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Health Care’s Already Been “Reformed”

Health Care’s Already Been “Reformed”
It’s called Medicaid and Medicare. They’re working exactly as Obamacare is predicted to work — which is that they’re crushing states with costs. Daniel Henninger writes in the WSJ that the “public option” we’re being promised for health care is “Son of Medicaid”:

Spending on health and welfare, largely under Medicaid, makes up one-third of California’s budget of some $100 billion. In New York Gov. David Paterson’s budget message, he notes that “New York spends more per capital ($2,283) on Medicaid than any other state in the country.”

After 45 years, the health-care reform called Medicaid has crushed state budgets. A study by the National Governors Association said a decade ago that because of “new requirements” imposed by federal law — meaning Congress — “Medicaid has evolved into a program whose size, cost and significance are far beyond the original vision of its creators.”

In his speeches, Mr. Obama makes the original vision of his “public option” insurance plan sound about as simple as driving through toll booths with an electronic pass on your windshield. It’s going to be all about “best practices” with patients “reimbursed in a thoughtful way,” as if the federal government is about to become just another big Google.

Medicaid is a morass. Since the program’s inception, Congress has loaded it up every few years with more notions of what to cover, shifting about 43% of the ever-upward cost onto someone else’s tab, mainly the states. A 1988 congressional mandate requires local schools to pay for schooling and related services for disabled children, but because Congress underfunds its mandates, the states pay the rest through Medicaid.

…Mr. Obama’s plan is intended to “guarantee” health insurance for all. Whatever the truth of that, its outlays — larded atop Medicaid, Medicare and Social Security — guarantee that Congress will become more like the states’ clown shows. But they are expensive clowns.

In his speech, Mr. Obama said the cost of the Public Option won’t add to the deficit: “I’ve set down a rule for my staff, for my team — and I’ve said this to Congress — health-care reform must be, and will be, deficit-neutral in the next decade.” If we’re honest, that means tax increases are inevitable. Sounds scary to me.

In case you didn’t see the link before, Virginia Postrel suggests we fix Medicare first — before embarking on any new adventures in going into vast levels of debt.