July 28, 2009

July 28, 2009 | Commentary on Health Care

What Obama Doesn't Know Can Hurt the Rest of Us

President Obama admits he doesn't know about major parts of the House health care bill, but he's promoting the measure anyway. He's violated a cardinal rule of salesmanship: Know your product.

Nobody should buy from a salesman willing to make false claims.

When asked in his blogger phone conference about Section 102 and its destruction of private health coverage, Obama replied, "You know, I have to say that I am not familiar with the provision you're talking about."

Anyone who even skims the 1,018-page bill finds this part immediately; it's right at the start, actually beginning with Section 101, and it would impose restrictions on private health insurance. (The entire bill is available online at fixhealthcarepolicy.com.)

The ability of private carriers to make a profit is curtailed. One provision empowers a presidential appointee to dictate how much profit or administrative costs will be permitted.

Obama's approach is stealthier than President Clinton's 1993 proposal for a total health care makeover. Realizing that whoever controls the payment system can call the shots, Obama has chosen the takeover route. Supplant private insurance with a government-run program and government now has control.

Takeovers are the vogue, in health care as in banking, mortgages and auto-making.

So let's look at the consequences, and then the details.

Polling shows 77 percent of Americans are satisfied with their existing coverage. Too bad for them: 88 million Americans would be forced out of their current private health plans, with 83-million of them pushed into a government-run plan. That means almost half of everyone with private coverage today would lose it very soon. (The numbers come from a Lewin Group report, commissioned by The Heritage Foundation.) Remaining private plans would then wither and be supplanted more gradually.

President Obama simply doesn't like private enterprise. He told NBC News' Nancy Snyderman last week, "A whole lot of people are having bad experiences because they know that recommendations are coming from people who have a profit motive."

So he's backing a bill that would drive private health plans into government-sponsored oblivion by destroying their ability to succeed.

How? By outlawing the methods used by private insurance to control costs and hold down the premiums you pay:

  • Section 101 outlaws new health benefits plans that don't meet the new federal requirements.
  • Section 102 requires existing employer group plans to meet the new requirements within five years.
  • Section 111 requires insurers to accept anyone regardless of previous health, without limits or conditions. Presumably, you could enroll after arriving at the hospital and still be covered for whatever problem sent you there.
  • Section 113 requires charging the same premium to everyone, varying only by age and geography. No discounts for non-smokers, non-drinkers, fitness buffs, healthy eaters or anything else. It also limits higher premiums based on age, thereby increasing the premiums charged to younger people.
  • Section 114 outlaws any limits on coverage of mental health and substance abuse.
  • Section 115 shifts authority over networks of health care providers, moving them from state regulation to federal control.
  • Section 116 is the real kicker. If insurers are able to turn a profit despite the federal restrictions and public plan competition, they must give back much of that profit to their customers, as dictated by a new federal bureaucrat. This so-called "medical loss ratio" gives power to a presidential appointee, the new Health Choices Commissioner, to dictate the permitted level of administrative costs and profits.

Even without these provisions, the bill gives an automatic advantage to the new public health plan. The public plan uses price controls, requiring doctors and hospitals to accept Medicare-designated payment amounts. Typically, these are significantly lower than private plan payments, often paying less than the cost of providing the care. (This is why so many doctors today refuse Medicare patients.)

Private plans lack this power, so doctors, hospitals and clinics will offset their public plan losses by shifting the costs onto the bills of their other patients -- making private plans even costlier. The Lewin study estimates this cost-shifting will add an extra $460 per person per year to the cost of private insurance. That worsens the automatic disadvantage they have of competing against a taxpayer-subsidized government plan.

Trying to rush this 1,018-page bill through Congress before the public disenchantment grows worse is like a midnight burglar trying to grab all the goods before the homeowners wake up. When the president doesn't know what's in a bill, that's a sign everybody else should start finding out. Ignorance may be bliss for some, but not for the rest of us.

Ernest Istook is recovering from serving 14 years in Congress and is now a distinguished fellow at The Heritage Foundation.

About the Author

Ernest Istook Distinguished Fellow
Government Studies

Related Issues: Health Care

First Appeared in Human Events