NCPA - National Center for Policy Analysis


September 3, 2009

The roiling debate over health care this summer has included a host of accusations from opponents of the plan that have been so specious that many in the mainstream news media have flatly labeled them false.

Far from embracing the attacks, many leading conservative health care policy experts said in recent interviews that the dynamic was precluding a more robust real-world debate.

Dr. Scott Gottlieb, a fellow at the American Enterprise Institute, is among those making policy-laden arguments against Mr. Obama\'s plan that do not lend themselves to easily digestible catch phrases like "death panels" or false but sensational assertions that the elderly will be told to choose euthanasia as a cost-saving measure.  But his critique is based on related fears that the plans being discussed would inevitably lead to increased government involvement in personal medical decisions and eventually affect vital services.

Like many of his conservative peers, Dr. Gottlieb said he was concerned that the administration\'s plan would fail to control costs adequately while increasing demands for services.

  • The result, he said, is that Medicare, Medicaid and any new government insurance program would be forced to deny payment for procedures deemed unnecessary.
  • Administration officials contend that the plan would not cause a draconian increase in rationing by finding savings in Medicare and Medicaid because it would be largely financed by cutting waste in Medicare, more than $500 billion over 10 years.

Their argument holds that they can find that money with real efforts to decrease redundant procedures due to poor record keeping - causing a doctor, for instance, to prescribe an expensive test a patient has already had - and the correction of similarly exorbitant inefficiencies throughout the system.

Health care expert Gail Wilensky said the entire health care system should stop paying doctors an individual fee for each service they provide patients - something experts say encourages over-treatment and waste - and alternatively, for instance, persuade them to join together with different specialists to offer an array of services for one lump sum.  This idea is widely supported by conservatives and liberals alike, but no proposal to set up this new payment system has gained attention.

"Part of the problem on the Republican side is an unwillingness to say, Let\'s find a right way to do this, and let\'s go ahead even if all the special interests don\'t like what we\'re doing," said John Goodman, president of the National Center for Policy Analysis.

Source:  Jim Rutenberg and Gardiner Harris, "Conservatives See Need for Serious Health Debate," New York Times, September 2, 2009.

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