John R. Graham, the director of health care studies for San Francisco’s Pacific Research Institute, has been a critic of the national health overhaul law – not surprising, considering the institute is a free-market think tank. Graham answered three questions posed by reporter Victoria Colliver.
Q: What are some of the aspects of the health reform legislation that concern you the most?
A: Where to begin? Most would start with the cost. Although the majority advertised the cost at just under a trillion dollars over 10 years, most of the costly elements of the “reform” don’t kick in until 2014. The first decade of actual operations will cost more like $2.3 trillion. Plus, the “reform” will not reduce the deficit as advertised. However, I think the bigger problem might be the reduction in peoples’ access to medical services. About 10 million seniors, including many in California, will lose access to Medicare Advantage plans offered by the likes of Kaiser Permanente and be forced onto the traditional Medicare Fee-For-Service program. Those with chronic illnesses will face poorly co-coordinated care and lack of access. Finally, many more small businesses and individuals will drop coverage than the Congressional Budget Office estimates, because it ignored the fact that the flipside of forbidding insurers from using pre-existing conditions to price premiums is that people can wait until they get sick to apply for insurance.
Q: Which parts of the bill do you think will actually work and be an improvement over the current situation?
A: I would have to go through this legislation with a very fine-toothed comb to find anything positive. But there’s got to be something. Hmmm. The new law will allow insurers to charge smokers up to 50 percent higher premiums than nonsmokers. That’s the only concession to actuarially fair underwriting. But I suppose it’s a good start, although the government should cut tobacco taxes as a trade-off!
Q: Almost immediately after the bill passed, the polls showed public opinion started shifting in favor of the legislation. What do you make of that?
A: I suppose that anytime the president succeeds in getting big legislation passed and holds an emotionally satisfying signing ceremony, the polls over the next day or two will show an upswing. That does not change the fact that the federal government’s seizing control of Americans’ access to medical services via very expensive legislation has divided the country and the Congress.
This article appeared on page C – 3 of the San Francisco Chronicle