President Obama intends for his health care initiative to be a kind of cure for the nation’s health care system. While there has been a lot of theorizing about its possible effects, his exact plan has never been tested. Before Obama implements it on a national scale, perhaps he should test it first in a smaller laboratory, like Washington DC. And since it’s an experiment, the federal government should be required to follow the same protocol that it requires researchers to follow.
The Office for Human Research Protections (part of the Department of Health and Human Services) requires that researchers provide subjects with an explanation of the study’s purposes and procedures; a description of foreseeable risks; a disclosure of appropriate alternative courses of treatment; and a statement that participation is voluntary and that the subjects may discontinue participation at any time without penalty. Like competent, ethical doctors, the Obama administration should also follow these procedures if they decide to expand the initiative to the general population.
First, the Obama administration should candidly explain that it is trying to achieve universal health care instead of cloaking its initiative with rhetoric advocating for increased “personal choice.” In fact, many independent public policy experts predict that the Obama initiative will lead to a decline in personal choice.
Lewin, an econometrics group based in Virginia, estimated that under Obama’s plan, 21.6 million Americans would lose their private coverage. Of the 21.6 million who would lose private coverage, 18.6 million would end up on the government plan because their employers switched plans. What choice will employees have if their employers switch their coverage?
Second, the Obama administration must make people aware of the risks that the initiative entails, one being a reduction of insurance options. Because private insurers, unlike the government, cannot mandate that providers accept lower payments, many private insurers will be unable to compete with government and will thus go out of business. Further, because the government will pay providers less, providers will pass on medical costs to private insurers, which will pass on the costs in their premiums.
Notably, the government’s promise to reduce health care costs will also reduce physician compensation, which may deter bright, promising medical students from pursuing patient care. I know a few pre-med students who are considering pursuing research rather than patient care because of the reduced stress of dealing with the health care bureaucracy and a foreseeable reduction in compensation for patient care.
Another caveat that should be issued is that not all of the procedures that people want will be available or covered. Obama’s plan involves an “independent” authoritative, federal regulatory agency that determines which services and benefits will be covered and reimbursed. While it may be difficult dealing with HMO bureaucracies, you can only imagine how long it will take for a federal bureaucracy to approve referrals and procedures. This omnipotent federal agency will essentially ration healthcare. Some Washington bureaucrat will hold your life in his hands, deciding whether a procedure is cost-effective given your age and condition.
Perhaps the greatest foreseeable risk that the Obama administration has not disclosed is the cost. The Lewin group estimates that Obama’s plan would add another $1.5 trillion to the $11.5 trillion national debt over the next ten years. Paying off this increased debt will lead to increased taxes and inflation. Since the Obama administration plans to cut/eliminate taxes for 95 percent of Americans, the top five percent (who will probably be the only ones able to afford private insurance plans) will be saddled with the majority of the public health care costs. Ironically, studies also show that the wealthiest are the healthiest. Thus, the government will create a system that encourages free-riding and removes incentives for the poor to lead healthier lives.
Third, Obama should disclose alternative options that might prove more effective in reducing health care costs and expanding options—plans that think tanks like Cato and Hoover have proposed, but have garnered little political attention.
Lastly, the president should enable taxpayers for whatever reason to discontinue their participation in his plan at any time. If taxpayers choose to opt out, they should also be free from any tax increases that result from the plan.
By being forced to follow the Department of Health and Human Services’ disclosure protocol, the federal government would get a taste of its own medicine.