Last night, Senator Barack Obama looked straight into the camera and told the audience that, if they wanted to keep their employer-sponsored health plans, they could.
A nice selling point for his proposal, that. But it’s not true.
The Lewin Group, an independent health policy consulting firm, estimates that 22 million workers and their families would lose their job-based coverage under the Obama plan.
And then there is Michael Dobbs of the Washington Post, who wrote in his review of the candidates’ claims from last evening that
[T]here is little to support McCain’s charge that Obama would “force families into a government-run health-care system where a bureaucrat stands between you and your doctor.” The Obama plan bears little resemblance to the socialized national health systems in Britain and some other European countries and is based instead on expanding the current U.S. system of privately backed health insurance.
But unfortunately, that’s not a fact at all. Under current law, Lewin expects 172 million Americans would have private coverage and 86 million would have public coverage in 2010. If the Obama plan is enacted, Lewin sees those with private insurance coverage falling to 150 million and enrollment in public insurance increasing to 135 million—nearly 50 million more than expected under current law.
It is hard to see how this can be described as “expanding the current U.S. system of privately backed health insurance.”
Even the Lewin study is probably too easy on the Obama plan in this regard. Neither Mr. Dobbs nor Senator Obama made it clear to their audiences that Obama’s plan includes a new, government-run insurance option which would look a lot like Medicare. For people who enroll in this insurance, the government would decide what to pay doctors and hospitals, just as Medicare does today.
But of course Medicare doesn’t negotiate fees with doctors and hospitals; it presents them on a “take-it-or-leave-it” basis, knowing full well that few providers of care have the market clout to refuse patients in a government-sponsored plan. Lewin makes the generous assumption that the government plan in the Obama proposal would pay fees at the half-way point between Medicare’s current rates and what private insurers typically pay today. But there will be great pressure on Congress to keep the costs of the program down, and the easiest way to do that would be to have the new government plan adopt the Medicare fee schedules without amendment. If the Lewin analysts had made that assumption,they would have projected even more people migrating from private to public insurance under the Obama plan.