Free-market economists have long known that “controls breed controls.” In health care, leading Obamacare supporters are now proposing unprecedented new government controls over all medical spending — private as well as public — to “solve” problems caused by prior controls. Welcome to ObamaCare 2.0.
In a recent article in the New England Journal of Medicine (NEJM), several prominent Obamacare supporters have called for a binding “global spending target for both public and private payers.” In regular English, this means a government-enforced cap on how much Americans may spend in aggregate on their health care, both public and private. The co-authors of this article include former Obama administration officials Dr. Ezekiel Emanuel (former White House health care advisor and brother of Rahm Emanuel, former White House chief of staff), Dr. Donald Berwick (former head of Medicare), and Peter Orszag (former budget director).
The authors argue that current Obamacare cost controls do not go far enough. Although Obamacare will reduce government-sector health spending (e.g., Medicare and Medicaid), insurers and medical providers will simply shift those costs onto the private sector. To properly control health care costs (they claim), the government must therefore also control private health spending.
The state of Massachusetts has already passed into law a global cap on public and private health spending to deal with the skyrocketing costs of their “universal coverage” plan. Given that Massachusetts has been the testing ground for national health legislation and given the political clout of the NEJM authors, this proposal will likely be the basis of Obamacare 2.0.
In particular, voters should be aware of five key points:
1) This means rationing.
Obamacare proponents have long denied their plan would result in “rationing,” even going so far as to advocate avoiding the “R-word” in public discussions.
But a hard cap on private medical spending means the government must necessarily restrict Americans’ right to spend their own money for their own medical care. The rationing will not be overt. Instead, the government will use proxies (such as “Accountable Care Organizations”) to limit medical care. But it will be rationing all the same.
2) Get ready for the lobbyist feeding frenzy.
A fixed health care “pie” will create an intense “feeding frenzy” from special interest groups seeking their piece of that pie.