Monday, April 06, 2009

The Tactics of Nationalizing Health Care

Combining a couple of items from the AmSpec blog, the beast takes a lumpenshape.

First, Klein quotes Dionne (a well-connected guy, indeed):

Though only some of the players will say so now, the plan will ultimately include a mandate requiring everyone to have insurance, quelling opposition from the insurance companies. They hope that having a bigger market will compensate them for whatever they might lose from regulatory changes

Then Klein mentions the tactics.

One of the major fights in the upcoming health care push will be over whether the legislation should allow Americans the option of enrolling in a newly created government-run plan. President Obama said that the so-called public option was a way to "keep the private sector honest" and Howard Dean, among others within the movement, has argued that this should be the hill to die on for progressives

The Lewin report's upshot?

...the creation of a public option would shift more and more people from private health care to government health care, thus creating a single-payer, or socialized health care system, over a period of time

Not exactly news. That's been out there since before the election. But the numbers are interesting:

If as the President proposed, eligibility is limited to only small employers, individuals and the self-employed, public plan enrollment would reach 42.9 million people. The number of people with private coverage would fall by 32.0 million people....

If the public plan is opened to all employers as proposed by Senators Clinton and Edwards, at Medicare payment levels we estimate that about 131.2 million people would enroll in the public plan. The number of people with private health insurance would decline by 119.1 million people. This would be a two-thirds reduction in the number of people with private coverage (currently 170 million people).

But there's more.

...if government uses its bargaining power to restrict payments to doctors and hospitals as it does under Medicare, Lewin estimates that doctors' pay will shrink by $33.1 billion in 2010 and hospitals' earnings will drop by $36 billion.

Of course, docs could opt out of the plan, as many have done with Medicare. That's why the "forced enrollment" part (above.) Hospitals cannot 'opt out,' and if 130++million enroll in the Fed plan (and they will--the incentives will be very desirable) where can the docs go?


Anonymous said...

For some time now I have been advocating medical choice. (Is it not funny how those in favor of choice in one area so oppose it in others?)

That is, if you want socialized medicine, you can have it, but must pay a much higher tax rate than those of us who want freedom. The other part of the program is that any and all medical providers who wish can also opt out of the program, and refuse to provide services to the government funded program. I suspect very few socialists to favor my program, because freedom is probably the last thing on their agenda.

Ken Van Doren

Jack Lohman said...

Dad, there is no question that they will mandate coverage of some kind. That's the reward the insurance industry gets for its millions of dollars in campaign contributions. Nice to hear that even Obama can be bought. I was afraid things were going to change.

We can only hope there is a reasonable public option that employers can opt into. It would be simpler and less costly to go to a universal single-payer system that employers did not have to pay for, but there are enough politicians on the take that that will not happen overnight. Isn't our free-market political system great?

Incidentally, over 60% of Docs prefer a single-payer system, as do even more business leaders. So the Docs will not opt out for long.

And yea, yea, Ken. We'd like to trash freedom altogether.

Jack Lohman

Jack Lohman said...

And incidentally, if "private" really is more efficient than Medicare, the public system will not survive. How's that for competition?

But it's not, and that's what the privatizers fear.