The New English

It's hard to tell which came first, the chicken or the egg, but Senate Finance Committee Chairman Max Baucus (D. Montana) certainly tried to decipher the president's health care reform criteria: Not a dime added to the deficit....unless "spending cuts" are made if "savings" don't materialize. Of course Baucus could find "savings" only or almost exclusively in added costs and fees for consumers and providers of health care. The result is those with insurance will pay more for less to cover those without. That will save the government money. Meanwhile, those presently without health insurance will be forced to pony up some of their cash (and some of the taxpayers') to receive services many of them would not voluntarily have deemed worth their penny.

And all of us are left wondering what this has to do with health care "reform," although it certainly falls into the definition of "change" for one-fifth of our national economy.

Two areas of traditional savings have been identified by the administration: 1. electronic record keeping and 2. a $500 billion cut in Medicare (at the expense of seniors' popular Medicare Advantage supplement insurance programs). Writing in The American Thinker (http://tinyurl.com/lcb2wh), Dr. Gerald T. Reiss, a neurologist, finds the savings from eliminating paperwork will be negligible, but says electronic health records will save money "by using computer algorithms to override the medical decisions of doctors in favor of less expensive alternatives." And does that also mean "less effective" alternatives? The government will decide. As to Medicare Advantage, sorry, old folks.

Writing in Real Clear Markets (http://tinyurl.com/kkamxn), Diana Furchgott-Roth of the Manhattan Institute said the increase in health insurance premiums under the Baucus plan will be "a major cost...to the American public," and along the way wondered if this is "a major violation of President Obama's promise not to raise taxes on those making under $250,000 annually." Well, hey, is a government mandated "increased cost" synonymous with a tax raise? The administration will decide.

But there are a few pluses: The Baucus plan will cover most of those who don't already have coverage even if it's by threatening to impose fines of from $750 to $3,800 on those who don't comply...and by charging businesses a $400 fee per employee for not providing coverage. The Baucus plan will subsidize, on a sliding scale, insurance for those with incomes up to 300% of the federal poverty level by placing a 35% tax on high end plans (guaranteeing that they will become either more costly or less generous) and charge burdensome additional fees on both insurance providers and providers of medical devices (and that's not just scooter chairs, but knee and hip replacements and stents). Isn't it a bitch, being sick and getting old?

Doctors have been promised more reasonable Medicare reimbursement, but this is not included in the Baucus plan and would, naturally, add to its cost...possibly bumping it over "the not one dime added to the deficit" rule and thus requiring additional cost to consumers or a much to be regretted "sorry, Charley" notice to physicians.

One group that won't be affected by traumatic changes in health care provision are trial lawyers. Oh sure, the president made a curtsey to the concept of "tort reform" in his speech before the joint session of Congress. He'll look into a couple of isolated pilot projects to be conducted under the auspices of Health and Welfare Secretary Kathleen Sebelius, eight years head of the Kansas State Trial Lawyers Association... although The Wall Street Journal's Kimberly Strassel claims the dollar "savings" with tort reform are estimated at from $65 to $200 billion dollars annually (http://tinyurl.com/lhnj7w). Do you wonder how politicians missed that saving? Well, Strassel points as one example to Rhode Island Senator Sheldon Whitehouse, who rhapsodized about the virtues of the tort bar without mentioning the "nearly $900,000" it contributed to his reelection campaigns. But let's not be cynics.

Did we really expect a free lunch? And won't we feel the warm fuzzies of caring for our less fortunate citizens? ...well, perhaps citizens, perhaps residents. We'll see how that shakes out five or six or eight years down the road. We'll be able to decide then when it's change we can hardly believe happened.