- The Washington Times - Sunday, December 13, 2009


Increased and broadened access to health care, control of costs and improved quality are goals all Americans share, regardless of party affiliation. No one is “against reform,” contrary to the claims the defenders of the current bills.

The problem is that the bills as written not only fail to address the access, cost and quality challenges - they will make each one worse.

An appropriate, sustainable safety-net health care system is something nearly all Americans can agree is desirable. For the approximately 10 million Americans who are chronically uninsured, supposedly they merely have to wait until 2014 for relief under this bill. But complications abound.

Yes, a new “high-risk pool” is created in both the House and Senate versions, but it is woefully underfunded and the premiums will be 25 percent higher than premiums today. A prescription for health? Few think so.

The politicization of access even to preventive care has reared its head. A small group of “experts” who do not treat women dealing with breast cancer determined that women from ages 40 to 50 should forgo mammograms. Their opinion would matter little to women concerned about breast cancer and those who love them, except for the simple fact that Congress is considering giving that same group enormous power to influence what care will be available in the new “health exchanges,” with or without a government-run plan.

Access to care for populations at risk due to income or ethnicity, which proponents seek to resolve, is also ignored in the bills. Low-income Americans are shoved into the Medicaid system, primarily because the Democratic leadership has determined that it is cheaper than allowing low-income Americans access to the health insurance exchanges available to those of better means.

How can those who claim to advocate for the poor stand silently? And, with the massive influx of millions into the system, who will care for them?

In Massachusetts, the model upon which these bills are based, 40 percent of primary care practices are closed to new patients. The Senate bill does nothing to address this impending, identifiable crisis.

And this is even before the nearly 40 percent cuts in payment to doctors under Medicare (before inflation) that are not addressed in the bill. What ensures that doctors will keep accepting Medicare and Medicaid patients?

With such unanswered questions about access, one would surely expect that Congress is tackling the cost problem.

Let’s see. The bill would start generating revenue right away but give precious little to the American people in return for the next four years. Over the next several years, costs would begin to explode while revenues fail to keep pace.

The bill also forces massive spending through mandates on individuals, families and businesses. Failing to buy what the government would offer (and it is uncertain whether it will even be able to deliver the product the mandates propose) will result in penalties, taxes - and failing that, greater penalties and possibly even criminal prosecution.

And most amazingly, nobody - from the House to the Senate to the White House - is now even willing to say health care will become less expensive.

Nor can they prove that the quality of care would increase.

The House and Senate bills confuse the concept of quality care with creating dozens of new commissions and task forces to generate reports, create programs, write rules and enforce regulations, all while providing no actual health care to anyone.

The Senate bill being considered, and the House bill that squeaked by, are abject failures in the three main areas for which they were ostensibly written.

An ever-decreasing minority of Americans thinks Congress should actually pass these bills - and those who do are motivated by either a fear of political Armageddon or an irrational belief that the bill will be easier to “fix” once it is the law of the land.

Dr. Eric Novack, an orthopedic surgeon, is senior fellow in health policy for Americans for Prosperity and chairman of Arizonans for Health Care Freedom.

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