In 1988, Congress passed and President Ronald Reagan signed into law the Medicare Catastrophic Coverage Act. Officials in Washington were firmly united in creating the single-largest expansion of Medicare since 1965. Fast-forward 22 years, and we’ve just witnessed a monumental government takeover of the private health care sector.
But this doesn’t mean ObamaCare is set in stone. As we saw with the Medicare Catastrophic law, a focus on higher costs, disrupted health benefits and public revulsion to intrusive government bureaucracy helped ordinary America over the powerful players in Washington.
What We Learned. The debate on Medicare catastrophic was a refreshingly open process; a civics textbook example of good government in action. The Reagan Administration in 1986 had held public hearings on the idea, seeking public comment from people across the country. HHS staff worked hard to hammer out the specifics. When Congress started work on the proposal over many months, there were lots of hearings and mark-ups. Additionally a large number of interest groups, representing seniors, medical professionals and the health care industry, as well as health policy experts had the chance to testify and offer their best ideas.
How It Relates to the Present. There are some important differences between the 1988 Medicare act and the recent Patient Protection and Affordable Care Act:
– Instead of affecting 32 million Americans, Obamacare affects 300 million.
– Instead of an open-government process, the health law’s legislative process showed an unforgettable display of congressional arrogance, vote trading and backroom dealing.
– Instead of broad, bipartisan effort, Obamacare was forced through on razor-edge votes, using parliamentary tactics.
– Instead of having wide public support, Obamacare failed to rouse a majority in most polls. In fact, support for its repeal increased after the health care law was enacted.
Still, ObamaCare has the same fundamental issues we saw in the Medicare catastrophic dust-up, which could ensure enough public demand for its prompt demise.
Massive disruption of the health benefits. Before its repeal, the Medicare law forced angry seniors to pay more for a government-designed benefit that they did not want or need. In the case of Obamacare, millions of Americans will see their existing employment-based health insurance coverage disappear. The only debate is how many millions will be pushed out of their current plans.
Inaccurate claims of fiscal responsibility. The ill-fated Medicare law’s projected costs at passage doubled within 12 months. The new health reform law is following suit. The Congressional Budget Office recently revised its 10-year cost estimate from a $143 billion deficit reduction to an additional $115 billion cost. The new law also is expected to increase insurance premiums, taxes for the middle class and overall health care spending.
An explosion of federal bureaucracy. When Congress enacted the Medicare catastrophic law, HHS bureaucracy was tasked with implementation. Just the electronic- claims processing system would have affected more than 60,000 pharmacies nationwide. ObamaCare will create 160 new federal agencies and programs that impact every aspect of our health care services.
