Be afraid. Be very afraid

The Obama administration’s new strategy to sell its health-care plan to the masses is now to tell people how the opposition is fear-mongering. Sometimes that strategy works, usually when calling on people to do what they know is morally or ethically right.

But the health-care plans pushed by Democrats in Congress are no such thing. Greater government involvement in health care is not a moral or ethical issue in the way, say, civil rights was. Some of the heavier breathers on the Left might disagree, trotting out the 40-plus million “uninsured Americans” as Exhibit A.

“Isn’t it a shame that the greatest country in the world cannot insure all of its people?”

Or, at least, that’s the refrain that has come to characterize the pity party Democrats want us to have on the health-care issue.

The great irony is that we do have the resources and wherewithal to provide affordable health care to all Americans. Certainly, if we can register every automobile in the country, or inoculate all schoolchildren against rubella, a nationwide health-care service – run for the people, by the people – is not too far-fetched from a logistical point of view.

The problem is money, not so much today, but down the road.

You see, health-care expenditures have grown faster than nearly every other kind of expenditure in the United States over the past few decades, even faster than the cost of a college education. But contrary to the Democrats’ claims, health care today is hardly premised on the free market. It is a wickedly complex mixed market, filled with loopholes, treatment gaps, reimbursements, non-reimbursements, premiums, co-pays…well, you get the picture. Health care in the US is a Frankenstein monster of programs and markets, and at every turn, government is already deeply involved.

So when health-care reform advocates cite statistics about the inefficiency of the American system – such as how we spend almost twice as much as other advanced nations (as measured by percentage of gross national product) on health care – one could just as easily argue that less government, rather than more, is the solution. After all, without a track record of controlling costs – and at this point, the Democrats don’t even have a viable plan to control costs – why should anyone trust that the budgets allocated to health care in today’s plan will be observed tomorrow?

Indeed, Health Affairs, a public policy journal, published in 2002 its projections on health-care costs, saying that they were poised to rise quickly, from roughly 13% of GDP to over 17% in 2012. Well, we passed the 17% mark in 2007 with a bullet (just half the projected time period). The point is that very smart people have studied this area of spending for a very long time, and they, too, tend to undershoot in their projections, sometimes massively so. If the best and brightest can’t get the math and the projections right, why would we expect the federal government to do any better? And more to the point, when health insurance becomes part of the federal mandate, what happens to the budget when we experience cost overruns or undershoot our projections? You guessed it: (a) ever-greater taxes; (b) ever-poorer service; (c) and the shifting of resources to health care away from areas like roads, bridges, energy, and education.

Make no mistake, judging from Washington’s inability to curb spending to date – and this in an industry with heavy government involvement already – any government-led health insurance plan will devolve into an ever-dwindling set of services for an ever-increasing amount of taxes. It will be just as wasteful as the current system is, but at least the current system doesn’t “socialize” the waste by making all of us pay for it.

A far, far better way forward is achieving small goals in incremental steps. The federal government, despite President Obama’s personal popularity, is simply not trustworthy. If there is to be federal health insurance, Congress will ultimately set the rules for it; therefore, congressional leaders need to build trust with political moderates; they need to demonstrate that they can be fiscally responsible, that they understand the issue, and that they can develop solutions that are something more than throwing tax money at the problem. Before taking one extra dime in taxes, Congress needs to demonstrate that it can control health-care costs. It needs to show folks who provide the cash that it can say No to industry lobbyists, activists, and other special interests who ply the health-care route for government booty.