Guest Editorial

ObamaCare on the Fast Track — Will Physicians Be Steamrolled?

By Fred Barnes

ObamaCare, the president's sweeping plan to overhaul the health-care industry in America, is the biggest item on the menu in Washington this year. Obama has a big agenda, but much of it won't be passed, at least in 2009. But his health care plan has an excellent chance, better than 50-50, of being enacted.

So beware. There are two aspects of ObamaCare that are threats to medical practice as doctors and patients know it. One is a "public" or government-run health insurance plan that would be open to everyone. Chances are, it would draw millions away from more costly private insurance and give companies an incentive to stop paying for their employees' insurance.

The second is $1.1 billion in funding for studies to determine the best and most cost-effective medical procedures and medicines. Doctors may at first welcome the objectivity of studies not funded by the drug industry. But the fear is that once government controls the health insurance business, it would then dictate what practices and medicines should be used and, just as important, which ones the government will pay for.

If you're watching the Senate debate on health care this summer, you'll hear a lot about the public insurance scheme, but not as much about the effectiveness study. This is because the public plan is what most starkly divides Democrats and Republicans. There's no middle ground on it. Senator Chuck Grassley of Iowa, the top Republican on the Senate Finance Committee, says Republicans won't vote for any bill that includes a public insurance plan and Democrats won't vote for any bill without it.

He's right. And thus it is important to remember who has the votes in Congress: Democrats, with a crucial 60-40 Senate majority. Democrats may have enough votes to overcome any Republican obstacles, though not without a fight. We'll see.

One thing is certain. Obama and his friends in Congress have benefited from the mistakes made by the Clinton White House in 1993 and 1994 when HillaryCare was on the table. Clinton did just about everything wrong.

The Clinton bill was drafted in secret at the White House, angering Democrats on Capitol Hill. This time, Obama is letting congressional Democrats write their own bill, one they are sure can pass. Knowing that Democrats are in sync with him on the issue, Obama feels safe in letting them handle the details of the bill.

That's only the first of Obama's smart moves. The president talks about health care in an appealing fashion. Everyone can choose whether to stay in their employee-based plan or jump to the "public" plan. He never refers to it as "government-run." It's Republicans who stress that point.

Obama learned from extensive polling on health care that most people have two fears about reform. One is that the government will mediate between them and their doctor. The second is that health care will not only cost them more as patients, it will cost them more as taxpayers as well.

So the president aims to ease their fears on both. It's entirely their call on insurance. On cost, there's probably no point Obama has made more often than that the price of health care will be reduced for every American.

This is a highly dubious claim. It's obvious, for instance, that the uninsured will consume more health care once they are insured. And Obama is asking now for more than $600 billion in federal money just to get his reform off the ground. The best guess now — and it's a conservative guess — is that ObamaCare will cost at least $1.2 trillion over the next 10 years. That's "t" for trillion.

What stands in the way of passage of ObamaCare? The same coalition that defeated HillaryCare 15 years ago. The problem is that the coalition has yet to coalesce, and may never. The insurers and others in the health care community are afraid of taking on Obama, figuring they'll get a better deal if they go along.

They're wrong.

It's up to Republicans to organize the coalition again. And so far they haven't been up to that task. There's not much time left. Obama wants to push his bill through Congress this summer, and for good reason. Republicans dragged out consideration of HillaryCare for months, allowing all its ugly parts to be fully examined and debated. Obama wants to avoid that. If he does, ObamaCare will be the law of the land and, I suspect, the scourge of the medical community. OM