By Ronald E. Bachman
How will health care reform affect you? It may be confusing and complicated but it does not take a degree in mathematics. At an early age we are all taught certain basic truths, such as 2+2=4. Even those who learned “New Math” know this, even though it may at times be an inconvenient truth.
Three key challenges emerge in all health care reform proposals: access, quality and cost. In the debate process, look for truthful answers to these simple questions. See if it all adds up for you.
Access: If 47 million currently uninsured lives are added into the system, will you find it easier or harder to get an appointment with your primary care physician? With a specialist? Supporters of current congressional proposals are promising increased access to care. To many, that doesn’t sound logical. Those with the most to lose are Medicare beneficiaries. Many doctors today limit the number of new Medicare patients. Medicare beneficiaries aren’t buying into the political rhetoric that more lives covered will mean less waiting for them. It just doesn’t add up.
Quality: The proposals include $500 billion taken directly out of Medicare. Will the quality of medical treatments under Medicare improve or lessen? If doctors are paid less, will the quality and time spent with your physician increase or decrease? Supporters of current congressional bills are saying that quality of care will be improved. Supporters have not adequately explained how a negative – reducing Medicare’s budget by $500 billion – will create a positive (improved quality).
Cost: The Congressional Budget Office has estimated the several leading proposals will cost an additional $900 billion to more $1.6 trillion. Plans proven to lower costs by 12 percent to 20 percent, such as health savings accounts, are likely to be prohibited or greatly inhibited under current proposals. Under proposed bills, cost-effective, comprehensive, catastrophic coverage cannot be priced at less than 30 percent below a government-determined acceptable plan, even if current generation products are priced 40 percent to 50 percent lower. It doesn’t take a math whiz to figure that real cost containment is not the goal. Citizens can’t understand how increasing expenditure by more than $1 trillion will lower health care costs.
In a story that may be apocryphal, a king once objected to a mathematical factor called pi that showed up frequently in formulas. Pi is the ratio of the distance around a circle (the circumference) to the distance across its middle (the diameter). The value of Pi is approximately 3.14159…, but its actual value has an unending string of numbers to the right of the decimal point. How inconvenient! The king declared that the “governmental value” of pi would hence forth be equal to 3.0! The result was that citizens could no longer draw perfect circles and round columns could not be built to hold up buildings. The empire eventually collapsed.
Americans are not stupid. Politicians and kings can try to force the public into believing 2+2=5, but “fool me once, shame on you, fool me twice shame on me.” The public trusted the government with bailouts, takeovers, cash for clunkers, and stimulus programs that don’t seem to have worked. This time, Americans are doing the math and not accepting answers that are more or less.
Ronald E. Bachman FSA, MAAA, is a Senior Fellow at the Georgia Public Policy Foundation, an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. He is also a Senior Fellow at the Center for Health Transformation, an organization founded by former U.S. House Speaker Newt Gingrich. Mr. Bachman worked as an outside expert with members of Congress and the Clinton administration during the 1993-94 health reform. Nothing written here is to be construed as necessarily reflecting the views of the Foundation or the Center for Health Transformation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.
© Georgia Public Policy Foundation (Oct. 2, 2009). Permission to reprint in whole or in part is hereby granted, provided the author and his affiliations are cited.
By Ronald E. Bachman
How will health care reform affect you? It may be confusing and complicated but it does not take a degree in mathematics. At an early age we are all taught certain basic truths, such as 2+2=4. Even those who learned “New Math” know this, even though it may at times be an inconvenient truth.
Three key challenges emerge in all health care reform proposals: access, quality and cost. In the debate process, look for truthful answers to these simple questions. See if it all adds up for you.
Access: If 47 million currently uninsured lives are added into the system, will you find it easier or harder to get an appointment with your primary care physician? With a specialist? Supporters of current congressional proposals are promising increased access to care. To many, that doesn’t sound logical. Those with the most to lose are Medicare beneficiaries. Many doctors today limit the number of new Medicare patients. Medicare beneficiaries aren’t buying into the political rhetoric that more lives covered will mean less waiting for them. It just doesn’t add up.
Quality: The proposals include $500 billion taken directly out of Medicare. Will the quality of medical treatments under Medicare improve or lessen? If doctors are paid less, will the quality and time spent with your physician increase or decrease? Supporters of current congressional bills are saying that quality of care will be improved. Supporters have not adequately explained how a negative – reducing Medicare’s budget by $500 billion – will create a positive (improved quality).
Cost: The Congressional Budget Office has estimated the several leading proposals will cost an additional $900 billion to more $1.6 trillion. Plans proven to lower costs by 12 percent to 20 percent, such as health savings accounts, are likely to be prohibited or greatly inhibited under current proposals. Under proposed bills, cost-effective, comprehensive, catastrophic coverage cannot be priced at less than 30 percent below a government-determined acceptable plan, even if current generation products are priced 40 percent to 50 percent lower. It doesn’t take a math whiz to figure that real cost containment is not the goal. Citizens can’t understand how increasing expenditure by more than $1 trillion will lower health care costs.
In a story that may be apocryphal, a king once objected to a mathematical factor called pi that showed up frequently in formulas. Pi is the ratio of the distance around a circle (the circumference) to the distance across its middle (the diameter). The value of Pi is approximately 3.14159…, but its actual value has an unending string of numbers to the right of the decimal point. How inconvenient! The king declared that the “governmental value” of pi would hence forth be equal to 3.0! The result was that citizens could no longer draw perfect circles and round columns could not be built to hold up buildings. The empire eventually collapsed.
Americans are not stupid. Politicians and kings can try to force the public into believing 2+2=5, but “fool me once, shame on you, fool me twice shame on me.” The public trusted the government with bailouts, takeovers, cash for clunkers, and stimulus programs that don’t seem to have worked. This time, Americans are doing the math and not accepting answers that are more or less.
Ronald E. Bachman FSA, MAAA, is a Senior Fellow at the Georgia Public Policy Foundation, an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. He is also a Senior Fellow at the Center for Health Transformation, an organization founded by former U.S. House Speaker Newt Gingrich. Mr. Bachman worked as an outside expert with members of Congress and the Clinton administration during the 1993-94 health reform. Nothing written here is to be construed as necessarily reflecting the views of the Foundation or the Center for Health Transformation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.
© Georgia Public Policy Foundation (Oct. 2, 2009). Permission to reprint in whole or in part is hereby granted, provided the author and his affiliations are cited.
