Opt-outs and Triggers: Government-run Health Care by Stealth

Liberals have nearly achieved their decades-long goal of taking over health care in the United States. The House passed its plan by a vote of 220-215. The vote was close, but close was all the liberals needed.

The Senate vote on government-run health care will also be close. In fact, it is likely that liberals will need some kind of stealth plan in order to gain the 60 votes they need. They are working on so-called compromises right now that will essentially give us a government-run health care system without it looking like it. Two plans are being floated that could very possibly garner the last couple of votes Senate liberals need to pass their own version of a massive government takeover of health care.

The Opt-out Plan

The first plan is known as an Opt-out plan. Under this proposal, each state would get to decide whether or not it wanted to allow a government-run plan to be offered within their borders. While it sounds like a nice nod to states rights principles, the truth of the matter is that it is highly unlikely that any states would opt-out of the plan. For one thing, it is simply a political non-starter. There are several reasons. First, the government-run plan will promise lower health insurance premiums. Citizens will not tolerate the prospect of paying higher premiums for the same coverage available in other states that offer the government-run plan. Second, health insurance subsidies for low income people will likely be tied to the government-run plan rate. So, the subsidies may not cover as much of the gap between the cost of health insurance and what people can afford in opt-out states. This will not be received well by the citizens of those states. It is even possible that subsidies will not even be available to states that opt-out. Third, uninsured/underinsured citizens and businesses in opt-out states will be forced to pay taxes and penalties that will be used to help pay for the government-run plan for people in other states, with no benefit for themselves. They will certainly resent this inequity.

The other problem is purely economic. The states are looking at serious financial shortfalls as soon as the stimulus funds run out. They call this event ominously “the funding cliff.” If the states think they can close their impending gaping budget holes by moving their employees into what they are told is a cheaper government-run plan, they will likely feel compelled to grab any rope thrown their way, and then, so much for states opting out. Of course, all of the currently proposed government-run plans will lead to increased rates for everyone, but this will not be evident until the government-run plan is introduced in the states. Then the states’ health insurance dilemmas will be even more perilous. But it will be too late.

The Trigger Plan

The second plan is called a Trigger option. In this scenario, the government-run health plan would be included in the bill, but would only be activated if insurance companies fail to achieve certain benchmarks set by the health care reform legislation. If this option passes, one thing seems quite certain—the trigger will be pulled. It is easy enough to imagine that liberals, who are determined to create a government-run plan, could simply create a set of goals that are nearly impossible to meet. For example, they could require that health insurance premiums decline by a certain percentage—which is certainly a reasonable gauge—but fail to do anything to help drive down costs.

The stage for higher health care premiums has already been set. Consider these facts. The bills liberals have put forward do not allow for interstate competition among private health insurers, without which it will be hard to drive down costs. The bills require free preventive care, which people will appreciate, but which will make health care costs go up. Everyone knows this. The reform proposals prevent insurance companies from denying coverage based on pre-existing conditions. Again, this is an important reform measure, but it will not make insurance premiums decline. It will cause them to go up. There is no tort reform in any of these bills, which means that doctors will be forced to continue to engage in defensive medicine to protect themselves from lawsuits, once again, driving up the cost of health care and consequently driving up premiums. So, when the lower premium benchmark is not reached, the government-run plan will be triggered.

Government-run Health Care Must Be Stopped

Whether one includes a state opt-out or a trigger in the Senate’s health care reform bill, the same result is assured—government-run health care, which will certainly lead to higher costs, rationed care, and poorer service. The only way to prevent this is to insist that the Senate not pass any bill with a government-run plan in it, regardless of when or how that plan might be implemented. The time to insist on this is now. Every person who cares about their and their children’s health care must contact their senators immediately and often and insist that they vote against any health care reform plan that includes a government-run health care option.

The Public Health Plan: A Pro-Life Non-Starter

Friends,

Healthcare reform is on everyone's front burner now. Here is my take on the bill unveiled recently by the Senate HELP Committee. I hope you are enjoying your 4th of July. We have much for which to be thankful. Please join me in praying for our military and their families.

