More ObamaCare

So today, I was reading this transcript of Fox News Sunday with Chris Wallace interviewing Budget Chief Peter Orszag and Sen. Judd Gregg (R-NH).

I just don't think Orszag was making a convincing case for health reform. He didn't have a good argument against the CBO director's claim that the plan will raise the cost curve and hurt the economy. He didn't have a good conceptual reason why it's okay to tax only rich people at <60%. And, he didn't have a good defense for what the plan might do to small businesses. He did, however, have a clear and cogent explanation for why the Republican fearmongering charges that bureaucrats will "stand between you and your doctor" and "ration your care" are totally bogus. Right now, insurance companies (and Congress, to some extent) determine what patients can get treated for. Health care is already rationed! Only by income for those who can't afford treatment or for the sick who are denied coverage by their insurers. I don't see why anyone has a problem with comparative effectiveness research and using an independent commission of DOCTORS to determine what would be the best form of care. Drugmakers and insurance providers do this already, and shouldn't we expect doctors to make better decisions? The drug and insurance lobbies are ridiculously powerful, though, so of course we shouldn't expect congresssmen to make rational decisions based on evidence.

Back to Orszag: I'm not sure why the administration can't just say flat-out that they won't allow taxpayer money to pay for abortions. I'm pro-choice, of course, but I don't think it's fair for public money to go towards a procedure that half the country thinks is murder. (Although: I see the counterargument that state money pays A LOT to execute inmates, which IS actually murder.) But, I will admit that I have no idea how people pay for abortions now or even how much they cost.

As for raising taxes: maybe it's just my love for Atlas Shrugged talking, but there is something fundamentally un-American about taxing the top 1-2% to subsidize health care for the uninsured. That's in theory, of course. Timothy Noah pointed out that the revenue generated by the surtax (some $544b) is a lot less than what that same group got in tax cuts from the Bush Administration. And from what I understand, the majority of the uninsured is made up of young, healthy people and not poor people or illegal immigrants.

My theory about Orszag is that he doesn't really have any good arguments against taxing health care benefits because the administration doesn't want to be on record for supporting it because Obama promised that no one who liked their current plan would lose it. This is all despite the fact that most economists and policy wonks think it's the best way to cut costs and limit overutilization of health services. This is also where Sen. Gregg actually made a lot of sense. He supported taxing health benefits and changing the way doctors are reimbursed (by quality and outcomes rather than number of procedures). The current House and Senate bills don't seem to really address the reimbursement issue.

I'm really tired of hearing Republicans say that the power of health care should be put back in the hands of consumers so they can purchase the best plans on their own from the private market. I don't think health care functions as a free market system. The incentives for doctors and insurance companies are all at a whack, and consumers are not rational thinkers.