NCPA - National Center for Policy Analysis


August 4, 2009

The most misused word in the health care debate is "reform."  If you listen to President Obama, his reform will satisfy almost everyone.  It will insure the uninsured, control runaway health spending, subdue future budget deficits, preserve choice for patients and improve quality of care.  These claims are self-serving exaggerations.  They have destroyed what should be a serious national discussion of health care, says columnist Robert Samuelson.

The health care conundrum involves a contradiction that the administration steadfastly obscures: in the short run, government cannot both insure the uninsured and rein in health spending.  Here's why:

  • The notion that the uninsured get little or no care is a myth: they now receive about 50 to 70 percent of the health care of the insured.
  • If they become insured, their health spending would rise toward 100 percent, increasing both government and private health costs.

Congressional proposals reflect this reality, continues Samuelson:

  • The Congressional Budget Office (CBO) judges that the legislation in the House would, through expanded Medicaid and subsidies for private insurance, cut the uninsured to 17 million in 2019, from 46 million in 2007.
  • But the cost would be $1 trillion over the decade; of that, $239 billion would add to the budget deficit.
  • Worse, the costs would rise faster than the sources of financing, including a tax on the wealthy; in 2019, the deficit would be $65 billion.
  • Assuming that deficit rises four percent a year, the cumulative shortfall in the second decade would total $800 billion.

Judged objectively, reform may do exactly the opposite of what Obama says.  It would bloat spending, not restrain it.  But because the president is so well spoken, he has the ability to make misleading statements sound reasonable or sophisticated, says Samuelson.

Source: Robert J. Samuelson, "Health 'Reform' That Isn't," Newsweek, August 3, 2009.

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