There is no Medicare free lunch

In an exchange of e-mails with my good liberal friend Rich, I finally realized something profound. Many liberals believe that if they re-elect Obama, Medicare will somehow cost less or at least, the cost to the consumer will never go up.  

Let’s make one thing perfectly clear, the only way Obama can make Medicare cost less is to provide less of it.  That is a big part of his plan. When Dr. Ezekiel Emanuel, health adviser to President Obama says things like “In the next decade every country will face very hard choices about how to allocate scarce medical resources” he is expounding on his and Obama’s belief that doctors should at some times compromise what is best for a particular patent in to do what they believe is better for society.  Dr. Emanuel goes on to say that the usual recommendations for cutting medical spending are mere window dressing.  Feb. 2008 in the Journal of the American Medical Association  (JAMA) the good doctor wrote "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely 'lipstick' cost control, more for show and public relations than for true change."

In the June 2008 issue of JAMA, Dr. Emanuel states “Medical school education and post graduate education emphasize thoroughness. This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath's admonition to 'use my power to help the sick to the best of my ability and judgment' as an imperative to do everything for the patient regardless of cost or effect on others."  And this explains the doctor’s and Obama’s view on healthcare in general and Medicare in particular.  They believe that sometimes your options for healthcare should be limited in order to decrease the cost to society.  But who should make this decision? Not you of course and not your doctor, but someone in a government office in Washington DC will make the decision if your need is great enough. The President thinks the only way to make the Medicare program sustainable, other than decrease coverage, is to increase taxes to pay for the program. So even if the Medicare user does not see an increase in the amount he pays into the program in the form of co-pays, he is still paying more through his taxes, there is no free lunch.  The money has to come from SOME PLACE!

When Obama siphons 700 billion dollars from Medicare to Obamacare, it is not because he believes it is what is best for the seniors living on Medicare.  He does it because he believes that money should be spent on younger citizens. Dr. Emanuel uses a theory he calls “complete lives system” to explain how the government should allocate health resources and in a Lancet Medical Journal article admits that his program discriminates against older citizens,   "Unlike allocation by sex or race, allocation by age is not invidious discrimination. . . . Treating 65 year olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not."

 "When implemented, the complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get changes that are attenuated.

The youngest are also expendable: "Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments”. The article included a curve of how medical spending should be distributed by our overseers in Washington.

 "Principles for Allocation of Scarce Medical Interventions" The Lancet, January 31, 2009e

Does anyone else find terms like “life years” disturbing? And even more so that aberrantly the President and Dr.  Emanuel believe someone in Washington should be determining which citizens are more useful than others.

 

 It is true that Obama will attempt to force high income citizens to pick up the tab for the rest of our Medicare insurance and if you believe that Bill Gates should pay for your health care just because he was more financially successful than you then you definitely should support the President. But remember that the Bill Gates of this country do not have nearly enough money to eliminate the one trillion dollar a year deficit this President is running, so the only solution left is make you pay more in the form of taxes and cut the health care you receive. Both of those will happen under President Obama.

I am not saying that Emanuel or the President are bad people or do not care about seniors. From everything I have read Dr. Emanuel is a doctor who has dedicated his life to medicine. The problem is a belief that things like health care dollars is a pie of limited size the only fair thing to do is let the government decide how to cut that pie. Conservatives believe the solution is to grow the size of the pie and your health care dollars are yours, not the governments. You and your doctor should determine the best way to spend them. The President believes it is fine to ask you to compromise your health care to provide health care for someone else, and Washington will decide how much and when you will need to compromise. Conservatives believe Washington bureaucrats cannot, and should not be making those decisions.  

So pay more taxes and get less health care under Obama, or support a market based solution like that proposed by Romney/Ryan. We know the way to reduce the cost of any product and that is the free market. My next blog will address a solution that does not involve some bureaucrat in Washington making your health care decisions.