If the Senate health care bill becomes law, your preventive care will become “free.” Now, now: Don’t go raising a quizzical eyebrow. We have the word of Colorado Sen. Michael Bennet that the bill guarantees “free preventive care for everyone.”
Bennet, speaking from the Senate floor a few days before the bill passed, did not explain how exactly a colonoscopy, mammogram, pap smear or alcohol counseling in certain settings — to cite a few of the many qualifying preventive services — could possibly cost nothing, or how “everyone” could avoid paying for expensive medical treatments administered to tens of millions of Americans.
What the senator actually meant, of course — and would eventually get around to explaining in the speech — is that the bill mandates preventive care “without co-payments.”
Meaning you won’t pay for preventive care directly. You’ll pay for it indirectly through higher premiums, higher co-pays for other services or higher taxes and greater national debt.
As a consumer, of course, you may well like the idea of preventive care with no co-payments. And you might be willing to pay more for such coverage or to trade such a benefit for more cost-sharing for other treatments. (Given the choice, I wouldn’t, but to each his own). However, unless you believe that “free” preventive care is the only sensible approach to insurance coverage — which it clearly isn’t — why would you applaud Congress mandating it for every policy in the land?
The details of the preventive-care mandate in the Senate bill (there’s a similar one in the House bill) offer the clearest lesson yet of how Washington intends to micromanage health insurance. Forget about meaningful choice. It won’t be too many years before you will enjoy the same choice that Henry Ford touted for the Model T: any color at all, “so long as it’s black.”
In the Senate bill, the judgment of obscure federal outfits such as the U.S. Preventive Services Task Force and the Health Resources and Services Administration (in the latter case, “with respect to women”) is elevated to holy writ: If they deem a preventive procedure valuable, it will soon migrate — by law — into our policies.
Except, of course, when Congress disagrees. Incredibly, in the same bill in which the Senate empowers the Preventive Services Task Force, it dismisses the task force’s recommendations regarding breast cancer screenings “issued in or around November 2009” because they advised against routine mammograms for women in their 40s. And you can bet that won’t be the last inconvenient opinion from federal experts that Congress will blithely override.
Whether Washington bureaucrats or politicians set the rules, however, the net result still will be an unprecedented level of micromanagement of medical coverage, according to Edmund Haislmaier of the Heritage Foundation — far beyond the existing regulations of any state. As the Los Angeles Times explains, “Democrats in the House and Senate have filled their bills with a dizzying array of rules and regulations on insurers. The insurance market provisions in the Senate bill alone run nearly 400 pages.”
Even if you favor a major federal role in expanding coverage of the uninsured and reforming insurance practices, how can the Senate’s hyper-regulatory approach be a smart way to go about it? How can legislation nurture competition and protect choice, as its proponents insist it will, while it whittles away differences? How can it reduce insurance costs at the same time it is piling on mandates that will only proliferate over time?
“It’s completely understandable that some Americans doubt whether this bill will improve their situation,” Bennet admitted. “They understand that we cannot live with the current system, but they are also deeply concerned about our capacity to make it worse.”
Unfortunately, Bennet seems to believe these doubts spring mainly from “special interests” deploying “tried and true tactics . . . to prevent reform.” Yet surely the bill’s substance has something to do with the skepticism, too.
E-mail Vincent Carroll at vcarroll@denverpost.com.
