John on April 25, 2011 at 8:20 am
It was really the worst kept secret in Washington. Health reform was always supposed to end with single-payer. The exchanges, the public-options–all of that was a set up for what was, and likely still is, to come. The plan was to establish a framework and then build on it. But there are always some people who get impatient with incrementalism. Hence, yesterday’s column by Robert Reich:
Americans are spending almost 2 1/2 times more on health care per person than other advanced nations. Yet the typical American doesn’t live as long as citizens in other advanced nations, and we have the highest rate of infant mortality.
Yes and the two are obviously going to be related. High infant mortality brings our overall average down. The high infant mortality in the US is especially prevalent in certain minority groups in the US. There are various theories about why this happens but the answer is still elusive. In any case, even with our elevated infant mortality our life spans are within a year or so of every other industrialized nation. I say all of that so you can see the disingenuous nature of Reich’s next line:
The reason: Here, doctors and hospitals have every incentive to spend on unnecessary tests, drugs and procedures. But they have little incentive to keep people healthy.
So from his shoddy premise, Reich leaps to an even shoddier conclusion, i.e. money ruins medicine. You’ll note that this is similar to the argument progressives make about every other sphere of life. Politics? Special interest money ruins it. Elections. Federal funding is the answer. Gas prices? Speculator money drives them up. Reich is really just applying the same Marxist lens to health care. Surprise! Capitalism is the problem. Obviously then, the solution is…
allow anyone at any age to join Medicare.
Currently, Medicare reimbursement rates are so low that many doctors refuse to accept them or limit the number of Medicare patients they will see. Reich’s solution is to let Medicare take over so that doctors no longer have a choice. Once Medicare is the only game in town, doctors will have to play ball.
Estimates of how much would be saved by extending Medicare to cover the entire population range from $58 billion to $400 billion a year.
Sounds great, except for all the doctors who retire because they consider the new system unworkable. And don’t think we’ll replace them quickly either. Who wants to take on $120k in school debt only to make Medicare rates for life? Millions more patients and thousands fewer doctors. Sound good to you? This is the Democrats plan for America’s medical future.
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