The Obama administration is saying that controlling costs is a priority for their health-care reform plans, and they seem to think that government could help in that area. The area of controlling costs. Hmmm. Based on what evidence, I wonder? As far as I can tell, the federal government hasn’t met an expenditure it didn’t like in some time now.
 
In a New York Times interview published on April 28th, President Obama said: “part of what I think government can do effectively is to be an honest broker in assessing and evaluating treatment options.”
 
When I read that, I instantly thought of how Americans reacted to the advent of “managed care” in the 1990s. Created to cut costs, Americans in managed care insurance programs, who were used to getting what they wanted, suddenly felt limited and pushed around by their HMOs. “That’s not covered” was a phrase they heard more often than they liked. This led to outcry over particular issues (“drive-by mastectomies,” etc., where insurance would only pay for a limited amount of hospital time). Which led to government mandates on health insurance (forcing insurance companies to pay for certain things). Which led to increased costs.
 
Does the Obama administration really think that it will be any different if the government makes the decisions on what’s “worth the expense?”
 
I suspect that efforts to control costs within the government-coverage-option will start with the best of intentions and unravel very quickly under consumer/taxpayer/voter pressures. Americans don’t react well to rationing, no matter what you call it. We’ll call our congressman and demand something better. And then, quite quickly, government-run health care will become just as expensive as conservatives threaten it will be.