CANADIAN PATIENTS FEEL WEIGHT OF THE WORLD
Canadians have a health care system that should be the envy of no one, says Investor's Business Daily (IBD). It's not free, it's funded by taxpayers, and it isn't truly universal. Two Canadian Court justices made this clear three years ago when they concluded that "access to a waiting list is not access to health care."
Delayed treatment in an overused system has been the root of much unnecessary suffering, says IBD:
- To prevent premature deaths and the needless misery that are hallmarks of Canadian care, the British Columbia Automobile Association began offering waiting-list insurance to some of its members in August as part of a pilot program.
- Those who bought the coverage would receive treatment in a private clinic in British Columbia or the United States if they were placed on a government care waiting list longer than 45 days.
- The program, which took two years to develop, never got beyond the pilot phase, however.
- The association shut it down when critics howled and government officials checked to see if such a program was actually legal in Canada.
"This is an example of a company that's actively soliciting for clients that have the ability to pay for the privilege of queue-jumping," said Adrian Dix, a member of B.C.'s Legislative Assembly. "In my view, and in the view of the legal opinion that we obtained, it is illegal, and it violated both provincial and national health legislation."
HOUSE BILL RAISES, NOT LOWERS, HEALTH CARE COSTS
The Chief Actuary in the Centers for Medicare and Medicaid Services in the Obama Health and Human Services (HHS) department issued a memorandum this week looking at the potential impact of the House health reform legislation (H.R. 3200). As the Associated Press and other media outlets have been reporting, the study shows that the legislation would, as President Obama promised, bend the health care cost curve… but in the wrong direction.
The findings suggest that if the House legislation were enacted, President Obama would be breaking his long standing promise that reform would reduce rapidly growing health care costs, says the Heritage Foundation. Although the President has continually argued that Americans spend too much on health care, and that under reform they would spend less, the new HHS report finds the opposite is likely to occur under the House legislation. Here are some key findings from the HHS memorandum:
- The legislation would increase total national health expenditures in the United States by about 2.1 percent during the period between 2010 and 2019.
- As a share of gross domestic product (GDP) health care spending would grow to 21.3 percent compared to 20.8 estimated under current law.
- The bill carries a price tag of about $1 trillion dollars (from 2013 to 2019), which does not even represent a full 10-year cost estimate.
- The measure is likely to deliver only small savings despite the many provisions intended to reduce the growth in health care costs.
- While the proposal might cover 34 million uninsured it would still leave 23 million people without coverage, including as many as 18 million Americans who would remain uninsured and face a new tax penalty.
- More than 50 percent of the new coverage gains under the bill (18 million out of 34 million) would come from expansions in the Medicaid program.
- Some 40 percent of those obtaining coverage through a newly established health insurance exchange could be enrolled in the public option.
- Cuts to the popular Medicare Advantage program for seniors could have the effect of reducing enrollment by 64 percent, with projected enrollment in 2014 falling from 13.2 million to only 4.7 million seniors.
- All told, the plan puts new strains on health care providers which could lead to price increases, increased cost-shifting onto the privately insured, and/or compromised access to high quality care.
SCHIP BAIT AND SWITCH
Now that the Baucus Plan has been introduced as actual legislative language, it is clear more time is necessary to have a full understanding of the massive 1,500-page health care reform bill. As members get the opportunity to read the bill, more problems are likely to emerge on a daily basis, says Dennis G. Smith, a Senior Fellow with the Heritage Foundation.
For example, the Baucus Plan either puts states into fiscal jeopardy or provides another budget gimmick to avoid paying the full cost of the legislation through the treatment of the State Children's Health Insurance Program (SCHIP). The SCHIP provisions have significant budgetary implications for either the federal government or the states, explains Smith:
- Section 1611 of the Baucus Plan provides a new 23 percentage point increase in the federal funding for SCHIP.
- That would seem like good news for states, however, under current law, there are no additional appropriations for SCHIP after 2012 and the Baucus Plan does not provide any increased funding.
- There is a budget cliff in 2013 that will cut federal funds for SCHIP in half; in scoring the Baucus Plan, the Congressional Budget Office (CBO) must assume its current law baseline remains level.
With the increased federal percentage under Section 1611, states will substitute the federal dollars for state dollars so long as federal funds are available. In other words, the federal funds in the SCHIP pipeline will be spent faster, depleting the funding earlier than what would occur under current law. When that happens, states will be hit with a choice -- reduce SCHIP benefits to lower the overall cost of the program or switch to Medicaid.
Switching to Medicaid means returning to the regular Medicaid match rate:
- Instead of an 88 percent federal match rate as promised by Section 1611, for example, New York will get only a 50 percent match rate.
- The states, who have been promised that the federal government would bear the majority of the cost of the new Medicaid expansion for adults, will end up paying more than they do under current law for their children.
- To pay for SCHIP reauthorization at enhanced match rates would likely cost the federal government $40-$50 billion.
Leaving the funding out either means the legislation is not really paid for, which breaks the President's promise to the budget hawks, or it shifts those costs to the states, says Smith.