Fix Health Care Policy

White House Silent on Obamacare Transparency Bill

A freshman congressman has offered legislation that would make the extensive federal rulemaking process associated with the new Obamacare law dramatically more transparent. The bill would also give Congress a stepped-up oversight role as federal agencies begin drafting rules to implement the law, which will go fully into effect by 2014.

In fact, both the purpose and letter of the Creating Sunshine, Participation, and Accountability for Our Nation Act (H.R. 1432) align well with President Obama’s stated concern for transparency in federal rulemaking.  (Read the rest on The Foundry…)

Tags: ObamaCare, oversight, repeal the law, transparency, White House

Why the White House Is Wrong — Again — On Health Care Spending

Nancy-Ann DeParle, the Director of the White House Office of Health Reform, posted a note – ironically titled “Reality Check” – on the White House blog this morning claiming that a new report from the federal government’s health actuaries supports the administration’s position on health care reform.

But all that report says is that U.S. health care spending continues to increase – even though the rate of increase actually hit a historic low in 2008 (the latest year for which figures are now available). DeParle’s argument is basically this: We spend too much on health care, therefore the reform proposals currently in Congress will fix everything.

However, DeParle seems to have missed the actuaries’ earlier report on what those reform proposals will actually do – which is, to make health care spending grow faster, not slower. In particular, actuaries estimate that if the Senate health reform bill becomes law, total U.S. health care spending would increase by 0.7%, or $234 billion through 2019. And that’s after taking into account what little savings would be achieved by cutting Medicare benefits and encouraging employer to cut health benefits by taxing private insurance plans that are “too generous.”

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Tags: health actuaries, health care spending, Nancy-Ann DeParle, White House

Will Obamacare Be Run from the West Wing?

The latest Senate leadership health care compromise is a “Bumper Sticker.” There are no details yet, but the Bumper Sticker tells us enough about where this compromise is heading: a massive concentration of political control over the health care system.

While the Senate leadership has decided to turn the outlines of their latest “breakthrough”- perhaps even the legislative text- to the Congressional Budget Office for a cost estimate, we know something about what they have in mind. The broad outlines tell taxpayers a great detail about where the congressional liberals are going with this scheme. Curiously, with the right tweaks, it could do something quite unusual: end up concentrating control over the nation’s health insurance markets, literally, in the West Wing of the White House.

Here’s how. Part One of this scheme would empower the United States Office of Personnel Management (OPM), the federal agency that runs the federal civil service, to enter into a contract with two large health insurers (probably the Blues and Kaiser) to sell health plans in the state- based health insurance exchanges set up in every state of the Union, under the Senate bill. According to the press reports, these giants will be “non-profits,” reflecting the Left’s ideological hostility to profit-making insurance, regardless of its performance or patient satisfaction. That probably means that the Blues or Kaiser will have the inside track on any contract and stipend from the government.

These two giants would then compete against private health plans everywhere in the country. Now the key issue is how the OPM will administer this process. (Precious details, details, details.) Presumably, OPM will determine the health benefits, medical treatments and procedures to be offered on the national scale – the federal government would set benefits in any case, whether the exact determination will be made by OPM or the Secretary of Health and Human Services. So, these two giant “private plans” will administer the federal government’s benefits package. Be sure of that. Even more important is how the OPM will set premiums. This again, is a crucial piece of the puzzle. Will the premiums simply reflect free market rates, or would the premiums reflect the White House’s policy agenda. Why the White House? Simple. The Director of OPM reports to one person: The President of the United States.

Free markets are not in vogue on Capitol Hill right now, and surely not in the West Wing. It’s a good guess that the premiums will reflect some form of administered pricing scheme, enabling OPM to secure below-market rates for its contractors and drive private sector competitors out of the markets, consolidating federal control over the insurance markets in the same way that a “robust” public option was designed to do at the beginning of this process. Same end, different means.

