anything they say make basic economic sense? President Obama and
the Democratic Party propose to save money (or what they call "bend the
cost curve") on health care spending. They will spend less, they say,
but also cover more people the 47 million or 30 million uninsured
(Obama has used both numbers). This will be accomplished without
reducing care for anyone and without raising taxes on anyone except the
rich. In fact, care will be improved.
Sounds great. But do these people know what they're doing? They mouth
the words "choice" and "competition" but only, ironically, in praise of
a "public option." The concept of encouraging choice and competition in
the health insurance market say by permitting interstate sales is
off the table.
The Wall Street Journal provided a handy chart of "Uncle Sam's Cost
Overruns." In 1965, when Medicaid was enacted, the House Ways and Means
Committee estimated that first year costs would amount to about $238
million. The actual price was $1 billion. The program now costs $251
billion annually and is climbing fast. The record is similar for
Medicare. In 1965, Congress predicted that by 1990, Medicare would be
costing $12 billion. The actual cost $90 billion. As Peter Orszag,
director of the Office of Management and Budget has admitted, "If costs
per enrollee in Medicare and Medicaid grow at the same rate over the
next four decades as they have over the past four, those two programs
will increase from 5 percent of GDP today to 20 percent by 2050."
So the same people who brought you cost spirals in Medicare and Medicaid
now propose to introduce another government health program. Don't worry,
they assure us, we know how to provide efficiencies. It's not necessary
to dwell on the risible claim that they will cut half a trillion in
waste from the Medicare budget. If they know where that waste is, why
aren't they cutting it now? Where, on the books, are the federal
The administration has also highlighted two other ideas that will
supposedly provide tremendous cost savings. Both have been in the news
Starting during the campaign, President Obama touted digital medical records to
reduce errors, improve care, and cut costs. More than $19 billion of stimulus funds
were earmarked for it. But when the Washington Post examined the matter, they
discovered that digital records not only fail to produce the promised benefits, they
actually reduce efficiency and cause errors. The digital systems currently available
give physicians too much information. Pages upon pages of digital information
document every conceivable ailment a patient might have. Doctors have difficulty
wading through all of the unnecessary data to reach the critical information. One
emergency room physician at a hospital that had adopted a digital system complained,
"It's been a complete nightmare. I can't see my patients because I'm at a screen
entering data . … Physician productivity and satisfaction have fallen off a
cliff." Some hospitals have adopted digital systems only to abandon them.
Another silver bullet the administration has peddled is preventive care.
Everyone knows that a timely PSA test will detect prostate cancer at an
early and treatable phase thus saving the patient's life and saving
money, right? Not exactly. The test is obviously worthwhile for that
individual. But testing all men for prostate cancer an overwhelming
majority of whom will never get the disease is expensive. If more and
more of us are tested for more and more diseases even accounting for
some illnesses found early health spending will rise, not fall.
Further complicating the picture, the National Cancer Society has
announced that the benefits of cancer screenings, particularly for
breast and prostate cancers, have been oversold. They aren't saving very
many lives, but they are causing needless tests and surgeries.
The Baucus bill even before being melded with House versions
weighed in at 1,502 pages of new taxes, fees, and mandates. Every single
page proclaims something that is dubious that the Democrats know what
they are doing.
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