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Advantage Cronyism

If you like your doctor, you will be able to keep your doctor, at least if you pay cash.

12:00 AM, Jan 5, 2010 • By JEFFREY H. ANDERSON
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One of the many problems with funneling our nation's health-care system through our nation's political system is that it would politicize health care. The health-care bill that recently passed the Senate could hardly provide better evidence of this claim.

Advantage Cronyism

Sen. Bill Nelson (D-Fla.)

James Madison wrote that "history informs us of no long-lived republic which had not a senate," as such a "temperate and respectable body of citizens" is necessary to ensure an "attachment to the public good" and to prevent us from falling prey to those "stimulated by some illicit advantage." But Senate Majority Leader Harry Reid's conception seems to differ somewhat from Madison's. Responding to accusations that the process culminating in a 1:00 AM Sunday night (Monday morning) vote on Obamacare had degenerated into something approximating "Cash for Cloture," Reid replied, "I don't know if there is a senator that doesn't have something in this bill that was important to them. And if they don't have something in it important to them, then it doesn't speak well of them."

By Reid's standard, we certainly have no choice but to speak well of the Democrats. There was the "Louisiana Purchase" of Mary Landrieu's vote, in exchange for $100 million in extra Medicaid funding for Louisiana; the $100 million "Cornhusker Kickback" to Ben Nelson, to make Nebraska the only state in the union that wouldn't have to pay into Medicaid; and the "U Con" secured by Christopher Dodd, to get Americans to pay $100 million for a medical center in Connecticut. One gets the impression that Reid had a sign on his door, saying, "Will pay $100 million for votes."

Things got so bad that even Democratic Senator Michael Bennet of Colorado declared on the Senate floor, "I'm not happy about the backroom deals." (He was happy enough, however, to vote for the bill that contained those backroom deals.)

But as egregious and disreputable as these examples are, the most significant example of the politicizing of health care involves Medicare Advantage, the popular program in which nearly a quarter of all seniors are currently enrolled. Under Obamacare, those 11 million seniors would lose Medicare Advantage benefits and, in some cases, access to Medicare Advantage plans altogether. This would, of course, be in direct contradiction to President Obama's very public pledge that "no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what."

The President's pledge would also prove to be untrue for many Americans with high-deductible, consumer-driven health-care plans. Such plans put people in charge of their own health-care dollars. But the essence of Obamacare is to expand the role of government and insurers, at the expense of individual's control. According to the Congressional Budget Office (CBO), Obamacare would funnel $1.0 trillion over 12 years from American taxpayers, through the federal government, to private insurers (and not for consumer-driven plans), while requiring Americans to buy the insurers' product. It's no coincidence that insurers back Obamacare.

And they're not the only ones. Eighty-nine percent of seniors currently have some form of supplemental, or Medigap, coverage in addition to Medicare. For many lower-income Americans, Medicare Advantage provides that supplemental coverage. So, Medicare Advantage cuts would often result in their having to buy Medigap plans. The largest seller of such plans? AARP--one of Obamacare's marquee supporters.

It turns out, however, that not everyone enrolled in Medicare Advantage would lose their benefits. Senator Bill Nelson cut a deal with Senator Reid to carve out an exception for residents of Florida. Dubbed "Gatoraid," this exception would, in the words posted on Senator Nelson's website, "preserve the benefits for most of the current Medicare Advantage enrollees in Florida," where "an estimated 800,000 would be grandfathered in."

This isn't merely another example of politicizing health care by giving pork to a particular state and making all Americans pay for it. Here, with just a few exceptions, the benefits preserved in one state would be lost in all of the others. Only Floridians (and a smattering of others) would continue to enjoy benefits now available to all seniors nationwide.

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