Obamacare needs reform

Reggie Love, a former Duke University basketball team captain and a fellow who wears the look of one who can take care of himself, emerged last month from a session on the hardwood with his boss and a few pals sporting a bandage on his chin. It is unknown whether President Barack Obama inflicted the wound but it is believed that his team won three of five games, perhaps a testament as much to the necessities of political upward mobility as to the chief’s game, though word is he has some.

So, too, would the government, presumably, if the president’s health care overhaul survives. The plan has a rub, like the one that happened in 1914 in the Atlantic. Detractors, the devils, warn of icebergs, otherwise known as costs. The messages vanish in the night. Obama neither hears nor heeds them.

Delicately, as if lofting a soft jumper, Obama proposes what he calls “a public insurance option,” which would appeal in the fashion of saying no to the man with the gun. “If private companies have to compete with a public option,” the president explained, “it will keep them honest and help keep prices down.”

The result would be competition of the sort Love apparently experienced. Government has the right responsibility of establishing rules to ensure fairness in competition and then, until recently at least, standing back and permitting free markets to do the remaining work. If the overseer steps in as participant, the rules inevitably will be altered to favor it. And then among options, there will stand one, which, we suspect, is precisely as Obama wants it.

But should the country, and does it, desire the same?

Providing coverage to uninsured Americans – almost a fifth of them illegal immigrants – would cost as much as $1.2 trillion over 10 years, according to the Christian Science Monitor. Obama says he can save $313 billion, but inevitably costs will be passed on to consumers. Administration officials respond with blank stares or the rhetorical equivalent to questions over how much money would be saved in the federal budget.

Among wrinkles Obama favors is tort reform, a prospect over which Democrats and their constituent posse of trial lawyers long have chafed. The American Medical Association says “liability pressure,” driven by exorbitant jury awards, increase annual health care costs by $84 billion to $151 billion annually. Obama sees these concerns, which Republicans frequently cite, as a potential lever. The president does not support a cap on jury awards, as George W. Bush did, but he has expressed interest in reducing the payouts and pushed for the same as a senator.

That, Obama hopes, will whittle resistance from the AMA. It also would help as government wades deeper into the health care insurance business. Obama’s willingness to consider what so many in his party have fought is encouraging, but not to the point of buying a plan that will spawn more diseases than it cures.

Reform in which we can believe starts with the states, giving them greater flexibility to set programs that match the unique needs of their people while ensuring and enhancing private competition and providing for portability, which allows people to remain in an employer’s group plan after they’ve left their jobs. Tax credits should be provided to people who purchase their own insurance rather than through an employer. Steps should be taken to ensure that consumers have information in advance about costs of treatment and competing insurance plans so they can take greater charge of their health care decisions and force providers to produce better prices and value.

Government’s record in improving efficiency and lowering costs – the ostensible aim of reform – is similar to that of underlings competing with bosses. Give Obama what he seeks on health care and America, rather than Reggie Love, will be the one taking it on the chin.