Blessings,

Barrett

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The Public Health Plan: A Pro-Life Non-Starter

The Senate Health, Education. Labor and Pensions (HELP) Committee has posted on its website the health care reform bill they have been working on. It’s called the “Affordable Health Choices Act.” As promised, it contains a public healthcare option. The impact on other health insurance providers is reason enough to oppose a public health plan, but an even greater reason is the way it is going to undermine pro-life values.

The public plan’s immediate and long-term threat to pro-life values is what makes it a non-starter. The plan’s immediate threat to pro-life values is evident from its failure to provide any pro-life protections. There is no protection for health care providers who, due to their faith convictions, cannot provide abortion or abortion referrals. There is no protection for pharmacy owners or workers who cannot in good conscience dispense abortion drugs. There is no restriction on abortion, either. There is no language in the bill that would prevent the public plan from paying for any abortion under any circumstance. The bill does not even prevent the eventual inclusion of assisted suicide as a benefit.

Some will argue that the bill doesn’t have anything to say about these things one way or another, but that is precisely the point. The bill’s failure to explicitly protect these pro-life values will be interpreted as a requirement to ignore them. It is instructive to remember the struggle to stop abortion funding through Medicaid on this point. In Medicaid law what isn’t explicitly prohibited is therefore required. This is why Medicaid began paying for abortion as a covered benefit when abortion was legalized in 1973. It took the Hyde Amendment in 1976 to change that by explicitly restricting the use of taxpayer funds for abortions except in the cases of rape, incest, and danger to the life of the mother.

The argument today is that the Hyde Amendment continues to protect taxpayers from paying for elective abortions. However, the Hyde Amendment is itself on a death watch these days. The amendment must be approved annually. It is clear that many in Congress would happily drop the Hyde Amendment language if they could. Many of us thought Congress would try to omit the amendment last year. Furthermore the Hyde Amendment doesn’t protect other pro-life values, like conscience protections and banning assisted suicide.

Of further concern is that the bill authorizes the Secretary of Health and Human Services to create the public health plan. The person currently sitting in that seat is Kathleen Sebelius, a longtime abortion rights protector. The fact that the benefits provided under the public plan will be decided by political appointees and entrenched bureaucrats out of public view should be enough reason to fear for pro-life values.

Given Congress’ history of excess, the long-term prospects for pro-life values are bleak as well. An insurmountable problem with the public option is that the government will be deciding what the plan will cover. Can you imagine what a health plan built by the government will look like after a few years? It will be loaded down with every imaginable benefit and coverage. In his Wall Street Journal opinion piece, “Public Option: Son of Medicaid,” Daniel Henninger, comments, “Medicaid is a morass. Since the program's inception, Congress has loaded it up every few years with more notions of what to cover, shifting about 43% of the ever-upward cost onto someone else's tab, mainly the states.” There is no reason to think that Congress will exercise any restraint with a new health plan.

As Congress loads more benefits onto the plan, the costs will skyrocket in the same way they have for Medicaid. While the government will certainly raise taxes and/or premiums to pay for the higher costs, it will eventually have to resort to the same rationing scheme under which people in England and Canada are suffering. In England, it is illegal for doctors to even tell patients about drugs that the country’s health care rationing body has determined to be too costly. It doesn’t even matter if the drug has proven helpful to some people. If it costs too much per person, it can be disallowed for coverage, and doctors cannot even tell their patients the drug exists. In Canada a person can literally die while waiting for rationed treatment.

While the American health care system has its flaws, especially when it comes to abortion, it still places a much higher value on life than either the English or Canadian plans. I suppose rationing is one way to keep health care “affordable,” but I’m sure it’s not what most Americans want. If England and Canada can’t figure out how to make a public plan work without rationing, there is no reason at all to think our government will do any better. We must continue to move pro-life values forward, not backward.

Making it possible for every person to get and keep health insurance is a pro-life value worthy of everyone’s support. But I do not believe it is necessary to throw our other pro-life values under the bus in order to achieve that worthy goal.