Senior Administration Official Admits: Government-Run Plan Will Ration Care
“The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here….There is going to have to be a very difficult democratic conversation that takes place.”
— President Obama, interview with The New York Times
President Obama recently nominated Sherry Glied to the post of Assistant Secretary for Planning and Evaluation within the Department of Health and Human Services. In this position, she will serve as the chief policy advisor to Secretary Sebelius and the President regarding implementation of health reform. The Republican Conference has compiled a series of quotes from Dr. Glied’s 1997 work Chronic Condition: Why Health Reform Fails that highlight her thoughts on health reform—many of which directly contradict the President’s assertions about the ramifications of his plan.
Government Attempts at Cost Containment Will Never Work
“Most Americans will grumble about the increase in costs but they will pay for more care, just as they have for the past 65 years. People who see well will gladly work more hours to fund better eyesight, when medical advances enable them to do so. People who cannot walk will willingly move to smaller dwellings if doctors offer them a chance to purchase physical mobility in exchange. More people will undergo screening tests—and costly treatment—for cancer when those tests become less uncomfortable. People at risk of strokes will skip vacations to buy artery cleaning that promises to diminish those risks. People in pain will sacrifice much of their other consumption for respite. People whose incomes rise will buy more health care without giving up anything they have today. Simply put, health costs will continue to rise.” (213-14)
Government-Run Health Care Will Lead to Rationing
“If government sets the overall level of spending, the gap between that level and privately desired spending will increase as innovations occur. The system will appear “underfunded” and those who can afford it will seek ways around prohibitions on private care. A two-tiered system will emerge, complete with disparities between private and public care…” (216)
“With health care spending rising more rapidly than incomes or economic output, a broad-based tax—which is a tax on overall economic activity—will over time fall short. The government can, for a time, broaden the tax base, as it did in funding the Medicare trust fund, or it can raise rates; but ultimately, increasing costs will require the government to take an active hand in forcing costs down. Any public program thus raises the specter of more and more government cost containment—with government regulation eventually intruding into the private health care sector.” (230)
Rationing Health Care Leads to Delays in Treatment
“In health care, waiting lines have a more complex role. To the extent that they are used to generate pre-production inventories, they can reduce the average cost of health capital, even while raising patient costs in terms of time and inconvenience. Health care waiting lines represent a trade-off between patient costs and capital costs.” (99)
“[Other countries] achieve [lower costs] by slowing the introduction and diffusion of new technologies, concentrating costly procedures at a limited number of centers, delaying access to expensive care, and using more generalists and fewer specialists. It is important to recognize that the costs of these strategies are real ones. As recent studies comparing Canada and the United States suggest, patients in cost-contained systems may experience more discomforts and delays that patients who spend more money. Delays in access to high-technology care will, in some instances, lead to worse health for particular patients than might have been achieved through speedier treatment. Most evidence, however, suggests that on average these differences in access to costly services have minimal effects on overall physiological health.” (227)
Fully Taxing Health Benefits Does Not Increase Taxes Enough to Pay for Health Reform
“Unfortunately, simply abolishing the tax treatment of employer-provided health insurance…would reduce the effects on government budgets of increases in private health costs, but it would not generate a stream of new revenues to offset the costs of those who require subsidies. Eliminating the tax treatment is an important step toward developing a sustainable financing system, but it does not take us far enough.” (223)
Given these series of quotes, many Members may have additional questions about health care reform under the Democrat majority:
- Do President Obama and Democrats in Congress agree with President Obama’s nominee that government attempts to control health costs are inherently futile?
- Do President Obama and Democrats in Congress agree with President Obama’s nominee that a government-run plan will always be under-funded, leading to a two-tiered health care system?
- Do President Obama and Democrats in Congress agree with President Obama’s nominee that health care “waiting lines” constitute an acceptable “trade-off between patient costs and capital costs?”
- Do President Obama and Democrats in Congress agree with President Obama’s nominee that delays in care will result in “worse health for particular patients”—but that rationing through waiting times and delays imposed by federal bureaucrats should be pursued because “on average” patients will be better off?
- Do President Obama and Democrats in Congress agree with President Obama’s nominee that, in addition to taxing all health benefits fully, Congress should impose even more tax increases in order to finance government-run health care?
Given President Obama’s nomination of an individual who supports explicit rationing of health care services, some Members may be concerned that spending more than $1 trillion on a government-run health plan will increase federal bureaucrats’ role in making patients’ personal health decisions—and lead to unacceptable delays in life-saving treatments for many Americans.