Health Care on the Slippery Slope
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A few days ago when we pointed out that the word “compete” deserved no place in a question about the creation of a government-run health insurance plan one of our commenters complained that we were using a slippery slope argument -- that such a plan could eventually lead to single-payer government-run health care. Our response was, basically, given that the stated goal of the proponents of such a public option is single-payer government-run health care it would be incredibly naïve to think that they would not put forth policies to achieve that goal.
We have always maintained that there is no way that government can act as both player and referee in a competition for coverage, but will also seek to manipulate the rules to its own advantage. Yesterday our position moved from common sense and theory to a very nonsensical reality. Armed with polls skewed by such notions as "choice" and "competition" House leaders are pushing the notion of a "robust" public option to lower costs. As the Wall Street Journal notes:
A so-called "robust" public option will cost the government less than other plans, since it will pay doctors and hospitals fees pegged to Medicare's price controls on thousands of services. The Congressional Budget Office has reportedly found that these below-market payments would result in "savings" of $110 billion, compared to requiring a public option to negotiate rates with providers like a private company would.
Out of the gate and onto the slope:
Yet as the government pays less, the private sector pays more. Like Medicare today, hospitals will shift some of their losses into higher private insurance premiums. Meanwhile, the public option's premiums will be artificially lower, even before the heavy subsidies that Democrats plan to offer. As private insurance costs increase, private payers will lose market share, intensifying the cost-shift and precipitating an exodus to government from commercial carriers.
And it is a double-black diamond:
For liberals the key is to get the architecture in place this year and expand it over time, much like Henry Waxman and the late Ted Kennedy did with Medicaid in the 1970s and '80s. At least for now, we still don't see how Democrats get to 60 votes with a public option. But its revival shows that the Democratic Party's left is running this show, and how radical their plans for U.S. health care really are.
