Medicare for All Revisited

Awhile back I wrote about the many issues with “Medicare for All.” Dr. J. Deane Waldman, a
University of New Mexico professor in the Health Sciences Center, offers a few “inconvenient truths” about Medicare.

Medicare was intended to be self-sustaining by having workers pay in while employed and taking out of the fund as needed after they retired. It was supposed to pay for itself: no additional funds required. Hah!

Inconvenient truth #1: Medicare quickly became a Ponzi scheme just like Social Security. According to the Government Accounting Office, Medicare will run out of funds in 2017, even before Social Security. The addition of President Bush’s ill-conceived Drug Program For Seniors sped up a process of collapse by adding another (unpaid for by the contributors) entitlement. Medicare-for-all will be no care for all.

Medicare tries to contain its costs in two ways: neither works and neither is what patients want. First, it rations care. Yes, I said it. Many things your doctor would like for you are denied as not “cost effective.”

Let’s just ignore inconvenient truth #2, that there are at present virtually no scientific cost effectiveness studies on which the government denies payment. Denying payment means denying care and thus again, Medicare-for-all is no care for all.

Inconvenient truth #2A: Beware of what President Obama is touting as cost-effectiveness studies in the proposed health care reform bill. Just like in Great Britain and Australia, what the government defines as effective is often not what patients and doctors want as positive effects.

While the “public option ” seems to be dead for now, it will inevitably come back again. Professor Waldman’s points are highly persuasive.

Reforming Health Care Takes Smart Shoppers

Albuquerque Dr. Barry Krakow hits the nail on the head in his excellent opinion piece in the Albuquerque Journal. And I’m not saying this just because he mentions my advocacy for such “consumerist” behavior in the health care sector at Rep. Martin Heinrich’s health care town hall meeting.

Writes Krakow in a passage that sums up his argument:

Some of us, including doctors who provide these services, may forget health care is a service with a cost, a profit margin and a price to pay. Politicians and others imagine insurance as a right or benefit owed to citizens. Only politicians can enact such legislation, but the fact remains — health care is first and always a service.

Unlike health-care services, the real world marketplace suffers no confusion about costs, profits and sale prices. You pay for food at a grocery that stocks the food you want and can afford; you don’t ask the cashier “what’s my copay?” or “will my deductible cover it?”

Rio Grande Foundation Health Care Debate Footage Available

The Rio Grande Foundation recently hosted a health care debate between Michael Cannon of the <a href="http://www.cato.org">Cato Institute</a> and Carter Bundy of the <a href="http://www.afscme.org/">American Federation of State County and Municipal Employees.</a> The debate lasted about 1.5 hours and covered a broad array of reform issues.

You can watch the debate on YouTube.

Health Care Experts to Debate at August 31st Public Meeting in Albuquerque

(Albuquerque)— With the Obama Administration’s health care proposal changing on a near-daily basis and Congressional town hall meetings stirring up controversy like never before, citizens need to be involved now, more than ever, in the health care debate.

To that end, the Rio Grande Foundation will be hosting a health care debate between Cato Institute Director of Health Policy Studies, Michael Cannon and AFSCME’s Carter Bundy; on August 31, 2009 from 6pm to 8pm at the Albuquerque Museum which is located at 2000 Mountain Road NW, Albuquerque, NM 87104.

Cost of the event is $10 payable by cash or check at the door. Light snacks and beverages will be available. Space is limited and this is sure to be a popular event given the pressing nature of the topic, so let us know you’re coming by emailing us at: rsvp@riograndefoundation.org.

Cannon and Bundy will discuss the current state of the health care debate in Washington, explain how it impacts New Mexicans, and offer thoughts on recent legislative changes and reforms he would like to see Congress make to the US health care system. Said Rio Grande Foundation President Paul Gessing, “We are very excited to be hosting these health care experts at a time when Congress is ready to debate and make a final push for greater government intervention.”

Said Gessing, “We will provide a respectful and fair forum. Media outlets are welcome to cover the event as well as long as appropriate arrangements are made ahead of time.”

Cannon has recently been in heavy rotation as a guest on television and radio talk shows and he has worked closely with Rep. John Shadegg (R-AZ) on free market health care legislation that would weaken the grip health insurance companies have over customers in particular states.

Bundy has written and spoken extensively on health care issues on a variety of New Mexico media outlets, most prominently at the website www.NMPolitics.net.

Heinrich Town Hall Video Now Online

Check it out and let me know what you think.

