Costly ‘Obamacare' is a sucker's game
In his commentary, former Democratic nominee for governor Mark Fernald says critics of Obamacare focus too much on its cost and complexity, but utter "nary a word about its benefits."Like any good salesman, he hopes we will get so excited by the shiny rims, leather seats and bright red paint that we ignore the cost and whether the darn thing will actually run!Throughout the debate over health-care reform, President Obama repeatedly stated that no one with health insurance would lose it. In reality, many companies - even large companies like Home Depot, Disney and AT&T - are considering dropping their coverage. Sure sounds like someone is losing their coverage!Why are these companies considering such drastic measures? Because Obama's reforms have made it more expensive - not less - to provide health insurance to their workers. Other companies, like McDonald's, have discussed dropping the plans that are most attractive to lower-income workers. So not only are people losing their insurance, it's the most vulnerable workers who are most likely to be impacted.Obamacare's answer is that even if those nasty, penny-pinching, profit-maximizing employers aren't willing to provide you with insurance, the government will ride to your rescue. Washington will provide subsidies to make sure everyone can afford coverage, especially the 31 million uninsured out there. And, in a sounds-too-good-to-be-true moment, the author suggests it will do so while reducing the deficit.But you can't provide subsidies to 31 million people and have it be cheaper.Obamacare reduces the deficit by increasing taxes and cutting Medicare reimbursement - changes mostly independent from health-care reform. You might believe that reducing reimbursement to physicians who provide care to Medicare patients is appropriate, but do not be bamboozled into believing we are reducing the deficit by changing the fundamental costs of health care in this country.Fernald does identify an important point, arguing that 40,000 deaths per year could be avoided with better access to health insurance. The important point from a public policy perspective is that access to or lack of health insurance is not itself the problem - the real problem is lack of care. The uninsured who suffer tragic health outcomes delay care because they fear the economic consequences, not because having health insurance provides some magic halo of protection.If we want to achieve true savings, not phony ones, and avoid the tragic deaths of those who fail to seek timely care, we need to provide better access to care and the best way to do that is to address the underlying costs of providing care.Let's give patients more responsibility - more information about cost and quality - about deciding what care to seek and where to obtain it. Let's also give them more financial responsibility to inject market forces into the health care arena. And let's enact tort reform to reduce barriers to entry (like malpractice insurance) as well as reduce the costs of defensive medicine, which costs tens of billions of dollars every year.As much as Obama's supporters have tried to misdirect attention away from the costs and destructive impacts of the plan, the American people have not been fooled. Elections results since the health care reform debate show the American people are not suckers, and are not interested in purchasing any bridges.Peter Angerhofer of Durham, who has spent the last 15 years working in health care policy and administration, is a member of the board of the Josiah Bartlett Center for Public Policy.