By Greg Scandlen, Heartland Institute director of Consumers for Health Care Choices
Once again Washington politicians are attempting to bring us health care reform,
but as has happened so often before, the debate will be truncated and no really
tough choices will be made, in order to hold together a political coalition to
get a law enacted.
For the politicians, passing a law is the goal. They don’t worry themselves
with whether it can actually be implemented or achieve what they have promised.
Most likely, they won’t even read it before voting on it.
More of Same
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We’ve been there many times before. Grand promises are made, laws are
enacted, and the politicians declare they have solved the problems, but no good
ever comes of it.
In 1988, then-governor of Massachusetts Michael Dukakis declared when signing
his health care reform law, “Massachusetts will [now] be the first state in the
country to enact universal health insurance.” The next year, then-governor
Barbara Roberts of Oregon declared, “Today our dreams of providing effective and
affordable health care to all Oregonians have come true.”
In 1992, then-governor of Tennessee Ned McWherter said, “Tennessee will [now]
cover at least 95 percent of its citizens.” In 1992, then-governor Howard Dean
of Vermont said, “This is an incredibly exciting moment that should make all
Vermonters proud.” Similar declarations were made in Kentucky, Maine,
Washington, and other states.
All of these laws have since been repealed. Not one of them worked as
promised. In most cases they made no difference at all or even aggravated the
problems they were supposed to fix.
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Failed National Plans
The same thing happens at the national level. Faced with increasing demand
for services and rising costs due to the then-new Medicare program, Congress
enacted the National Health Planning Act in 1974. The idea was to reduce costs
by limiting the supply of services—exactly the wrong strategy at a time of
increasing demand. It failed and was repealed after years of bureaucratic
boards, consultants, hearings, and regulations.
In 1988 Congress enacted the Medicare Catastrophic program, requiring people
on Medicare to purchase coverage for prescription drugs and copayments. It was
endorsed by AARP, passed by a Democratic Congress, and signed into law by Ronald
Reagan. But beneficiaries didn’t understand it and didn’t like it. In Chicago,
elderly people chased House Ways & Means Committee Chairman Dan Rostenkowski
down the street and beat on his car with their canes as he tried to escape. The
law was quickly repealed.
Actually repealing a law is very unusual in Washington, unlike the states.
Usually there are enough people making money off a law, no matter how
ineffective, that it stays on the books forever. That’s the case with a host of
federal laws and regulations that may not cause riots in Chicago but don’t work
very well and cost a fortune—COBRA, HIPAA, SCHIP, Medicaid, and so on.
More Failures Likely
And so it will be for the laws already passed this year, on health
information technology and comparative effectiveness research. Lots of
consultants and vendors will get rich at taxpayers’ expense, but very little
good will be accomplished.
And that is the likely effect of President Barack Obama’s big health care
reform law yet to be enacted. Bells will ring, flags will fly, and bands will
play for the signing ceremony. Grand speeches will be made about how “we have
given you health care.”
But in the end it will never be implemented, or it will solve nothing and may
even make the problems worse than they were before. Promises, promises.