What happened to Obamacare? Rhetoric met reality. As both candidate and president, the master rhetorician could conjure a world in which he bestows upon you health-care nirvana: more coverage, less cost.I think another part of the problem is that Americans understand that health care is a complex policy issue and are having a hard time swallowing the notion that a one-size fits all solution or even a single solution.
But you can't fake it in legislation. Once you commit your fantasies to words and numbers, the Congressional Budget Office comes along and declares that the emperor has no clothes.
President Obama premised the need for reform on the claim that medical costs are destroying the economy. True. But now we learn -- surprise! -- that universal coverage increases costs. The congressional Democrats' health-care plans, says the CBO, increase costs on the order of $1 trillion plus.
The fact is, we as Americans spend a great deal of money on health care, probably too much. It is not that we pay too much for a specific procedure or treatment, but that we use health care too much. If you really want to cut costs in health care you have to do two things:
1. Get rid of third party payers--specfically private insurance companies and get serious about reducing the payment government pays.
2. Make health insurance true insurance. You don't pay for oil changes on your car with auto insurance. You shouldn't pay for check-ups with your health insurance.
In order to control costs, we have to get Americans to be more cognizant of how much health care really costs. When a person goes to the doctor they pay their $10 or $15 co-pay, they will usually get an explanation of benefits letter from their insurer (which by the way increases costs a little), but most people don't look at them. Most people don't have any idea how much the actual cost of a doctor's visit really is. So we use health care far too much.
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