Health-care fantasies

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Americans who care about their health care need to pay close attention in an election year to politicians of all parties who seem bent on becoming much more involved in the details of what health care will be allowed and at what cost.

Neither the Democratic nor Republican platforms make for very edifying reading on this subject. The Democrats convening in Boston come up first.

According to the Web site for the 2004 Democratic Platform Committee Report under the section Reforming Health Care, a long list of new government spending on health care is what they mean by "reform." We should explore the last item on their list first, "Honoring our veterans."

Funding for the Veterans Administration needs to be greatly increased, the platform maintains. We need to address the "inexcusable backlogs" in veterans' claims. Now we should all remember that this is not a welfare program. It is an employee benefit earned by those who spent years in the military, often at considerable risk on behalf of America. If these veterans currently are subject to "inexcusable backlogs," where will they and the rest of us be if the government expands -- as this platform proposes-into the entire health-care system and starts "honoring" us all in the same way?

The platform maintains that those Americans who pay for their own health care "pay too much." It also says that their employers pay too much for health care. The solution? "We believe that health care is a right and not a privilege." If those who pay nothing for health care have a "right" to it, how will it be provided to them? Who will pay for it? There is no one else left to pay for it, but those individuals and those businesses are already paying too much, according to this platform. As P.J. O'Rourke has said, "If you think health care is expensive now, just wait until it is free."

The platform also proposes a "Patient's Bill of Rights to put doctors and nurses back in charge of making medical decisions with their patients -- instead of allowing HMO bureaucrats to decide what a patient needs." In 1993, the Clinton administration proposed legislation that would have forced millions into HMOs, as managed care was its almost magical solution to increasing health-care costs. Now the Democratic platform proposes that HMOs no longer be allowed to "manage" what they pay for, but be required to pay for anything a doctor or patient wants to do. Is that cost control? Is that even reality?

The platform advocates "securing more funding for aggressive biomedical research." However, it elsewhere attacks drug company profits. These profits fund more than $22 billion in drug research a year. The only intent here must be to replace private research, which must get results in the marketplace, with government research, which requires no results, except in the advanced sciences of grant-proposal writing and political connections.

There is one gesture in the direction of cost control "by using American technological know-how to cut billions of dollars wasted in administrative processing and paperwork." The federal government, it appears, will offer its expert experience and advice on reducing paperwork by introducing the health-care industry to computers. One would think that anyone who has tried to make sense out of a medical bill or an insurance statement in the last 30 years would realize the industry is already using computers. Only someone who thinks that Al Gore invented the Internet would believe that the federal government could reduce the cost of anything by using computers.

The only redeeming proposals in this platform allow the importation of prescription drugs -- which should be an option open to Americans, even if it is unlikely to save them much in the long run -- and unspecified tax credits to "individuals and businesses" for health coverage. Otherwise there is no mention of what would really improve health care: more freedom and less government involvement.

In another month, we will be able to look at what the Republicans have to offer. Don't get your hopes up.

Richard E. Ralston is executive director of Americans for Free Choice in Medicine.