Specifics, Please

By  I B D 
IBDEditorials.com

Health Care: From the president we now know that cops are stupid, doctors are greedy, Republicans don't play nice, people are dying and we're all going broke if we don't embrace socialized medicine in a week or so.

Everything, in other words, but what Wednesday's press conference was supposed to be about: the health care reforms the president and his party want voted on by the time Congress breaks for another vacation.

Sure, we heard a lot of wonkish rhetoric — this president seems to think all he has to do is talk, and everyone will bend to his will — but there were few specifics.

And a few specifics would be nice before we place our health care system — 17% of the economy — under government control.

We didn't even hear the president explain how he could demand immediate action on bills that he himself hasn't read. (But then, to be fair, the somnambulant journalists in attendance didn't bother to ask.)

This became obvious Monday, when he was asked about a point we brought up in an editorial last week on whether the House bill in effect outlaws new private individual health care insurance the year it becomes law.

"You know," Obama told a group of hand-selected, sympathetic bloggers, "I have to say that I am not familiar with the provision you are talking about."

Obama isn't the only one who isn't familiar with the "reform" he wants so badly. Tens of millions of other Americans are also trying to make heads or tails out of it — because it's something that will affect each and every one of them.

Fortunately, some people are sorting through the particulars. For example, the Lewin Group, a consulting firm respected for its nonpartisan analysis of health care issues, put out another report this week that found, among other things, that:

• More than 88 million Americans could lose their employer-based health coverage as businesses switch to the new taxpayer-subsidized public option that will compete with private insurers for enrollment. Doesn't this refute the claim that we can keep our current coverage?

• Yearly premiums for Americans with private coverage could rise as much as $460 per person as a result of the cost-shifting that would result from the public option. How does this jibe with the claim that costs will be lower?

• Physicians' net income would fall by 6.3%, or an average of $18,900 per doctor, as a result of lower reimbursements under the public option and higher practice expenses associated with providing services to the newly insured.

If this results in fewer doctors, what does it mean for the promise of better care, especially when 47 million more people are gaining access to the system?

These questions and many others demand answers from the president — in or out of press conferences — as well as Congress before this legislation gets any further. Because all we're being told now is that if we cede control to Washington, we'll get better care for more people at lower costs, and these claims just don't add up.

One, care will be poorer as fewer doctors become overworked by the rush of newly insured patients. Two, more than 103 million Americans, the Lewin Group says, will be herded against their wishes into the government-run public option. Third, costs will keep rising because incentives to self-ration will be further weakened by a system that encourages patients to overuse it.

Until we hear some specifics that refute our reading of the legislation, we remain unconvinced that government-run health care will live up to its promise.

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