I “Punked Heinrich” (or so says the left)

I was invited by Rep. Martin Heinrich (along with two doctors) to be a panelist at the Congressman’s health care town hall on Saturday. First and foremost, I give Heinrich credit not only for inviting someone with a different perspective to take part in the town hall, but for inviting someone like myself who will provide a competent, principled defense of free market health care instead of an executive from a health insurance company of drug company who would merely provide a self-interested opposition to Obamacare, but not a principled argument and no alternative vision.

The town hall room was completely full with 600 folks attending (a slight advantage for the single-payer folks, approximately 60-40 split between supporters and opponents). Another 300 people watched the proceedings on site in a separate room on closed-circuit television.

Surprisingly enough to me, Heinrich did not stack the rest of the panel with supporters of Obamacare. Rather, one of the physicians, John Vigil, wound up agreeing with me more often than not. He concluded the meeting with a strong statement against the third-party payer model for health care. I was of course critical of Obamacare and the left’s real favorite option, single-payer. I had dozens of positive messages from conservative and free market advocates in my email inbox over the weekend. The folks at ABQRally.com have a good re-cap of the event as well. Then, there are the lefty blogs including two from Daily Kos here and here.

The postings at Daily Kos are so amusing that I quote them at length below:

Then there was the conservative lobbyist….

The lobbyist is from one of the most conservative alleged “research institues” in New Mexico. I was absolutely disappointed pissed off that he put Paul Gessing on a panel discussing health care reform. Gessing brought nothing to the table except to rile up those in attendance who were shills for the Heritage Foundation.

He wasn’t a doctor, he wasn’t a nurse, he wasn’t even a health insurance administrator. He was a lobbyist who regurgitating the same talking points I had heard in line, and, while sitting in the auditorium.

Why was Gessing asked to be on the panel? What legitimacy did he bring to the debate? I have heard Heinrich wanted some “balance.” Bad choice. Lobbyists don’t bring balance. They only bring talking points from those that pay them. If balance was needed then put an insurance executive on the panel.

I’ll borrow a question from a blogger friend of mine,

was Heinrich punked?

I wonder.

Why are we continuing to pander to these people? The health care reform we all want, whether it be a single payer system or a strong public option, won’t be accomplished this way. And when Progressive candidates have conservative industry hacks/shills/lobbyists answering questions at a Town Hall meeting, how will we respond?

Hopefully we won’t respond by sitting on our thumbs and biting our lower lips. I saw way too much of that yesterday.

Lots of anger there. Of course, they didn’t take time to find out that Rio Grande Foundation does not lobby. If the left thinks I “punk’d” Heinrich, then I take that as a compliment, but I was invited to take part in the event and I’m sure he was abundantly aware of my positions on the issues.

Some of the comments on the Daily Kos postings are quite amusing as well:

While I agree that Martin Heinrich had some strong points, his choice of Paul Gessing (a local Libertarian tea bagger who represents insurance industry desires) to be on a panel about health care reform was idiotic. Gessing had no business on that panel. He is a shill. I went to hear answers from experts in the field, not from a well known tea bagger.

Anyway, it was a great day. I’m working to get video of the event so we can upload it to the website. Check back often.

Free Market Voice to Appear at Rep. Martin Heinrich Town Hall

Rio Grande Foundation president Paul Gessing will be included as a member of Rep. Martin Heinrich’s health care panel at his upcoming town hall meeting this Saturday, August 22, 2009. The event will be held from 3:00 to 4:30 p.m. at the UNM Continuing Education Building which is located at 1634 University Blvd. NE,in Albuquerque.

Gessing will represent the Rio Grande Foundation on the panel and will be a voice for market-based health care reforms. He'll also show how government is not the solution to all of our health care problems. While he'll undoubtedly be outnumbered, his inclusion on the panel at all is a clear sign that proponents of additional government intervention in American health care are starting to realize that other opinions must be recognized in this important public policy debate.

Reaching out to Rep. Heinrich

In case you have been hiding under a rock or left the country for vacation recently, you are probably aware that Congress has heard an earful from the American people on the issue of health care and President Obama’s move to vastly expand government control over Americans’ health care. In light of these outbursts, Members of Congress are being very careful about how they handle their town hall meetings.

Rep. Martin Heinrich is not alone. He has one town hall scheduled on health care. The event is scheduled for Saturday, August 22, 2009, 3:00 to 4:30 p.m and will be held at the UNM Continuing Education Building which is located at 1634 University Blvd. NE, Albuquerque, NM 87131. From talking to his staff, the idea is to have a panel of experts on hand to explain Obamacare.

