January 2012

In Tuesday’s Washington Post, Glenn Kessler looked at Republican claims about Obamacare, such as the claim that it “is a ‘government takeover’ of the health care system.” He said that claim was “not true,” and approvingly cited PolitiFact’s controversial claim that this was the ‘2010 lie of the year.’” (He didn’t mention that PolitiFact’s claim was rebutted by newspapers like the Wall Street Journal, or the president’s own prediction that his health care plan would eventually lead to a government-run “single-payer” health care system.)

PolitiFact based its claim that Obamacare will not lead to a government takeover of health care on the false contention that Obamacare is not like European socialized medicine because the “European approach” is “where the government owns the hospitals and the doctors are public employees.” But that was a straw man argument, since the government does not own all the hospitals or employ most of the doctors even in many European nations long run by socialist parties.

France’s universal health care system is a classic example of the “European approach.” But even there, “doctors and other health care professionals are mostly self-employed,” especially general practitioners,” including all the physicians who have ever treated my daughter, a French citizen. Nor does the government own all the hospitals. For example, the private sector there has “half of all surgical beds.” Moreover, 92.2 percent of all French people purchase additional private insurance. When my father-in-law, a socialist trade unionist, recuperated from his quadruple bypass, he did so at a private convalescent home, using his supplemental private health insurance policy. Nonetheless, given its government’s dominant role in funding and supervising the health care system, France is commonly described as having socialized medicine.Moreover, the government’s share of healthcare spending is already higher in America than in various foreign countries. As a health care economist noted a few years ago, “the Swiss government only pays for 24.9% of health care costs (compared with 44.7% in the U.S.).” (PolitiFact itself had admitted that the government’s share of health care spending was already at 46 percent, and other estimates range up to 55 percent, if you add together state and federal spending.) Switzerland, not the United States, is the “country with highest annual out-of-pocket household spending on health.”

Obamacare will greatly increase the government’s share of health care spending by radically expanding state Medicaid programs to cover 16 million more people, resulting in the government paying for the lion’s share of health care spending in America. That is plausibly viewed as a government takeover.

Moreover, our health care system will become “government-run” under Obamacare in important ways. Obamacare imposes onerous government rules on our health care system, creating much more red tape than exists in many European countries, and turning health insurers into tightly-controlled public utilities. It will also spawn a potentially vast wave of lawsuits against state governments and private employee-benefit plans.

As a Wall Street Journal reader argued in criticizing PolitiFact, under Obamacare, government control is pervasive: “Government defines what health insurance is. Government defines what ‘minimum essential coverage’ is. Government forces everyone to buy one of four varieties of overpriced, low-value health insurance. . . .Congress establishes 159 government agencies to run the new health-care system. The government grants new powers to the Secretary of Health and Human Services, who will ‘deem,’ ‘create,’ ‘define,’ ‘determine,’ ‘approve,’ ‘disapprove’ and otherwise dictate everything about health care in America. The government takes away the power of individuals to appeal bad decisions by the secretary to the courts. The government penalizes doctors who don’t . . . follow cookbook medicine guidelines while expanding rationing powers of government and the insurance companies that it now effectively controls.”

As another Wall Street Journal reader noted, the fact that Obamacare “requires 15,000 to 18,000 additional IRS agents for implementation” is another sign of expanding government control. (An estimated 16,500 IRS agents will be required to implement the health care’s law requirements – the “biggest expansion of the IRS since World War II”).

The American people see Obamacare as a government takeover of health care, although not all view that as a bad thing. PolitiFact itself admits that “53 percent of respondents in a Bloomberg poll said they agreed that ‘the current proposal to overhaul health care amounts to a government takeover.’”

(While it dramatically increases regulation and red tape, the health care law has done little to control costs; health insurance premiums have risen substantially in many states as a result of its passage, such as a 47 percent increase for some policyholders in Connecticut.)

At best, PolitiFact’s claim that the government takeover of health care is a “lie” is as silly as saying it’s a lie to call a glass that’s half-empty “half-full.”