Thursday, November 05, 2009

Do the Ends Justify the Means?

John Cassidy of the New Yorker thinks so:
So what does it all add up to? The U.S. government is making a costly and open-ended commitment to help provide health coverage for the vast majority of its citizens. I support this commitment, and I think the federal government’s spending priorities should be altered to make it happen. But let’s not pretend that it isn’t a big deal, or that it will be self-financing, or that it will work out exactly as planned. It won’t.

Many Democratic insiders know all this, or most of it. What is really unfolding, I suspect, is the scenario that many conservatives feared. The Obama Administration, like the Bush Administration before it (and many other Administrations before that) is creating a new entitlement program, which, once established, will be virtually impossible to rescind. At some point in the future, the fiscal consequences of the reform will have to be dealt with in a more meaningful way, but by then the principle of (near) universal coverage will be well established. Even a twenty-first-century Ronald Reagan will have great difficult overturning it.
Regretably, this analysis is where we're heading: who cares what it costs, just enact it!

God help us when the check comes due.

-Wes

2 comments:

Anonymous said...

Dr. Wes,

Are you ok with USA rankings on providing health care to our citizens? (infant mortality, life expectancy, etc.) Please note if you make it to 65, your life expectancy gets pretty good in comparison. Of course, that is when medicare kicks in.

Are you ok with all the "God help us" being uttered by sick folks without insurance or lousy insurance ot pre-existing conditions?

Are you ok with this country being the only Western country without national health care but number one in defense (too often used offensively).

Are you ok that many citizens have bought the idea that taxes are poison whether to pay for war or health care?

And who the heck designed the medicare prescription bill that prohibited the government from negotiating drug prices?

Do you think our present system is sustainable?

DrWes said...

Anony-

Reform is necessary, I believe you and I agree on this fact. The two main problems with reform remain (1) the uninsured and (2) our ever-escalating costs that I agree are non-sustainable.

So why aren't we concerned about the UNFUNDED obligations to Medicare, Medicaid, Social Security and Federal Pensions that exceed $109 trillion and instead want to add more obligations that promises to be over budget? Congress's inability to correct the Medicare problem foreshadows their effectiveness at controlling costs in even a larger program. That being said, shouldn't we fix Medicare first before adding more entitlement programs? (BTW, I agree the Republicans blew it with the recent Part D entitlement).

The infant mortality statistics you rely on are the old liberal canaard that ignores differences between country's data collection techniques, and last time I checked, life expectancy is fine here, especially as it relates to cancer care.

Your defense argument misses the central issues at hand, so let's leave that out, shall we?

Both Republicans and Democrats have failed for years to effect change - hence both are responsible for our current health care crisis and unless overt rationing, be it my cost or availability of serves occurs, we will affect little change to the so-called "cost-curve." The trick, of course, is how to make that politically palatable to the masses. It seems the current administration wants to shove it down people's throats before careful consideration are vetted appropriately. So much for transparency of our democracy, huh?

Bottom line: if we are not brazenly conscientious about costs going forward and permit the whole thing to remain unsustainable, then what have we accomplished?