Brilliant

The Death and Life of Health 'Reform'

A glimpse of a future without nationalized health care.
By HOLMAN W. JENKINS, JR.

The following is a draft of a speech titled "The Obama Years: A Reappraisal" that mysteriously was never delivered at the 2070 national meeting of the Institute of Advanced Obamalogy:

So it came to pass in the waning days of the health-care wars that Democrats learned the American people really didn't want a nationalized health-care industry.

The Obama administration's "public option," which all knew to be a vote for a government takeover, proved a drink too stiff for four or five Democratic senators whose re-election was not in the bag.

President Obama applauded himself for achieving "85% of what we set out to accomplish." But pundits and wonks were in despair. They retreated to their watering holes and cried into their Stoli martinis. The cause of their lives was over. A once-in-a-generation opportunity had been muffed. Without a massive bill in Congress, with many titles and subtitles and subchapters, they moaned, there was no hope for fixing all that ailed the American health-care system.

But politics went on, and while the armies of wonkdom mourned, three little-known congressmen (Eric Paul, Ryan Cantor and Kemp Newtley) discovered an unexpected public enthusiasm for a flat tax.

Through incessant Twittering over the heads of the media, they persuaded millions of voters they'd be better off with lower rates even if it meant giving up tax-free employer provided health insurance. It didn't hurt, either, that the wailing of insurance and medical lobbyists was over-the-top -- convincing voters that the tax benefit really was just a form of corporate welfare disguised as a mostly illusory benefit for individuals.

Though the realization was slow in dawning, policy experts would eventually rediscover what they had known all along (but had conveniently forgotten in order to lend their voices to "solutions" that required ever more government spending) -- that tax reform, in the American context, is health-care reform.

And, lo, it proved true, as 100 million intelligent, well-educated employees of Corporate America were allowed to see for the first time what "tax free" health insurance was really costing them. They saw how it distorted their behavior and caused them to allocate far more of their incomes to the medical-industrial complex than they would have chosen for themselves.

Eyes newly opened, they demanded cheaper insurance options, covering fewer services (cancer wigs, family counseling, in-vitro fertilization), and opted for plans with higher deductibles and co-pays in return for much lower monthly rates.

Because consumers were now spending their "own" money on health care, doctors and hospitals found it necessary to publish and even advertise their prices. A hospital that specialized in heart surgery, performing thousands of procedures a year, found it had both the highest quality and lowest cost -- and now marketed itself as such. Ditto specialists in cancer, diabetes and other conditions.

For the first time, Americans spent less and got more. Spending fell overnight by 13%, which happened to be exactly what economists had predicted if the price tags were restored to health care and consumers were allowed to see clearly what they were getting (or not getting) for their money. As predicted, too, spending thereafter rose only in line with incomes.

What's more, many fewer people remained voluntarily uninsured now that health insurance was no longer a gold-plated extravagance affordable only by those in the top brackets who could slough off 40% of the cost on other taxpayers. Existing programs for the needy, in turn, could be downsized and revamped into voucher programs. The federal budget benefited twice over -- from fewer claimants and from medical care that was less costly. Fiscal wreck was avoided.

In truth, President Obama had been little involved to this point. Following his early domestic "successes," he was spending more and more time abroad sharing his matchless eloquence with previously unblessed audiences from Ulan Bator to Ouagadougou.

A highly symbolic moment, however, came when Mr. Obama, who had put on weight in office and now tipped the scales at nearly 300 pounds, returned from a speaking tour on the virtues of nonproliferation to audiences in the Islamic Republic of Palau. Having overindulged in local delicacies, he was surprised when the White House medical office handed him a Wal-Mart debit card and sent him to a nearby Wal-Mart supercenter boasting "Everyday Low Prices on Gastric Bypass Surgery."

Emerging afterward to the usual crowd of ululating network reporters and bloggers, Mr. Obama pronounced himself entirely pleased and satisfied with the "success of my health-care reforms."

And so it came to pass that historians and Obamalogists would count health-care reform among the incomparable triumphs of the Obama administration, and lost to history would be the names of Eric Paul, Ryan Cantor and Kemp Newtley.