Incoming Florida Governor Rick
Scott and Yale Professor Jacob Hacker offer two visions of the future of
American health care. Scott is focused on the immediate problem that Medicaid
is killing
state budgets, and says block grants with more individual control of their
dollars is the best way to go. The alternative is a program that is
unsustainable even before ObamaCare (witness
Texas), and ripe
for Constitutional review.
Stephen Moore’s interview
with Gov. Scott is worth reading:
Mr. Scott believes that the growing financial squeeze from programs such
as Medicaid means that "there’s going to be a lot of pressure from the new
governors to get Congress to block-grant the [Medicaid] money back to us."
The theory is that the states can more efficiently administer the program.His cost-containment strategy involves creating a health-care voucher for
eligible Medicaid recipients so that they can shop around for health care and
explore money-saving options like high-deductible health savings accounts.
"If poor people are spending their own money, it is amazing how fast they
will figure out how to keep a lid on medical bills," he says, based on his
own experience in the private sector.Critics say this will inhibit preventive care, but Mr. Scott scoffs at the
claim. "If the money is yours, don’t you think you will change to a
healthier lifestyle?"
Compare that with what Jacob Hacker, intellectual
godfather of ObamaCare and the public option, wrote in the latest edition
of the journal Democracy.
Hacker admits the law "looks like a Rube Goldberg contraption …
charitably described as complex." It rests on further expanding Medicaid,
creating exchanges and transforming "the present voluntary, regulated,
subsidized system of workplace insurance into a less voluntary, more regulated,
and less subsidized system." He criticizes the consolidation among
insurers and providers, but overlooks ObamaCare’s role in driving insurers out
of markets and driving
doctors into hospital
physician networks. Hacker’s goal is still to create a public-option that
would become a single-payer. His vision requires public acceptance of the law
Public acceptance of ObamaCare should be difficult to attain. The individual
mandate is even less
popular while the federal Department of Health and Human Services has approved
price controls and has "revived
death panels."
The future of health care remains is increasingly in the hands of patients who
use the internet to self-diagnose
and create their own medical histories
despite the best
efforts of the FDA to keep promising new therapies out of their hands.
