Healthcare Rationing: Real Scary - Newt Gingrich

http://www.healthtransformation.net/cs/opeds_news?pressrelease.id=2880

August 16, 2009

Concerns about government bureaucracies gaining oversight of your treatment are not misplaced. We need reforms, but the answer is not central planning.

By Newt Gingrich

When Sarah Palin said that the emerging healthcare reform legislation would lead to "death panels" and government rationing of care, her language was explosive, but her premise about rationing was not.

The most critical test of any reform proposal is whether it will empower individuals or impose on them. It is a fact that the leading bills in Congress would increase the power of government and decrease individual freedom. You cannot spend an additional $1 trillion of taxpayer money and reduce the role of government. You will get new bureaucracies, more regulation, more complexity. That means you will have less control of your healthcare.

Disagree? Just read the versions of healthcare legislation:H.R.3200 in the House. One key proposal is to mandate an "essential benefit package" for every private insurance policy sold in the United States. Currently, individuals and employers usually make these coverage decisions. This legislation creates a new federal Health Benefits Advisory Committee that would decide instead. For example, if you are a single male with no children, the legislation still requires you to have maternity benefits and well-baby and well-child care coverage. You don't want or don't need that coverage? Sorry, you have to pay for it anyway.

Other planned agencies would give the federal government unprecedented and unaccountable control over your healthcare. The so-called Health Choices Administration and the National Health Insurance Exchange would set various standards for all health insurance policies. The president is also pushing for another new agency called the Independent Medicare Advisory Council. Described as a cost-control initiative,it would be made up of five government appointees who would, by determining Medicare reimbursement amounts, in essence decide what would be covered and what would not. The fear of government rationing is based on the premise that once government has such power, especially the ability to control what is covered by your private insurance policy, it also has the power to deny and restrict.

Those defending the House legislation claim rationing is not in any of its versions, and though that is technically true -- no one wants rationing -- the unprecedented power this legislation would grant to virtually unaccountable government agencies is all but certain to lead to rationing.
Consider Medicare, which is projected to go broke within the decade. As the baby-boom generation ages, it will put only more stress on the system. With more than 25% of all Medicare costs generated in the last two months of life, government already has the motive to ration care to the elderly. If the House legislation were to become law, these new government bureaucracies would then also potentially have the power. Are we supposed to trust that they won't use it?

If such rationing occurs, rules will be needed to determine whether to spend federal healthcare dollars on a given individual. What might those rules look like? Dr. Ezekiel Emanuel is a key healthcare advisor to President Obama and the brother of White House Chief of Staff Rahm Emanuel. He co-wrote an academic article(09)60137- in January exploring the ethical challenges of valuing an individual's life in the context of allocating medical resources that are very scarce, such as organs or vaccines.

As an example, he and his coauthors proposed a system of valuation that could take into account that "[a] young person with a poor prognosis has had few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionately large amounts of resources will be directed to young people with poor prognoses."

In a 1996 article in another journal, Dr. Emanuel similarly hypothesized that "services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia."

Dr. Emanuel contends that he was exploring what rules might be used to ration care, not specifically prescribing policy. But isn't that the point? What we see at town hall meetings are Americans who legitimately believe it would be fundamentally unjust for government panels to make these kind of ethical decisions instead of individuals, loved ones and doctors.

To be clear, the healthcare system is in need of reform, particularly health insurance. But the answer is not central planning. The answer is more market competition -- giving consumers more choices, more information and more control.

Here is one example. There are more than 1,300 health insurance companies in this country, but currently, consumers can buy only a product licensed in each individual state. Creating a nationwide health insurance market where any individual or group can shop for less expensive coverage from another state would provide more choices, forcing private plans to create better products, improve services and lower prices.

We must also equip individuals with information on healthcare cost and quality. Releasing the Medicare-claims history of doctors and hospitals (with patients' personal information removed) would give Americans more knowledge to choose the most efficient institutions, practitioners and the most effective treatments. Inexplicably, this taxpayer-funded data remain locked away.

