The House passage of health-care reform Saturday night should be a moment of celebration. In a country as wealthy as America, no one should have to go without medical care. As in other developed nations, everyone should have access to doctors, to medicine, to preventive services. The House bill would take America a giant step closer to that goal.Can you spot the problem?
If not, you have not been paying much attention to the debate and to health care in America or how it is delivered.
First let us be clear, no one in this country in need of medical care will ever go without. If you need an emergency room, you can go and you will get treated. If you need a doctor, you can find one.
The problem is not access to health care, it is paying for health care. There are Americans who can't afford health care and make no mistake, this monstrosity of a bill will do absolutely nothing to reduce the cost of care, in fact, it will make health care more expensive by subsidizing it.
But here is the vicious self-fullfilling prophecy that we are going to be entering into.
1. In an effort to promote access to and payment for high quality health care services (which is by no means a right--no matter what anyone says), the government will subsidize care for those who can't get health insurance through their employer or what ever reason may exist.
2. As sure as the sun will rise in the East tomorrow, those people who previously had to make a decision about whether to go to a doctor, will now go without thinking twice because the govnerment is footing the bill.
3. Employers, unable to compete with the government subsidized health programs in terms of cost effectiveness will force more and more people onto the public rolls, which then adds to the demand.
4. As more and more people demand care without having to personally pay for it, the costs to the government will go up, leading to the verge of bankruptcy that Hiatt himself warns us of.
5. As a result, in order to control costs, the government will have to start controllling use of the health care services (to the uninitiated, that is how Canada, Britain and other Western Eurpean nations control costs--it is also, essentially, rationing).
6. Then the prophesy will be fulfilled when people are being denied access to care they need, not because they don't have the ability to pay for cadillac level health care, but because the government is telling them they can't.
The problem we face with this health care bill will be years away, if not decades, but given that we can see what happens with government run health care in other nations, why is it we can't see the future here. Do we really think that we are that much smarter?