Blog and News

ObamaCare's Catch 22

By Grace-Marie Turner

The Commonwealth Fund is at it again with another headline-grabbingsurvey, putting the U.S. dead last in its ranking of seven countries' health systems.

Commonwealth's bottom line: Only Canada has lower quality health care than we do. The U.S. is the most unsafe, the least efficient, the least equitable, and the worst in keeping people alive and healthy. Oh, and we spend way too much.

And, of course, Commonwealth reminds us that the U.S. placed 37th in a discredited, 10-year-old survey by the World Health Organization ranking health care systems.

So why would it be, then, that when people are sick and want the best medical care, they want to come to the U.S.? The study didn't discuss, for example, survival after being diagnosed with cancer, access to specialists, or investment in research to improve medical care for the planet.

Is there an agenda here? Of course. The report says that "The comprehensive health reform legislation signed into law in the United States will undoubtedly ameliorate some of these problems."

Do we have problems in our health sector? Absolutely. Is ObamaCare going to fix them? Absolutely not. In fact, access to timely, quality care and many other measures, including cost, are going to get much worse as a result of the health overhaul law.

The Commonwealth survey is based not on actual data about the effectiveness of care, but upon "patient and primary care physician perceptions of the care they received and administered."

To prove that this study should not be used as a guide, it concludes that the U.K. was second in overall rankings, and first in efficiency and providing effective care.

Commonwealth might want to rethink its criteria before we are hit with the full force of ObamaCare.

Broken promises: And to that point, House Republican Leader John Boehner this week released a 43-page report on "ObamaCare: Three Months of Broken Promises."

The very long list cites independent reports showing that health insurance costs are rising, not falling. That health spending and the deficit are increasing, not declining. That cuts to Medicare will indeed impact seniors. That millions of people will lose, not be able to keep, their current health coverage. That burdens and costs on businesses will increase, not fall. That small businesses, the engine of jobs creation, will be hit hardest. And that the new taxes will indeed hit the middle class.

The real wonder is why on earth the president thinks this legislation is going to become more popular as it moves forward. The administration's hubris in thinking they could rewrite the laws of economics and incentives will ultimately bring down ObamaCare.

No hearings yet: The president's choice to run the Medicare and Medicaid programs is running into trouble with no hearings yet scheduled for Senate confirmation.

Robert Pear had an article this week in The New York Times that explains why many of us believe the selection of Dr. Don Berwick is so politically tone deaf, especially among seniors concerned about big government blocking their access to health care.

Pear writes:

Long before the uproar over "death panels" last year, Dr. Berwick was urging health care providers to "reduce the use of unwanted and ineffective medical procedures at the end of life.

... In speeches and articles celebrating the 60th anniversary of Britain's National Health Service in 2008, Dr. Berwick said he was "in love with the N.H.S." and explained why it was "such a seductress."

"The N.H.S. is not just a national treasure," he wrote; "it is a global treasure."

... Dr. Berwick offered a suggestion to the British: "Please don't put your faith in market forces."

Even a columnist with Dr. Berwick's home-town newspaper, The Boston Globe, took direct aim:

No one can deny that America's health care system is flawed in many ways. But when it comes to the standard that matters most -- the quality of health care provided -- our haphazard, expensive, insurance-based system towers above the NHS.

"In Britain 36 percent of patients have to wait more than four months for non-emergency surgery,'' wrote journalist James Bartholomew in The Spectator. "In the US, a mere five percent do.''

By one metric after another -- cancer survival rates, performance of diagnostic tests, availability of CT and MRI scanners, consultation with specialists -- U.S. health care is superior. "British state-run health care,'' Bartholomew concluded, "is so amazingly, achingly, miserably, and mortally incompetent.''

That's the system that leaves Berwick feeling "romantic'' -- the system he proclaims an "example'' for the United States. And Obama wants him to run Medicare and Medicaid? Let us hope 51 senators say no.

Maybe someone should also tell this to the Commonwealth Fund. Major central planning for the entire health sector isn't working in the U.K., and won't work in the U.S.

Even if he is confirmed, Berwick will become the poster person for the complaints that seniors inevitably will have with the huge problems to come with ObamaCare. Maybe someone at the White House should be rethinking this.

Catch 22: And yet another adverse impact of ObamaCare is coming to light, trapping businesses in a Catch 22.

Karl Rove wrote about the grandfathering regulations for businesses in a column in The Wall Street Journal and so did the paper's news reporters. If employers change their plans, they lose their grandfathered status that protects them against more expensive federal mandates.

This started quite a debate in the blogosphere. New Republic Senior Editor Jonathan Cohn attacked Rove's (accurate) assessment of the impact of the regulations and, in the process, showed his cluelessness about how markets work. Cohn writes:

Among other things, [Rove] noted, a plan could lose grandfather status if employers decided to switch carriers -- 'a common practice when employers shop for lower prices.' Well, yes. So what?

The grandfather clause is there to let you keep your current insurance, assuming you like it and that it remains available to you. But if your employer is switching carriers, then it's not really the same plan anymore, is it? You've already lost your insurance. Obama didn't take it away from you. Your employer did.

But, of course, when a carrier knows a company can switch, it has a greater incentive to keep prices low. The company needs that flexibility to keep its costs down, as the Journal reported.

The Obama administration's grandfathering regulations traps them in the more expensive plans. They can't change without facing a battery of new (expensive) government regulations.

In fact, a new Kaiser study out this week proves Rove's point about the need for flexibility: It says that 77% of people surveyed buying health insurance in the individual market were facing average premium increases of 20%. But those who switched carriers and shopped for a better price were able to get their increases down to 13%.

Choice, competition, and flexibility are what we need, not central control and mountains of regulation. We will get there because that is what works.