Dan Calabrese

Who decided to make John Boehner the Republicans’ leader in the House? It is brutal to watch this man drone on about “1,900 pages of bureaucracy” and give out a web URL where everyone can read about the Republicans’ better solutions to health care.

It's what's on those pages that matters, John

Boehner may not be the best Republicans can do, but apparently he’s the best they’ve decided to do. That’s a shame because there are far more compelling arguments to be made against the House Democrats’ monstrosity of a health care bill. And here they are:

- The $900 billion price tag is fiction. This is for two reasons. The first reason is that it leaves out the cost of properly compensating doctors who serve as providers to Medicare. This is going to cost $247 billion over the 10-year period they keep using in discussions of the bill’s costs. Why don’t they include that in the stated cost? Simple. The Obama Administration has decided that $900 billion is the magic number that will make the bill saleable to the public, and including the doctor compensation fix would put it way over $900 billion. Thus, it is not included. Easy!

- The second reason the figure is fiction is that it assumes all kinds of things that simply aren’t the case. It imposes $80 billion in taxes and fees on medical device makers, for example, and assumes the medical device makers will not alter their way of doing business in any way as a result of the taxes and fees. It’s classic Democratic static scoring. Taxes and fees have no impact on the economy, they think, so you can impose them as much as you want.

- Insurers and even hospitals come in for higher taxes to pay for this beast. This is half of a recipe for disaster. The other half is the idea that you “cover” everybody, in which case you create unlimited demand, and by adding to the costs of delivering the service with taxes and fees, you begin to limit supply. What do you get when you create limited supply and unlimited demand? Scarcity, rationing, er, death panels . . .

- Pelosi emphasized that the bill will allow for lower out-of-pocket expenses. That’s exactly the wrong idea. Health care should be purchased with more out-of-pocket expenses by consumers. That would bring down costs because it would restore consumer awareness to the actual cost of health care. The more stuff you “cover,” the less people care about what it costs.

Health insurance has really ceased to be insurance. It’s become a big, privately operated welfare program in which people expect the insurer to pay for everything, and don’t know what to do when it doesn’t. Imagine if you expected your car insurance company to pay for your gas, your oil changes and your replacement headlamps. Ridiculous? Of course. Insurance isn’t intended to be used in that way. It’s to protect you against a monstrous cost you can’t afford, like when your car needs major repairs or has been totaled.

But that’s how we use health insurance, which drives up the costs enormously. And this bill will only exacerbate that fact.

- Remember tort reform? Of course you do. Is it in the bill? Of course it’s not.

- The health insurance “exchanges” are joke. They’re set up by the government to sell either the government insurance plan or private ones, all in a market in which one of the competitors – the government – sets the rules. These exchanges are little more than insurance agents for the government plan.

- About insuring people with pre-existing conditions, as I discussed in my piece yesterday, Democrats say they will set up a “temporary government program” to ensure them until 2013, at which point private insurers will be forced to take them without charging them more than healthy people. First, no government program is temporary. Second, there is a reason people with pre-existing conditions can’t get insurance for the same price as healthy people. It’s far more risky to ensure them. Charging them more is a rational business decision. Forcing insurers to charge them the same as everyone else is guaranteed to raise the premiums of the healthy. There is no way around it.

- Forcing companies to buy health insurance for their employees only imposes an added burden on companies who are already cash-poor. Because of existing tax incentives, as well as the notion of health benefits as a way to lure good employees, companies who can afford to offer insurance already do so. Those who can’t afford to would do so if they could, just to be competitive. Forcing them to provide health insurance will either force them to downsize or to go out of business. Unlike the government, these companies can’t simply print money to cover this expense.

- Finally, the nation is headed for bankruptcy because of our existing obligations to Social Security, Medicare and Medicaid, which total $58 trillion. Can you conceive of a worse idea than the creation of an entirely  new federal entitlement?

There are problems in health care. There are people who need catastrophic coverage and can’t get it, and I am not categorically opposed to a government role in solving that problem. But that’s a limited problem that can be addressed with a limited solution. What the House Democrats offered yesterday is a monstrosity designed to put all of American health care under government control.

You need to say more than “1,900 pages” and “more bureaucracy” to get that across, Mr. Boehner.

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