In 2009 President Obama went to Congress to speak to Congress about the need to overhaul health care. This was a pivotal moment for his Affordable Care Act, which came to be not-so-lovingly known as Obamacare. A moment that proved key to winning over those Democrats who wanted a plan more liberal than Obama thought he could achieve and some of those other “Blue Dog” Democrats who wanted something substantially more conservative.
“We did not just come here to clean up crises,” Obama said. “We came to build a future. So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.”
He went on to discuss the needs of the uninsured and the problems of preexisting conditions. But he dwelt most on addressing the ever-rising cost of health care, which was not only breaking the bank for many families, but our nation as well.
We spend one-and-a-half times more per person on health care than any other country, but we aren’t any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It’s why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It’s why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage. And it’s why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else’s emergency room and charitable care.
Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close.
President Obama diagnosed the problem perfectly. Our health care costs are too high, in large part because the incentives in the industry are askew. We’ve built a system predicated on a “fee for service” mentality, which is to say that doctors are incentivized to order more tests, perform more surgeries and prescribe more drugs because it increases their pay. Health care has become volume-, not a value- based business.
And that costs a ton of money. But Obama didn’t fix the problem. Indeed, he didn’t even try. Instead of focusing on realigning the incentives to reduce costs, his major “reforms” dramatically expanded Medicaid (the very system he admits was already under great pressure), mandated that individuals purchase insurance, and set minimum benefits levels on health insurance plans.
The sum result of these policies was to not only bend the costcurve upwards, but to increase the deficit. That’s not just partisan sniping, that’s cold hard fact. Politico reports:
Everyone, even many of the law’s supporters, admit premiums are going to go up under the health law – although may people will get subsidies to pay for coverage. Many of the costs – and the priciest benefits – were pushed beyond the 2012 election to 2014. Bt if the public revolts when they see 10 percent, 15 percent and 20 percent rate hikes, already shaky support for the health law could suffer.
Even those taxpayer-funded subsidies may be cold comfort given the now-exorbitant costs of insurance. According to the latest regulations released by the Internal Revenue Service, the cheapest health insurance plan available – labeled a “bronze plan” – will be $20,000 per year.
That is obviously unsustainable and will lead to calls for reform. The question is will President Obama finally heed the advice of conservatives and introduce competition and other market forces into the health care arena, or will he use it as further proof that what America really needs is a single-payer health care plan. Sadly, at this point is it even a question?