By Deane Waldman – Director, Center for Health Care Policy, Texas Public Policy Foundation
Biden’s Healthcare Plan
Americans want and expect care from their healthcare system, not simply insurance, particularly not if such coverage does not produce timely, indeed life-saving care.
Some mistakenly believe that Biden’s Health Plan with its public option will deliver the care people need when they need it. It won’t. Biden’s plans will reduce access to care, not improve it. Avoid wishful thinking that this time Washington’s political promises will actually materialize. For proof, evaluate the following evidence presented.
Recall that Democrats failed promises of $2500 in savings and “if you like your doctor, you can keep your doctor.” The centerpiece of Biden’s healthcare plan is the public option: a “public health insurance option like Medicare” and “like Medicare, [it] will negotiate prices with providers” and “negotiate lower prices” for drugs.
Any proposal that looks “like Medicare” should give us pause rather than provide reassurance. According to an internal audit, the hospital portion of the Medicare Trust will be insolvent by 2026. Within five years, Medicare will go broke. At that time, the program will be unable to pay for seniors’ in-patient care.
Private v. Public Healthcare Insurance
The public option refers to a federally operated insurance plan similar to private insurance, except that the public option has a limitless bank account that is backed by tax revenues and Washington’s ability to print money. Private insurance companies — Aetna, Anthem, Cigna, Humana, Kaiser, Molina, UnitedHealth, Wellpoint, etc. — must take in more revenue than they expend or go out of business. The public option is in no such danger because it can never run out of money.
With unlimited coffers, Washington’s public option can afford to and certainly will engage in predatory pricing. By pricing the public option below private premiums, Washington will quickly drive all private insurance out of the market. With federal insurance as the only option available to Americans, Washington will have a monopoly in the market. And with monopoly power, Washington will be in a position to dictate both medical care and medical pricing; essentially, the federal government will ration our care.
The Biden plan intends to resurrect the universally despised IPAB (Independent Payment Advisory Board) under a different name. Americans will then receive whatever care Washington allows, not the care individuals need. Doctors will no longer be able to practice medicine on patients, and federal bureaucrats will replace physicians. Biden claims Washington can “better coordinate…care” than individual, private physicians.
The public option will lead to strict rationing, i.e., less care, for all Americans … except, of course, for the elites.
Healthcare Right Now
There is proof that federal control leads to death-by-queueing, dying while waiting in line for care. The VA Health System is a U.S. single payer system totally controlled by Washington. A 2015 internal audit of the VA concluded that “47,000 veterans may have died” while waiting for life-saving care.
There is another way by which Biden Healthcare will reduce access to care: the bureaucratic diversion. Biden’s plans call for additional federal agencies along with a host of new financial and eligibility rules and regulations, such as elevating the FPL (federal poverty level) cap on federal insurance subsidies above the current 400 percent; eliminating co-payments; offering free public option in states that did not expand Medicaid; paying 75 percent of the cost for catastrophic insurance; premium tax credits; reference-indexed price controls on drugs; and negotiating (i.e., dictating) reduced payments to providers.
All these administrative activities cost hundreds of billions of dollars: Money for people to account for current implementation and subsequent financial effects; for bureaucrats to write the rules and regulations; and for officers to oversee activation and compliance plus all the expenses for offices, computers, compensation packages including salary, benefits, and pension contributions. Federal bureaucrats are paid 78 percent more than those in the private sector.
Money “diverted” to healthcare administration are hundreds of billions of “healthcare” dollars that the federal bureaucracy pays itself, dollars that cannot be used for patient care. As the bureaucracy expands, the money it consumes cannot be used to pay for care. Thus, the accurate epithet of bureaucratic diversion.
Recall that Obamacare cost $1.76 trillion. One look at the ACA organizational chart shows how greatly Obama’s namesake law expanded the federal bureaucracy with a bewildering complexity and subsequent spending. To pay for increased bureaucratic expenses, more than $700 billion was taken from the Medicare Trust Fund that was supposed to pay for hospital care for seniors.
More Money, More Problems
In addition to the cost of bureaucratic diversion, Biden intends to expend additional billions on administration and bureaucracy, viz. more than $1 billion to expand time-wasting, error-inducing electronic medical records; paying 75 percent of cost of catastrophic insurance; expansion of the Children’s Health Insurance Program, elimination of co-pays through additional federal subsidies; billions to community health centers; and an “addition of 100,000 nurses.”
Finally, Biden’s health plan declares that “healthcare is a right for all.” Healthcare is the professional service or work product of a caregiver. If that service is another person’s “right,” the caregiver must provide it on demand, whenever the patient wants, and for free. After all, no one pays for basic rights such as in the Bill of Rights (where health care is glaringly absent). A right to a provider’s work — medical care — takes away providers’ freedom, making the provider an indentured servant, or worse, a slave. Between enslavement and “negotiating” lower payments to physicians, the shortage of providers will get much worse. Access to care will suffer and wait times to see a primary care doctor will increase from months to years.
By crushing non-government insurance, because of too few physicians, with bureaucratic diversion and federal rationing, BidenCare’s promise to the American people will be, “No Care for You!”
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