There is a third consideration. The health plans are to be “non-profits” and serve a public agenda, as defined by the Senate liberal leadership. But will these non-profits also be “non-loss” plans? Will they be eligible for federal bailouts if they lose money? Good question. It’s hard to imagine that the congressional liberals would allow their latest scheme of “non-profit” health plans to fail. When this is finally unveiled in the light of day, read that fine print closely. They hope you won’t do that. So annoy them.

A government sponsored oligopoly is not anything like real competition – real competition is open markets and a level playing field, anybody can play – and the so-called private plans are “private” in name only, and they are simply hired guns to serve as the vehicles of Washington’s political agenda.

Part II of the compromise consists of an expansion of Medicare (including people as young as 55). And it’s big entitlement expansion. (That’s how the Congressional liberals now define “reform.”) Not surprisingly, Rep Anthony Weiner (D-NY) has applauded this part of the compromise as a big step toward the single payer option, and told the Los Angeles Times: “Expanding Medicare is an unvarnished, complete victory for people like me. It’s the mother of all public options.” Not to be outdone, the editors of The Washington Post said this morning: “ The irony of this late breaking Medicare proposal is that it could be a bigger step toward a single payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”

The prescription: Massive erosion of private coverage from “crowd-out,” as employers with a large number of older employees have new incentive to dump them; higher Medicare costs, and even more debt, as millions more are added to the Medicare program, which already has a long-term debt of $38 trillion. Of course, Medicare expansion means more people covered under Medicare rates and artificially lower rates for doctors and hospitals. Even the K street crowd, desperate to be in with Capitol Hill’s current “In Crowd,” and so eager to get a pat on the head and that coveted “Seat at the Table,” is having second thoughts about this latest compromise. The AMA, which is obsessed about Medicare payment above all else, doesn’t like it. The American Hospital Association and the Federation of American Hospitals have urged their members to oppose the bill, as it would cut reimbursement rates to hospitals, which are already heavily burdened.

Already, the Senate bill provides for an expansion of Medicaid, a welfare program, up the income scales. Together, entitlement expansions can be expected to accelerate the erosion of the private health insurance coverage for millions of Americans. There is no reform here. Few politicians stop to look at the poor quality of care provided under Medicaid; fewer doctors take Medicaid patients, which is why so many Medicaid patients crowd into the emergency rooms. The politicians on the Hill with their Medicaid expansion will guarantee even more hospital emergency room over-crowding.

So much for the Big Compromise – Senator Harry Reid’s latest Breakthrough Moment. The end is pretty much the same: More government dependency, more poor quality care, combined with a staggering deficit. There is one thing that one could say may be new – depending how the Senators write the crucial details – more power to the President, who can guide and direct the shape of the health insurance markets through his Director of the Office of Personnel Management. That, at least, is a fresh approach to government control.

Audrey Jones co-authored this post.

Tags: health insurance, ObamaCare, President Barack Obama, Sen. Harry Reid, single-payer system, White House

Video: Obamacare is Not a Good Fit for Women

First Lady Michelle Obama’s video on health care reform raises important issues about female patients who are falling through the cracks of the U.S. health care system. It’s not a perfect system, but Nina Owcharenko explains that ObamaCare would take women and the rest of the country in the wrong direction. Having to depend on politicians or faceless bureaucrats to make decisions about their care doesn’t empower women or improve their health care situations. Plus, the Obama health reform agenda isn’t what women want. A majority of female respondents told the Independent Women’s Forum in a recent survey that they don’t think government-run health care is best for them or their families.

Tags: fact checking the white house, fixhealthcarepolicy.com, Nina Owcharenko, Obama Health Care Plan, White House, women and health care reform

Understanding the Public Option Double-Talk

A Wall Street Journal editorial today outlines and translates the “White House’s conflicting proclamations this week about a new government insurance program for the middle class.”

In addition to highlighting what’s happened so far in terms of the Obama administration’s latest dialogue on the public plan, the editorial notes versions of a public option — from a robust version to one that is triggered when there is insufficient competition in the marketplace — would still be expensive and add new costs on governments benefits spending.

Tags: public plan, Wall Street Journal, White House