RALEIGH – While left-wing advocates of nationalized health care weren’t pleased when Congress stripped a Medicare-like universal “option” out of the ObamaCare legislation, they fought for passage of the bill nonetheless – recognizing that its provisions would hasten nationalization in the long run, even if it didn’t accomplish the objective in the short run.
They understood, far better than the gullible journalists and politicians who took the administration’s rhetoric about “cost savings” at face value, that the new taxes and regulations in the bill would work to unravel the individual and small-group markets for health insurance, thus stopping the spread of consumer-driven health care.
They further understood that there are only two ways to reduce health care spending: government rationing from above or more efficient consumption from below. They favor government rationing. So does their hero, Donald Berwick, whom President Obama just installed as his top health care official via recess appointment.
Berwick wants the United States to mimic the approach of Great Britain and other countries that use explicit rationing to carry out central planning of medical care. He says he is “romantic” about such policies, which favor “standardization to the best-known method” over “clinicians’ autonomy as a rule for care.” In other words, government officials get to decide who consumes what medical services – not doctors and their patients.
As for the other option – consumer-driven health care based on patient incentives and competition – Berwick has nothing but disdain. “In the United States,” he says, “competition is a major reason for our duplicative, supply-driven, fragmented care system.”
Hostile to the philosophical assumptions of consumer-driven health care, and bewildered by its early successes, the Left seeks to use ObamaCare to destroy it with two lines of attack:
• First, the new benefit mandates under ObamaCare will raise the cost of private health plans, particularly in the individual and small-group markets where consumer-driven health care already serves millions of Americans. These costs are already going up in the coming year for plans sold by Aetna, Blue Cross, and other insurers active in these markets. About half of the 18 percent hike Celtic Insurance is seeking for its North Carolina customers stems from ObamaCare mandates, for example.
• Second, ObamaCare will put the president’s Department of Health and Human Services in the position of deciding whether high-deductible health plans based around health savings accounts will be considered “insurance” for the purpose of complying with the legislation’s individual mandate.
The uncertainty about whether such plans will be illegal after 2014 has already driven some insurers out of the market, reports Health Care News. Unless the law is clarified or repealed, others may well follow, including my own insurance carrier.
Such an outcome would rob me and millions of other Americans of the choice to retain the current health care financing arrangements we prefer, contrary to President Obama’s oft-repeated promise. For the Left, however, this is a feature of the plan, not a defect.
Hood is president of the John Locke Foundation.