'Public Option': Son of Medicaid
Originally Posted At The Wall Street Journal
By Daniel Henninger
June 18, 2009
In his speech on health care to the American Medical Association, President Obama explained why the U.S. has "failed" (yet again) to provide comprehensive reform that "covers everyone." He had a list of the failing people, who "simply couldn't agree" on reform: doctors, insurance companies, businesses, workers, others. And "if we're honest," he said (ergo, disagreeing with this is dishonest) we must add to the list "some interest groups and lobbyists" who have used "fear tactics."
It seems to me, if we're honest, that one other contributor to the health-care morass should have been on the president's list: Congress. Indeed a close reading of Mr. Obama's speech suggests he holds the political class innocent insofar as he blames everyone else but them. Can this be true?
Back before recorded history, in 1965, Congress erected the nation's first two monuments to health-care "reform," Medicaid and Medicare. Medicaid was described at the time as a modest solution to the problem of health care for the poor. It would be run by the states and "monitored" by the federal government.
The reform known as Medicaid is worth our attention now because Mr. Obama is more or less demanding that the nation accept another reform, his "optional" federalized health insurance program. He suggested several times before the AMA that opposition to it will consist of "scare tactics" and "fear mongering."
Whatever Medicaid's merits, this federal health-care program more than any other factor has put California and New York on the brink of fiscal catastrophe. I'd even call it scary.
Spending on health and welfare, largely under Medicaid, makes up one-third of California's budget of some $100 billion. In New York Gov. David Paterson's budget message, he notes that "New York spends more per capital ($2,283) on Medicaid than any other state in the country."
After 45 years, the health-care reform called Medicaid has crushed state budgets. A study by the National Governors Association said a decade ago that because of "new requirements" imposed by federal law -- meaning Congress -- "Medicaid has evolved into a program whose size, cost and significance are far beyond the original vision of its creators."
In his speeches, Mr. Obama makes the original vision of his "public option" insurance plan sound about as simple as driving through toll booths with an electronic pass on your windshield. It's going to be all about "best practices" with patients "reimbursed in a thoughtful way," as if the federal government is about to become just another big Google.
Medicaid is a morass. Since the program's inception, Congress has loaded it up every few years with more notions of what to cover, shifting about 43% of the ever-upward cost onto someone else's tab, mainly the states. A 1988 congressional mandate requires local schools to pay for schooling and related services for disabled children, but because Congress underfunds its mandates, the states pay the rest through Medicaid.
The list of add-ons is endless, and there's little about it that is thoughtful. Why shouldn't one think that, as with Medicare and Medicaid, the Obama Public Option in time will become an impossible fog for patients to navigate? But unto eternity the program's administrative complexity will provide work for bureaucrats, Members of Congress, their staffs, lobbyist spouses and the "health-care" establishment of foundations and economists.
Oh, and the courts. The fact that this is a public program ensures not just congressional meddling but also makes it vulnerable to litigation. Over time, the Sotomayors of the federal bench will make it bigger. One piece of California's incredible budget mess flows from a federal judge's 2006 decision to seize control of the state's prison-health system and make the state pay billions for new health spending imagined by his appointed federal overseer.
Medicaid alone didn't put California and New York on the brink. Add in spending on public education and you've accounted for about 60% of their budgets. This drives the deficits and gets all the ink, but not least among the casualties of bigness is the idea of governance.
The elected legislatures of California, which holds 36.7 million American citizens, and New York, with 20 million, are essentially falling apart as governing bodies. The whole country has witnessed the spectacle of the comic "coup" in New York's Senate in Albany the past two weeks.
With collapse comes a truth: The bigger the government, the smaller the politicians. As mandated entitlements grow, the spending "crowds out" the need or obligation to think or to govern. Legislators with nothing very real to do become lazy, slack and corrupt. They become Albany. Or Sacramento. Or Trenton.
Mr. Obama's plan is intended to "guarantee" health insurance for all. Whatever the truth of that, its outlays -- larded atop Medicaid, Medicare and Social Security -- guarantee that Congress will become more like the states' clown shows. But they are expensive clowns.
In his speech, Mr. Obama said the cost of the Public Option won't add to the deficit: "I've set down a rule for my staff, for my team -- and I've said this to Congress -- health-care reform must be, and will be, deficit-neutral in the next decade." If we're honest, that means tax increases are inevitable. Sounds scary to me.
|
|
Urgent Petition
|
Sign the petition to stop Social Security Cuts and send a fax to every Member of Congress demanding they cut other spending, NOT SOCIAL SECURITY.
Share This Petition
|
Recent News
Friday, May 18, 2012
Congressional Republicans are back up to their old shenanigans on ObamaCare. Politico reveals that Republicans would try to replicate popular parts of Obama’s health care law if the Supreme Court overturns the law this summer.
Read Full Story
Tuesday, May 15, 2012
Source: ABC News
The Food and Drug Administration has warned doctors to watch for fractures of the upper thigh bone in patients taking several popular drugs designed to prevent hip fractures and fight osteoprothesis. The FDA warns that Fosamax and Boniva in particular, if taken unnecessarily or for too long, may actually be causing the bone fractures they are prescribed to prevent. Watch ABC News video.
Read Full Story
Thursday, May 17, 2012
 Exit Not An Option In Chuck Schumer's America. New York Senator Chuck Schumer has introduced the Fugitive Taxpayer Act of 2012 to re-impose taxes on expatriates after they flee the United States and take up residence in a foreign country. Proposal also would impose a mandatory 30 percent tax on the capital gains of anybody who renounces their U.S. citizenship and would bar such individuals from ever reentering the United States again.
Read Full Story
Wednesday, May 16, 2012
Whether President Obama gets his second term or Romney enters the Oval Office, there’s a third candidate no one’s paying much attention to, and that candidate is guaranteed to be the one clear winner of election 2012: the U.S. military and our ever-surging national security state.
Read Full Story
Friday, May 11, 2012
According to the New York Federal Reserve, two million US seniors age 60 and over have student loan debt, on which they owe a collective $36.5 billion; and 11.2 percent of this debt is in default. 4.2 percent of all student loan debt is held by people over the age of 60, and that share grows with each passing year.
Read Full Story
Tuesday, May 15, 2012
Across the U.S. economy, anxiety is rising about the potential for widespread disruptions after the November election, when a lame-duck Congress will have barely two months to resolve a grinding standoff over taxes and spending.
Read Full Story
Thursday, May 10, 2012
Two-thirds of Republicans and nine in 10 Democrats polled support making immediate cuts to the military across the board -- a position at odds with the leaderships of both political parties.
Read Full Story
Monday, May 7, 2012
Video revealing the circumstances of how a mentally ill homeless man in Fullerton, Calif. died last July was finally published Monday, revealing a stunningly brutal police assault that left Kelly Thomas bleeding, broken and near death.
Read Full Story
Monday, May 7, 2012
The number of people with jobs declined for the second month in a row, falling by 169,000 in April after easing by 31,000 in March. This means that there were 200,000 fewer Americans with jobs in April than there were in February. Additionally, the percentage of working-age adults who either have jobs or are looking for work, fell to 63.6%, which is the lowest level since December 1981.
Read Full Story
Tuesday, April 24, 2012
In November 2010, a police lieutenant from Parma, Ohio, asked Vanguard Defense Industries if the Texas-based drone manufacturer could mount a “grenade launcher and/or 12-gauge shotgun” on its ShadowHawk drone for U.S. law enforcement agencies. The answer was yes.
Read Full Story
Read All Recent News
Get in the Know Now
Get SSI Email Alerts
Social Networks
Action Center
|
