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Tuesday, August 11, 2009

How ObamaCare will control cost

Via Powerline:

At the end of the day there is STILL no way to have all three simultaneously of: (1) universal guaranteed coverage; (2) comprehensive quality and choice; (3) cost control....cannot be done...you get two out of three at most. Clearly the Obamacrats intend on sacrificing (2) since they are massively constrained by deficits and the basic premise of the middle class entitlement state is that it will never cost (you) anything...only "them"..."villains" or the "rich"....so the only choice is limiting choice and quality....and that in turn requires a de facto single payer accomplished through the subterfuge of dictating the terms of "private" insurance, turning them into all but public utilities, engineering the transfer to the "public option" over a relatively short period of time, and then dictating payment terms to providers through rate setting, service bundling and, most important in this context, the MedPAC council which will determine "quality-adjusted effective" treatment protocols. The net effect is that an elderly person won't get a hip replacement or a coronary bypass....and will have nowhere --- in the US --- to turn.


The disingenuousness of the left on this point is breathtaking. Perhaps some are just too stupid to get the point....but the issue is NOT euthanasia, living wills etc....that's a pure straw man however insidious the proposal is and however dishonest they have been in covering it up or describing it. The real issue is the MedPAC council....there won't be any actual "death panel" adjudicating case-by-case....there won't need to be!....the MedPac council will set up criteria and rules, more or less in secrecy....rules determined by "experts" and by design removed from Congress to prevent pressure to approve expensive protocols at the end of life....or for "life unworthy of life"....a faceless bureaucracy with a maze of rules will simply be built into the system....diffused responsibility, nobody accountable, just the way it will be, no one can do anything about it.

That's why they MUST control all provision through a de facto single payer...and effectively outlaw private provision....otherwise it will be seen that treatments are available and that some are "unfairly" grabbing medical "resources"...and they will not be able to control cost with a global budget.

That's the basic issue with Medicare...it's single payer, universal for those over 65, permits unlimited demand and choice....and has no cost controls...and is bankrupting the government while simultaneously through cost-shifting wrecking the private market. Politically, it's the only way to control Medicare costs: fold it into a universal single payer plan with effective global budgeting and cost controls.

Most people can see this or intuit it...and Obama and his minions have been effectively exposed as lying weasels....and liars who mistakenly assume that people are too dumb to figure out what's going on and what their real intentions and plans are.

It's another post but it is truly glorious to see them all hoist on their own petard of Medicare and demonizing the elderly after demagoging SS and Medicare for decades.



Bottom line: no one will tell you that you can't have medical care as you get older. It will the "rules" that will tell doctors and hospitals what treatment is provided and what is not. Pain pills will usher you into the next life.

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