patrick stephens at psjs.net

From the WSJ,

Last September Sen. Barack Obama promised that under his health-care proposal “you’ll be able to get the same kind of coverage that members of Congress give themselves.” On Monday, President Obama repeated that promise in a speech to the American Medical Association. It’s not true. …

Members of Congress “enjoy the widest selection of health plans in the country,” according to the U.S. Office of Personnel Management. They “can choose from among consumer-driven and high deductible plans that offer catastrophic risk protection with higher deductibles, health saving/reimbursable accounts and lower premiums, or fee-for-service (FFS) plans, and their preferred provider organizations (PPO), or health maintenance organizations (HMO).” These choices would be nice for all of us, but they’re not in the offing. Instead, if you don’t enroll in a “qualified” health plan and submit proof of enrollment to the federal government, you’ll be tracked down and fined (sections 3101 and 6055).

For a health plan to count as “qualified,” it has to meet all the restrictions listed in the legislation and whatever criteria the Secretary of Health and Human Services imposes after the bill becomes law. You may think you’re in a “qualified” plan, but the language suggests that only plans with managed-care controls such as the “medical home” will meet the definition (sections 3101 and 2707).

Great. The Obama plan is designed to “cut costs” by requiring doctors to “manage” care in accordance with govt. directives. Payments will be made to a subscriber’s primary care physician (PCP) based on how effectively the physician has followed federal treatment guidelines. That means that if your PCP orders a test that isn’t on the formulary for your preliminary diagnosis, or if he prescribes an individualized course of treatment that deviates from the standard directive–as set by the Secretary of Health and Human Services–then he’ll be financially penalized. That’s right. Under Obama’s plan, your doctor will be financially penalized for treating you and financially rewarded for limiting treatment.

If you don’t sign up for a plan that limits your care, you’ll be fined.

But what about Congress and Federal employees? Surely since this is the “kind of coverage that members of Congress give themselves” we should expect the formulary to be expansive, forgiving and inclusive? Ha.

“[Obama's Plan] specifically exempts members of Congress (along with federal employees; the exemptions are in section 3116).”

So, when the President says that you’ll be able to get the “kind of coverage that members of Congress give themselves” what he means is that that you won’t be able to get that kind of coverage.

It gets better.

What he said,

So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage - they like their plan and they value their relationship with their doctor. And that means 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. . . .

If you don’t like your health coverage or don’t have any insurance, you will have a chance to take part in what we’re calling a Health Insurance Exchange. . . .

You can keep your existing coverage, if it exists and isn’t forced under by government subsidized monopoly care, and if it does last, you can keep it and be fined for keeping it. How generous! Not only will Obama let you keep your existing health insurance, he’ll fine you for the privilege.

According to the AP, the White House has already backtracked some of these “promises,”

White House officials suggest the president’s rhetoric shouldn’t be taken literally: What Obama really means is that government isn’t about to barge in and force people to change insurance.

Well, they won’t barge in; they’ll be quiet.

Earlier this week, a preliminary analysis by Congressional Budget Office estimated that 10 million people would have to seek new insurance under a Democratic plan that a Senate committee is working on, because their employers would no longer offer coverage. Those workers and their families would shop for a plan through new insurance purchasing pools called exchanges. About 160 million to 170 million people now get employer coverage.

So, if you like your health insurance, and it matches what they want you to have, and you don’t get your insurance through your employer, then sure, yeah, you can keep it. But they’ll still fine you.

From Jim Lindgren at Volokh.com,

In other words, if you believed something closer to the opposite of what Obama promised, that would be closer to the truth. When Obama said he “will keep this promise”:

If you like your doctor, you will be able to keep your doctor. Period.

he actually meant:

If you like your doctor, many of you will NOT be able to keep your doctor. Period.

And when Obama said he “will keep this promise”:

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.

Obama really meant:

If you like your health care plan, many – perhaps most – of you will NOT be able to keep your health care plan. Period. Someone – perhaps your employer – may take it away. It all depends on how things work out.

Politics heath care reform