Associated Press/Photo by Charles Dharapak


Healthcare | Conservatives worry that the cost of a government health plan can go in only one direction

Issue: "Ready or not, here we go," March 28, 2009

WASHINGTON, D.C.-The last time a Democratic White House tackled health-care reform on the massive scale now being talked about by President Barack Obama, the plan was dubbed "Clinton-care," and it was ultimately derailed by two people named Harry and Louise.

Starring in a series of commercials paid for by the health insurance lobbying group, the dejected-looking middle-class couple sat at their kitchen table worrying that government bureaucracy was about to intrude on their health coverage.

Flash-forward to today's debate: Democratic Sen. Sheldon Whitehouse of Rhode Island rose at a recent White House summit on health care and declared that the situation is too dire to allow that to happen again.

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"This isn't a 'Harry and Louise' moment, it's a 'Thelma and Louise' moment," said Whitehouse, referring to the 1991 road trip movie featuring two women who band together while being pursed by the law. "We're in the car headed toward the cliff, and we must act."

But Obama seemed a little weary of such an analogy: "Now, I just want to be clear-if you actually saw the movie, they did drive over the cliff. That's not our intention here."

But conservatives are fearful that speeding health-care reform may already be hurtling America over the cliff-of greater governmental control under the guise of more choices. Obama's push for a government-run insurance option may decrease competition and lead to medical decisions being made in Washington instead of at kitchen tables across the nation.

Already with little debate and no congressional hearings, Obama was able to push through a $200 billion down payment on his health-care initiatives using the $787 billion stimulus package passed earlier this year: $65 billion to expand the federal health-care program for children of middle-class families making more than $60,000 a year; a $90 billion expansion of Medicaid; a $25 billion expansion of health-care subsidies for the unemployed; and a $20 billion investment on health technology research.

At the recent summit, an army of stakeholders representing doctors, insurance companies, businesses, unions, pharmaceutical companies, universities, and hospitals poured into the White House East Room at such a clip that White House aides had to keep bringing in more chairs. While disagreements are numerous, everyone seems to agree that something needs to be done. Health insurance premiums are growing at a rate four times faster than wages; in the last four years the average annual health premium for a family of four rose from $6,438 to $12,680. Nearly 46 million Americans are currently uninsured-and that number is expected to grow by 10 million during the next decade.

In broad terms the battle lines for fixing this are drawn between those who favor a market-based approach that fosters competition-building on the current employer-based insurance system that now insures 170 million-and those who envision an enlarged role for government. And the extreme version, a single-payer system, would make government the sole health insurance provider. Rep. John Conyers, D-Mich., has introduced legislation in previous congressional sessions to provide universal coverage by establishing the U.S. National Health Insurance Program. Sen. Ted Kennedy, D-Mass., has introduced legislation that would provide coverage by expanding the Medicare program to everyone.

During the presidential campaign, Obama proposed establishing a national public option plan as an alternative that would compete with existing private plans. Those opposed to a single-payer system worry that Obama's seemingly less radical reform still could further increase the role of government in health care and restrict the choices found in market-based coverage-in essence creating a de facto single-payer system through backdoor tactics-by creating an unlevel playing field where employers have incentive to dump their insured into the public plan, says Rep. Michael Burgess, a Texas Republican who is also a physician: "Obama said he doesn't want to take away the insurance you already have unless he prices the private market out of existence and then you have to take what he gives you."

Also worrisome are calls for a national health-care board, something Obama has titled the Institute for Comparative Effectiveness. In the stimulus package, $1.1 billion is set aside to lay the foundation for this institute that may start the government down the path of playing doctor with broad powers to determine what treatments work and are cost-effective. Richard Scott, a former health-care executive, has funneled about $5 million of his own money to run a $20 million ad campaign as part of his Conservatives for Patients' Rights effort-painting a picture of long lines at hospitals and personal decisions on care made by a national board. "When government gets involved, things go up, not down. I'm afraid we are going to have a FannieMed. We are going to do something where we end up hurting the people we are trying to help," he said.


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