Presidents in our times have come into office wanting sincerely to
make the great capabilities of American medicine more efficient and
extend health care in some form to all citizens.
Someone who was there when Clinton Care was being devised is here to breakdown Obamacare, and whether it’s more of the same, but with a higher price tag. Or not.
Back when HillaryCare was under consideration by
Congress, I was minority staff director of the congressional Joint
Economic Committee. I co-authored a report titled “A Billion Dollars a
Day,” referring to the true cost (i.e., after all the unrealistic
assumptions were discounted) of President Clinton’s plan to nationalize
health care and turn it over to Hillary to run. Congress rejected
HillaryCare, in part because the price tag was so astronomical.
Fifteen years later, a new president and a new Congress, this one
controlled by the president’s party, are trying once again to turn
health care over to the government to run.
Depending upon which estimate one accepts, the Obama program is
projected to cost between $1 trillion and $1.5 trillion during the
first ten years of operation. That works out to an average annual cost
of $100 billion to $150 billion, or somewhere between $274 million and
$411 million a day.
What’s wrong with this picture?
The cost, for one.
But there’s another answer, buried in this snip:
How on earth can the Obama administration claim it is
going to restrain the cost of nationalizing 17 percent of the U.S.
economy? First, much of the increased cost will be forced on workers
and their employers surreptitiously through mandates and regulations
that keep the cost from showing up in the federal budget — call it AIG
Second, administration officials speak sonorously of “cost control.”
One of the “cost-containment” schemes the president spent a lot of time
talking about in his AMA speech is centralizing and computerizing
health information. Yet, the Congressional Budget Office (CBO) has
estimated that health-information technology as provided for in the
recently enacted stimulus bill would reduce health-care spending by
only about 0.3 percent. Therefore, the main source of cost savings will
have to be direct rationing of health care through an
innocuous-sounding concept called “comparative effectiveness research”
— which will allow bureaucrats to delay and deny care on the grounds it
is not “effective” — and indirect rationing through squeezing the
reimbursement of doctors and hospitals.
There it is…..rationing of health care. Bob Moffitt
of the Heritage Foundation was on ‘America’s Lifeline’ explaining what
this “innocuous-sounding concept called ‘comparative effectiveness
research’ council” would mean eventually, though that’s under radar for
For those who counter that health care is already rationed by your
provider’s list of approved physicians or procedures, among other
complaints, this kind of rationing is something altogether
new for America and much darker. It starts off sounding good, the
promises of health care reform by this administration as it did in the
But price controls and spending caps it will be, just as
it would have been with HillaryCare, followed by health-care rationing,
just as it has been with Medicare. And although these bureaucratic
machinations will harm people, they won’t appreciably hold down costs.
That’s painful to consider, ‘will harm people but won’t hold down costs’.
It may be impossible to project the cost of next-gen
HillaryCare with precision (although I am willing to bet it will come
in at about a trillion dollars a year). But one thing we can say with
confidence is that the Obama administration’s current estimates are so
far askew from historical experience, so at variance with past
estimates for similar programs, and based on so many dodgy assumptions
that they are quite simply unbelievable.