If you hoped the debate Obamacare would be a break from business as usual, or that this administration was sitting on some clever plan to expand coverage while reigning in costs (ha!), Washington Post columnist Robert Samuelson advises you to think again. On health care, this guy is more status quo than Rick Parfitt:
One of the bewildering ironies of the health-care debate is that President Obama claims to be attacking the status quo when he's actually embracing it. Ever since Congress created Medicare and Medicaid in 1965, health politics has followed a simple logic: Expand benefits and talk about controlling costs. That's the status quo, and Obama faithfully adheres to it. While denouncing skyrocketing health spending, he would increase it by extending government health insurance to millions more Americans.
Between 1965 and 2008, Samuelson writes, health payments for individuals ballooned, "from less than 1 percent of federal spending…to 23 percent…" Obama blathers on endlesslessly about the need to control costs, but hasn't even head faked in that direction:
Just imagine what the health-care debate would be like if it truly focused on controlling spending.
For starters, we wouldn't be arguing about how to "pay for" the $1 trillion or so of costs over a decade of Obama's "reform." Congress wouldn't create new benefits until it had disciplined the old. We'd be debating how to trim the $10 trillion, as estimated by the CBO, that Medicare and Medicaid will spend over the next decade, without impairing Americans' health. We'd use Medicare as a vehicle of change. Accounting for more than one-fifth of all health spending, its costs per beneficiary, now about $12,000, rose at an average annual rate of 8.5 percent a year from 1970 to 2007. (True, that's lower than the private insurers' rate of 9.7 percent. But the gap may partly reflect cost-shifting to private payers. When Medicare restrains reimbursement rates, hospitals and doctors raise charges to private insurers.)
Way back in January, Samuelson offered up a series of "lessons from the great inflation." Click here to see Samuelson discuss his lastest book, The Great Inflation and Its Aftermath, with Reason.tv's Nick Gillespie.