Robert Samuelson, who has been relentlessly warning of the impending demographic train wreck of out-of-control entitlement spending for as long as I can remember, looks at ObamaCare and judges it more of the same: Even higher unsustainable spending into a system that is already unsustainable.
History is unambiguous. Originally, Medicare covered only the 65-and-over population. In 1972, Congress added the disabled, now about 15 percent of beneficiaries, notes Diane Rowland of the Kaiser Family Foundation. It also covered dialysis for kidney failure. In 2003, Congress created a drug benefit. Along the way, other services (hospice care, mammograms) were added.
Medicaid — the federal-state program for the poor — is the same story, says Rowland. Initially, it covered mainly people on welfare, as defined by states. Gradually, eligibility broadened. Now, children 6 to 18 in households under the poverty line ($22,050 for a family of four) get it. Congress also set higher limits (133 percent of the poverty line) for pregnant women and children under 6. In 1997, Congress created the Children’s Health Insurance Program (CHIP) to expand coverage further.
Meanwhile, open-ended reimbursement by government and private insurance has ballooned health spending despite repeated pledges to “contain” costs. For example, health payments for individuals rose from less than 1 percent of federal spending in 1965 to 23 percent in 2008.
Obama would perpetuate this system. No president has spoken more forcefully about the need to control costs. Failure, he’s argued, would expand federal budget deficits, raise out-of-pocket health costs and squeeze take-home pay (more compensation would go to insurance). All true. But Obama’s program would do little to reduce costs and would increase spending by expanding subsidized insurance. The House legislation would cut the uninsured by 37 million by 2018, estimates the Congressional Budget Office. The uninsured get care now; with insurance they’d get more.
“You’d be adding a third medical entitlement on top of Medicare and Medicaid,” says James Capretta, a top official at the Office of Management and Budget from 2001 to 2004.
None of this wild spending results in “free” anything. Someone has to pay. There are no miracles that make costs go away or that save oodles of money.
There ain’t no such thing as a free lunch.
We have already seen the budget deficit quadruple in just a year – and they want to spend more.
We have seen both Obama’s budget director, Peter Orszag and Barack Obama himself forcefully argue that care should be withheld from seniors – not cost-effective, don’t you know. (And no, they have not called for active euthanasia. Yet. Only for withholding high cost care and handing out some pills instead. But you can bet on active euthanization being a future “improvement” to the system. Just think like a bureaucrat for a moment.)
We have seen the massive failure of the “stimulus” bill that we were assured would save millions and millions of jobs.
We are already running on empty in this country. We do not need ObamaCare making things even worse.