Of course, some Americans also need financial resources to pay for their healthcare choices. Tax credits are one way to help consumers purchase private healthcare coverage, or we could allow individuals to deduct the cost of insurance they purchase, just as employers do now. These are just some solutions to create competition to drive down costs while increasing quality.

There is no doubt that we badly need to improve our healthcare system. I welcome the comprehensive debate now taking place across the country on how to accomplish this goal. But reform must empower individuals, not government.

Former Speaker of the House Newt Gingrich is founder of the Center for Health Transformation.

Copyright © 2009, The Los Angeles Times

Top 10 Reasons Obamacare Is Wrong for America

1. Millions Will Lose Their Current Insurance. Period. End of Story: President Obama wants Americans to believe they can keep their insurance if they like, but research from the government, private research firms, and think tanks show this is not the case. Proposed economic incentives, plus a government-run health plan like the one proposed in the House bill, would cause 88.1 million people to see their current employer-sponsored health plan disappear.
   
2. Your Health Care Coverage Will Probably Change Anyway: Even if you kept your private insurance, eventually most remaining plans--whether employer plans or individual plans--would have to conform to new federal benefit standards. Moreover, the necessary plan "upgrades" will undoubtedly cost you more in premiums.
   
3. The Umpire Is Also the First Baseman: The main argument for a "public option" is that it would increase competition. However, if the federal government creates a health care plan that it controls and also sets the rules for the private plans, there is little doubt that Washington would put its private sector "competitors" out of business sooner or later.
   
4. The Fed Picks Your Treatment: President Obama said: "They're going to have to give up paying for things that don't make them healthier. ... If there's a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half for the thing that's going to make you well." Does that sound like a government that will stay out of your health care decisions?
   
5. Individual Mandate Means Less Liberty and More Taxes: Although he once opposed the idea, President Obama is now open to the imposition of an individual mandate that would require all Americans to have federally approved health insurance. This unprecedented federal directive not only takes away your individual freedom but could cost you as well. Lawmakers are considering a penalty or tax for those who don't buy government-approved health plans.
   
6. Higher Taxes Than Europe Hurt Small Businesses: A proposed surtax on the wealthy will actually hit hundreds of thousands of small business ownerswho are dealing with a recession. If it is enacted, America's top earners and job creators will carry a larger overall tax burden than France, Italy, Germany, Japan, etc., with a total average tax rate greater than 52%. Is that the right recipe for jobs and wage growth?
   
7. Who Makes Medical Decisions? What is the right medical treatment and should bureaucrats determine what Americans can or cannot have? While the House and Senate language is vague, amendments offered in House and Senate committees to block government rationing of care were routinely defeated. Cost or a federal health board could be the deciding factors. President Obama himself admitted this when he said, "Maybe you're better off not having the surgery, but taking the painkiller," when asked about an elderly woman who needed a pacemaker.
   
8. Taxpayer-Funded Abortions? Nineteen Democrats recently asked the President to not sign any bill that doesn't explicitly exclude "abortion from the scope of any government-defined or subsidized health insurance plan" or any bill that allows a federal health board to "recommend abortion services be included under covered benefits or as part of a benefits package." Currently, these provisions do not exist.
   
9. It's Not Paid For: The CBO says the current House plan would increase the deficit by $239 billion over 10 years. And that number will likely continue to rise over the long term. Similar entitlement bills in the past, including Medicare, have scored much lower than their actual eventual cost.
   
10. Rushing It, Not Reading It: We've been down this road before--with the failed stimulus package. Back then, we also heard that we were in a crisis and that we needed to pass a 1,000-plus-page bill in a few hours--without reading it--or we would have 8% unemployment. Well, we know what happened. Now, one Congressman has even said it's pointless to read one of the reform bills without two days and two lawyers to make sense of it. Deception is the only reason to rush through a bill nobody truly understands.
    

For more information, please visit: http://FixHealthCarePolicy.com