Conversation: For the Nation's Medicine, a HICA Moment

3) Professor Scott Harrington of the University of Pennsylvania's Wharton School: "In reality, equal competition between a public plan and private plans would be impossible. The public plan would inexorably crowd out private plans, leading to a single-payer system. ... Health-care providers and other Americans should recognize this reality and be prepared for the consequences."

YOU obviously agree with those observations. Why?

For a number of reasons. Government estimates of the costs of things - in this case, $1.5 trillion over the next decade alone - always are notoriously wrong on the low side.

Not always.

Yes, always. Way low.

Next, there's medicine and there's inferior government-run medicine - just as there's the car business and (soon) the government-run car business, education and public (i.e. government-run) education. Where - anywhere - is government-run medicine better in terms of quality and efficiency of delivery than the private medicine available throughout the United States? If there were even a single example, it would be page-one news every day.

So?

So Obama and his rubber-stamp congressional lefties are hell-bent to Europeanize the nation's health care with state-run (yes, socialized) medicine. To borrow from two old songs, Give 'em the ol' razzle-dazzle and Promise 'em anything, but give 'em socialized medicine. Waits will grow longer, costs will go up, and quality of care will go down. It doesn't make any sense.

WHAT would make sense?

Politically, we probably have reached a time when the government has to mandate health care coverage for everyone. It could do that simply by requiring every taxpayer to attach to his federal tax return a certificate of coverage for him and his dependents. (Non-taxpayers would get medical care through a pool funded in any of various ways.) Then private insurance carriers would compete to sell state-sanctioned plans at the lowest costs for a multitude of coverage ranges.

That sounds a lot like the Federal Employees Health Benefits Plan under which congresspersons and presidents buy their medical coverage.

Bingo. Very much like that - and there was a time when Obama was suggesting it, but apparently not anymore. If such an arrangement is good for lofty congresspersons and presidents, is it too good for the everyday rest of us?

Wow. A plan already in place - and used by the president himself. Why isn't he using it as a model for the country?

Because he is a statist at heart - and he has the popular support and the votes in Congress to socialize medicine on the European model. And despite his tendency to complexify things and conceal them in an inky rhetorical cloud, that's clearly what he wants to do - and that's what we're likely to get, and don't bring up the new taxes that will be imposed in its name.

Complexify, Europeanize, socialize?

Indeed. With the consequent rationing that defines care restrictions and price controls - and the tearing up of the private doctor-patient contract that is the essence of American medicine. That's the freight train rushing at us.

Your father actually foresaw this?

He did - and in many ways the train already has arrived, which helps explain the smoldering fury of many of the nation's physicians. The new regime seems set on replacing private medicine with government medicine. In the slang acronym, we face a HICA moment.

HICA?

For Here It Comes Again.