Since we at the Rio Grande Foundation have done a great deal of work in the field of health care, we offered our services to appear on the panel and provide an alternative perspective. Unfortunately, we were told that although the panel for the 22nd was not full, our services were not needed (don’t expect to hear anyone who doesn’t think Obamacare is a good idea or that government should not see a much larger role in Americans’ health care decisions).

So, I followed up with Heinrich’s office offering to host a discussion of the topic in which free market voices are added to the discussion. Our letter is block-quoted below and we’ll definitely keep you posted if anything develops (I’m not holding my breath).

August 10, 2009

The Honorable Martin Heinrich
United States House of Representatives
20 First Plaza, Suite 603
Albuquerque, NM 87102

Re: Health Care Debate

Dear Representative Heinrich:

In the interest of giving the First Congressional District the full and open debate it deserves on the President’s proposals to change our national healthcare insurance and delivery systems, the Rio Grande Foundation is pleased to offer to convene for you a panel of experts and concerned citizens who favor free market approaches to the issue.

We understand your health care town hall meeting on August 22, 2009, will include a panel of experts who favor the President’s plan, but will not include any critics or proponents of free market alternatives (including representatives of the free-market oriented Rio Grande Foundation which is based in your home district in Albuquerque). We believe the citizens of your district deserve more than that, and that is why we make this offer.

We would be glad to schedule this panel discussion any time convenient to you. We look forward to working with your staff to arrange this educational event, and advance the public debate on an issue so important to your constituents.

We hope you will accept this invitation.

Sincerely,

Paul Gessing,
President

Free Market Health Care=Status Quo (more on my personal quest to expose the lie)

I have often written on the myth that America has a health care system that resembles a “free market.” Here and here just to name a few recent examples. Well, I was up to my old tricks again in a recent letter that appeared in Albuquerque’s alternative weekly, The Alibi. The letter is copied and pasted below:

[Re: News Feature, "Health Care on Life Support," July 16-22] Simon McCormack did a reasonably good job of discussing some of the problems currently facing American health care and some of the “reform” options now percolating in Congress. But, as is too often the case, the story aligns “free markets” with the status quo. Dr. Jason Cohen in particular is quoted in the story saying that certain doctors, insurance companies and the pharmaceutical industry support the current “privatized model.”

While I’d like to give the media the benefit of the doubt in confusing the current health care system with a free market system, one would think that it would be hard to overlook the fact that government spending on health care accounts for 46 percent of all such spending. That hardly sounds “free market” to me.

Additionally, federal tax policies favor third-party-purchased coverage by allowing employers to purchase coverage tax-free, thus taking cost decisions out of the hands of individuals and reducing the incentives for average workers to be cost-conscious consumers when it comes to health care. As if that is not enough, states also regulate care, thus piling on costly mandates. New Mexico has 51 of them.

America’s health care system is by no means perfect, but the supporters of “reform” have not shown how still more government intervention in health care will result in higher quality, less expensive care.

An additional example, that I have not previously used is that Congress could mandate that insurance companies take “all-comers” by passing a regulation called “guaranteed issue” and it could also add on an individual mandate (I’m describing the basics of the Massachusetts plan and parts of Obama’s). Given these regulations which would dramatically alter (for the worse) the health care system, it is worth noting that these do not result in “socialized” medicine or even government taking over an increased level of government spending. Needless to say, numbers can be deceptive, but Americans should not labor under the misperception that we have anything close to a free market health care system.

Independent analysis shows ugly impacts of ObamaCare on New Mexicans

The Lewin Group, a highly respected health care policy and management consulting firm, has examined the impact of the American Affordable Health Choices Act of 2009 (H.R. 3200).

In New Mexico, the impact of the health care bill on private coverage, the uninsured, physicians and hospitals, as found by the Lewin Group, is as follows:

- 45 percent of privately insured New Mexico residents would transition out of private insurance.
– 51 percent of New Mexico residents with employer-based coverage would lose their current insurance.
– 82 percent of New Mexico residents in a health insurance exchange would end up in the public plan.
– 49 percent of the uninsured in New Mexico would still lack coverage.
– Physicians in New Mexico could see their net annual income decline by $136.7 million, as a consequence of the new public plan.
– Hospitals in New Mexico could have their net annual income fall by about $314.6 million, with hospital total margins dropping to 1 percent.

While the Washington Post attacked the Lewin Group in a recent story, the story was unable to refute the numbers cited above. More importantly, Lewin’s clients include the government and groups with a variety of perspectives, including the left-leaning Commonwealth Fund.

The numbers above should be a wake-up call to those who think that Obamacare will solve our health care problems.