The Selling of the Whitewash

Are you buying it?

Erisa (the Employee Retirement Income Security Act) allows employers that self-insure—that is, those large enough to build their own risk pools and pay benefits directly—to offer uniform plans across state lines. This lets thousands of businesses avoid, for the most part, the costly federal and state regulations on covered treatments, pricing, rate setting and so on. It also gives them flexibility to design insurance to recruit and retain workers in a competitive labor market. Roughly 75% of employer-based coverage is governed by Erisa’s “freedom of purchase” rules.

Goodbye to all that. The House bill says that after a five-year grace period all Erisa insurance offerings will have to win government approval—both by the Department of Labor and a new “health choices commissioner” who will set federal standards for what is an acceptable health plan.

In other words, the insurance coverage of 132 million people—the product of enormously complex business and health-care decisions—will now be subject to bureaucratic nanomanagement. If employers don’t meet some still-to-be-defined minimum package, they’ll have to renegotiate thousands of contracts nationwide to Washington’s specifications. The political incentives will of course demand an ever-more generous “minimum” benefit and less cost-sharing, much as many states have driven up prices in the individual insurance market with mandates. Erisa’s pluralistic structure will gradually constrict toward a single national standard.

So when Mr. Obama says that “If you like your health-care plan, you’ll be able to keep your health-care plan, period. No one will take it away, no matter what,” he’s wrong. Period. What he’s not telling the American people is that the government will so dramatically change the rules of the insurance market that employers will find it impossible to maintain their current coverage, and many will drop it altogether. The more we inspect the House bill, the more it looks to be one of the worst pieces of legislation ever introduced in Congress.

This is bad news. You representative has not read what Obama is trying to ram through congress with unnecessary urgency. Obama himself doesn't know what he's so hastily promoting. How's this all sound to you, voters? But wait, there's more:

We hear endlessly about how many Americans don't have health insurance. But, if we stop and think — which politicians hope we never do — that raises the question as to why that calls for government-controlled medical care. A bigger question is whether medical care will be better or worse after the government takes it over.

As for those uninsured Americans we keep hearing about, there is remarkably little interest in why they don't have insurance. It cannot be poverty, for the poor can automatically get Medicaid.

Such questions seldom get asked, much less answered. We are like someone being rushed by a used car dealer to sign on the dotted line. But getting stuck with a car that is a lemon is nothing compared to signing away your right to decide what medical care you or your loved ones will get in life-and-death situations.

Politicians can throw rhetoric around about "bringing down the cost of health care," or they can even throw numbers around. But the numbers that politicians are throwing around don't match the numbers that the Congressional Budget Office finds when it analyzes the hard data.

The point is that health care is largely in your hands. Medical care is in the hands of doctors. Things that depend on what doctors do — cancer survival rates, for example — are already better here than in countries with government-run medical systems. But if political rhetoric prevails, we may yet sell our birthright and not even get the mess of pottage.