President Obama addressed the nation yesterday, unintentionally providing a devastating critique of his healthcare bill. In speaking about the need to reduce our out-of-control deficit, Mr. Obama made it abundantly clear that soaring healthcare expenditures are one of the main sources of our fiscal woes. That begs the question – what happened to Obamacare? Having subjected the nation to an entire year of squabbling over a healthcare bill that was meant to “bend the curve” on rising costs, the president now feels the need to tackle this sector anew. How can this be?
The truth leaked into Mr. Obama’s speech on our fiscal deficits. The president promised to “reduce wasteful subsidies and erroneous payments” in Medicare and Medicaid. Weren’t those targeted in the healthcare bill? He vows to cut the cost of prescription drugs by using Medicare’s purchasing power, and to “speed generic brands of medicine onto the market.” Does he mean that the drug companies will be allowed to earn less on their patented drugs?
For someone so keen to encourage research spending, and “investing in our future”, why would he not endorse ever-greater innovation by the pharmaceutical companies? Other than technology, it’s hard to come up with an industry that has made a greater contribution to our quality of life over the past fifty years. Mr. Obama surely doesn’t want to undermine future achievements by reducing the Big Pharma’s return on investment, does he? Does he connect those dots?
Most damning is Mr. Obama’s proposal to “change the way we pay for health care – not by procedure or the number of days spent in a hospital, but with new incentives for doctors and hospitals to prevent injuries and improve results.” What does that mean exactly? How are doctors supposed to prevent injuries? Does the president think that MDs are throwing things around operating rooms, or leaving bed pans where patients can trip over them? What in the world is he talking about?
Critics of Obamacare have argued that the bill does nothing to change the absurd reverse incentives in our Medicare program. Doctors won’t write prescriptions for benign allergy medicines for more than a month at a time, not because it is unsafe, but because they get paid by the number of patient visits they receive. It’s much more profitable to have a patient come in once a month for a new Rx. That Obamacare did not resolve this mess is one of the reasons that it was, and remains, so unpopular.
Also angering Americans is the notion that an appointed commission of medical experts will have ultimate authority over how our taxpayer dollars are spent on health care. Individuals under the contrasting plan put forward by Paul Ryan will finally have “skin in the game” and under his suggested voucher system will make choices dependent on probable outcomes and priorities. Yes, many people will have to pay more towards their care – and especially those millionaires and billionaires that Mr. Obama so often cites – but they will also have a greater say in what services they receive. Astonishingly, Mr. Obama chose to fall back on that same “commission” in the deficit speech, which reinforces the notion of increasingly distant and unaccountable authorities making choices that are extremely personal. It is an unappetizing proposal.
The truth is that Obama’s healthcare legislation had nothing to do with reining in health care costs, though that is how he tried to sell it, but all about providing coverage to tens of millions of currently uninsured Americans. While a worthy goal, many in our country do not think this is the time to saddle our beleaguered government with expensive new obligations. Indeed, considering the budget battles that loom, Mr. Obama may come to rue the day he waded into the healthcare swamp.Click here to visit the Debt Watch home page.