Proponents of health care reform everywhere have reason to celebrate like Kool and the Gang for finally triumphing in a struggle that predates that pop culture reference.
On Tuesday, President Obama signed into law the first sweeping health insurance reform bill since 1965, effectively providing coverage to 32 million uninsured citizens by expanding Medicaid and providing tax subsidies for those who cannot afford insurance.
Even with Democratic control of the legislature, it took a parting the Red Sea and beating up a gang of Goliaths to finally pass health care reform. It is truly a miraculous accomplishment.
Unfortunately, that was the easy part. Of the two crippling deficiencies in America’s health care system — millions of uninsured and unsustainable rising costs — the bill only truly tackles the first. It does little to control costs of a health care system that is projected to gobble up one out of every four GDP dollars by 2025.
But wait, didn’t the nonpartisan Congressional Budget Office report that, despite costing $950 billion, the bill would actually reduce the deficit? Yes, but this is because the CBO takes the bill’s claims at face value, ignoring the fact that politicians’ promises are as slippery as two eels having a K-Y Jelly wrestling match.
There is a lot of tricky arithmetic in this legislation, including a claim that $463 billion in Medicare spending will be trimmed. The bill contains no reforms to reduce Medicare’s operating costs, meaning that this money would come from cutting doctors’ Medicare payments.
If the past decade is any indication, these cuts will be deferred year after year. This makes the bill’s bottom line look a lot better on paper than it really will be.
Even if Congress bucked the trend and payment cuts did go through, doctors could only stay financially afloat by dropping Medicare patients or shifting costs to those with private insurance. This would either reduce health care access for elderly citizens or force the government to foot the bill for those who cannot afford rising premiums.
No matter how you slice it, these “savings” are bogus. Even the legislation’s legitimate provisions for revenue generation, like a tax on high-cost employer-provided “Cadillac” insurance plans, have been stripped down to appease labor unions.
Former Congressional Budget Office director Douglas Holtz-Eakin estimates that instead of cutting the country’s annual financial shortfalls, the health reform bill will actually raise federal deficits by $562 billion.
Despite its problems, this bill was still worth passing because it might have been the best chance in decades to try to right one of society’s biggest wrongs. And with almost everybody in the system, it might be easier to cut costs across the board.
But, in its current form, this bill threatens to deepen a national debt that now tops $12 trillion (more than $40,000 per U.S. citizen.) Eventually, we will need to dig ourselves out by slashing government funding for programs like education or levying hefty taxes.
So this is my plea to Congress: Now that you have taken the vital step of improving health care access with this bill, take pity on younger citizens and chip into our national debt by enacting real cost reforms.
I realize that I am no longer a teenager and am too old to be asking for money, but I swear this is the last time.
Andrew Moon is a second year medical student in the School of Medicine. Contact him at Andrew_moon@med.unc.edu
