Wednesday, April 24, 2013

In which the News Journal discovers the truth--and then mis-interprets it

In a rare burst of candor about the Obama administration, the WNJ editorial page discovers that the administration's claim that Obamacare is driving down medical costs is false:

“The idea that we have licked the problem of health care cost increases is no more probable today than it was in the past,” Drew Altman and Larry Levitt, Kaiser’s president and vice president, said. “Our nation has made no fundamental change in how health care is paid for or delivered.” 
This means the claims that the Affordable Care Act, or Obamacare, was slowing the cost increases even before it went into effect just are not true. 
Likewise, according to the Kaiser report, when prices start going up over the next couple of years, Obamacare will not be the cause either.
So far so good.

But then the editorial writer takes a bit of a detour:
This expected return to increasing costs means the debate about Medicare and Medicaid will have to continue. One of the first things we must do is recognize that public policy has trade-offs. We cannot have all of the health care we want and low costs, too. There will have to be controls. We are already seeing some of them in the form of higher insurance premiums. For example, workers with employer-sponsored health insurance already pay higher premiums for smoking cigarettes. Increasingly, workers will be called on to pay more for insurance if they are overweight. Co-pays are rising. Advocacy groups, such as the Bipartisan Policy Center, are pushing for a revocation of employer-sponsored insurance’s tax-favored status. In other words, don’t be surprised in a couple of years if the value of health insurance is treated as income and taxed accordingly. 
You don't have to be either a libertarian or a progressive to recognize what a mishmash this paragraph is.

First, the writer says we have to have controls to keep prices down.  The usual reading of that sentence is a call for government controls.  But then the sentence is followed by the implication that higher rates charged by private companies represent part of the controls we need.  All of a sudden we have mixed more than metaphors, as a paragraph which seemed to start by advocating government control detours into free-market solutions.

Then there's the issue of insurance companies charging more for obese patients.  Let me count the ways that this is too simplistic an example to even make sense.  1.  Obesity, for many people, would be a pre-existing medical condition that the ACA would seem to forbid insurance companies from taking into account.  2.  There is rising evidence that obesity is in large measure genetic for many folks, which makes for an interesting set of discrimination arguments.  3.  If we are going to charge people more for obesity (especially if genetically predisposed) what happens to charging people for a genetic predisposition to certain kinds of cancer?

Then there is the gratuitous swipe at reclassifying health insurance benefits as income so that they can be taxed again.  Now the WNJ editorial writer is saying--effectively--that we're going to fail to contain health care costs no matter what we try, so just prepare for the inevitable new taxes to pay for the rising costs.

Don't get me wrong:  there are plenty of valid arguments on both sides of the health care argument.

But this editorial piece is nothing less than an incredibly mixed-up and self-contradictory over-simplification that bespeaks more of deadline pressure than anything meaningful to say.

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