No news is good news. Not necessarily, these days, but the Healthcare Reform has not been in the news this week. Other issues, such as the Finance Reform Bill, and the oil spill in the gulf have taken over the headlines.
Let’s look at some of the unintended consequences (or maybe not unintended consequences) of the healthcare reform.
A poll of practicing medical doctors, taken before the passage of the healthcare reform bill, resulted in 41% of the doctors polled saying that they would retire or consider early retirement if the bill were to pass. While this is probably more talk than action, it does indicate that the doctors are unhappy with the bill. If even a small percentage of these doctors carry out this action; then it has to decrease the availability of doctors available to treat patients. Since it takes 10-12 years to fully train qualified doctors, a doctor shortage may develop. With millions of additional Americans now being covered by healthcare insurance, this greater demand for healthcare, coupled with fewer doctors, may lead to longer wait times for treatment or rationing of healthcare.
A more significant consequence may be the number of young persons entering the medical profession. While some people will still become doctors because they truly want to help people, many others will take a hard look at the financial prospects of being a doctor under the new guidelines. The Healthcare Reform Bill places limits on re-imbursement for medical procedures, reduces Medicare payments to doctors, and increases regulations and paperwork. Many of our best and brightest young adults may decide not to become a government employee and seek education in other fields of employment. This decrease in new doctors will not be felt for several years, but it will surely be felt.
Maybe, that is why the Healthcare Reform Bill also includes the reform of the student loan program. Since the government now controls the actual student loan process, not just guaranteeing private loans, the government will have a greater say in which areas of study the student loans are available. I can easily see where the government will direct students into areas of study that the government desires more people by allocating student loan funding into these specific programs of study. If student loans are more readily available for medical students, the government can direct more students into medical schools to try to alleviate the doctor shortage that may be caused by the Healthcare Reform Bill. Could this a first step into directing people into occupations that the government feels is best for the country?
Can you say, “Welcome to America, Comrade?” I knew you could.
This week a new cost analysis of the Healthcare Reform Bill was undertaken by the Congressional Budget Office (CBO). Surprisingly, (I’m being sarcastic) the new analysis projects a total budgetary deficit of over $300 billion as a result of the Healthcare Reform Bill. This is in direct contrast to the CBO’s analysis before the HRB was passed, which stated that the bill would reduce the federal deficit by $81 billion. It is important to remember that the CBO analyzes the budgetary consequences of any bill with the data that is provided to it by the bill’s sponsors. The CBO does not conduct any independent research into the accuracy of the information that is provided to it.
While this sharp about turn in budget projections after only a couple of months is disturbing, one needs to wonder about the accuracy of even these numbers. We need only to look back in history to get an idea of the accuracy of other budget projections on other major social policy changes in America.
The state of Massachusetts passed their own form of Government run (or mandated) healthcare insurance in 2006. This experiment in government healthcare insurance should give us a good indication of how well the national program might work. The governor’s budget for 2009 asked for $849 million for the healthcare program, $400 million more than in 2008, and is not sure if even this increase in funding will cover the costs. In addition to this massive increase in state funding, private insurance premiums have been rising 10-12 percent per year (about twice the national average) since the program became law. Total healthcare spending in the state has risen almost 28% since the law has gone into effect.
When Medicare was introduced in 1966 the initial annual cost was stated to be $3 billion. In 1966 the cost of the Medicare program was projected to cost the government $12 billion in 1990. The actual cost to the government in 1990 was $107 billion; a factor of almost 10 times the initial projection.
At the time of the passage of the Medicare Act in 1966, LBJ said words to the affect of, “If we had told the public the actual cost of the Medicare Bill, we would not have gotten it passed”.
What are the chances that similar thinking is taking place in Washington today?
As Erich Maria Remarque once wrote, “All Quiet on the Western Front” ( A great book to read by the way) as far as news on the Healthcare Reform Bill is concerned. The process of actually writing the rules and regulations that are mandated within the language contained within the bill is currently under way. What is happening behind the scenes is probably just as important as what is in the bill that was passed earlier this year.
The words that appear within the Healthcare Reform Bill: “to be determined by the secretary” are currently being defined in meetings among staffers. What these regulations will say is the scary part of the bill.
Questions that need to asked are:
Who is writing these regulations?
Who has input into the final product?
Who is contributing campaign funds to have favorable regulations written?
Inquiring minds want to know!!!
