Saturday, December 06, 2008

The Disastrous Daschle-Obama strategy to "fix" health care

Tom Daschle is President-elect Obama's choice for Secretary of Health and Human Services. But what sort of Secretary would he be? What positions might he take on "universal" health care, malpractice and tort reform, and other issues?

Insights into Daschle's approach may be gleaned from his book Critical: What We Can Do About the Health-Care Crisis, which was endorsed by Barack Obama. The details that emerge from a careful reading of the book are ominous at best.

Daschle first proposes the establishment of a board to set standards for health care. The board would be modeled after the Federal Reserve and the SEC, overseeing every aspect of care for public health systems. Thus the board would administer Medicare, Medicaid, the Veterans Health Administration, etc., or roughly one third of all health care in the country.

Apparently this board is desperately needed because there aren't enough bureaucrats overseeing medical affairs in Washington. And Daschle recommends the Federal Reserve-SEC central planning model, presumably because it's working so well to manage our current fiscal crisis.

On Page 179, Daschle writes, “The Federal Health Board (FHB) wouldn’t be a regulatory agency, but its recommendations would have teeth because all federal health programs would have to abide by them.” Although the FHB would have no official oversight of the two thirds of health care delivered through the private sector, Daschle asserts that Congress could easily change that aspect of the Board: "[Congress] could... link the tax exclusion for health insurance to insurance that complies with the Board’s recommendation.”

Got that? Health insurance that doesn't comply with the Board's strictures would lose its tax-free status.

By doing so, Congress would utterly and completely destroy America's private-sector health care system because no health insurance program could survive if it were denied the tax deduction.

Thus, the FHB would effectively control the operation and practices of every doctor, every nurse, every drug company, every hospital, every health insurance company, every third-party administrator, etc.

On page 199 Daschle helpfully describes who the "losers" would be in his centrally managed system: "Doctors and patients might resent any encroachment on their ability to choose certain treatments, even if they are expensive or ineffectual compared to alternatives. Some insurers might object to new rules that restrict their coverage decisions. And the health-care industry would have to reconsider its business plan." Put simply, government bureaucrats would decide every aspect of their operations.

Daschle says that the FHB will force and end to the "technology arms race", which he asserts health care systems use "to attract aging baby boomers with the latest diagnostic imaging machines." These are, strangely enough, the same machines that Daschle says "help(s) doctors estimate the spread of cancer or the extent of cardiac disease without surgery." (Page 125)

Daschle believes those tests often lead to treatment; and there's far too much of that going on. To prove his point, he spotlights a study of 828 angiograms in which a third were likely to benefit patients, 50% might or might not, and 14% were not likely to offer a benefit. Thus 86% of patients might benefit, but Daschle claims the approach is too wasteful: "When the test revealed a narrowing of the artery, however slight, cardiologists couldn’t resist doing something about it." Isn't that what they're supposed to do, Tommy?

In other words, the Obama-Daschle plan proposes to have the Federal Health Board dictate to cardiologists -- and all other Doctors -- which treatments can be rationed to whom. I somehow doubt that Daschle and his cadre of FHB bureaucrats would ever be denied treatment, though.

Daschle also offers a stunning criticism of the current private sector health care system: "Many patients with insurance want any care that might do some good, and plenty of doctors will oblige them." (Page 122)

Anticipating a massive outcry over this Politburo-style approach, he recommends two legislative tactics for creating the Federal Health Board. First, the bill must be passed in the first year of Obama's presidency, when he is most popular. Second, the bill must omit any details of the program. It must be nebulous and vague: "[the] Federal Health Board should be charged with... filling in most of the details. This independent board would be insulated from political pressure.” By "political pressure", Daschle means our representative democracy should not be permitted to interfere with the Kremlin of Health Care.

By hiding the details of the program, the FHB will be unaccountable to the American people.

* * *

With the Obama-Daschle plan for nationalized health care, the same government bureaucracy that brought you the massively underfunded Social Security system and Medicare, as well as the disastrous Fannie Mae and Freddie Mac, will now be running an even larger chunk of the U.S. economy.

Three guesses how this magnificent approach will turn out. And the first two don't count. Just picture the Hindenburg exploding and you should have a suitable illustration of the future of health care.

Based upon: Tony Blankley's "Daschle-Obama health care possibilities". Hat tip: Mark Levin.

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