Facing growing public skepticism and falling approval ratings as a result of his push for nationalized health care, President Obama told a group in Virginia last week that he didn’t want, “the folks who had created the [health care] mess to do a lot of talking, I want them to get out of the way so we can clean up the mess.” It was a remark meant to rally the base to Obama’s side, and shore up his flagging poll numbers on the issue. Obama may have thought he was chiding Republicans in making the comment. But even a cursory look at the “mess” in the American health care system shows that on the issue of who is responsible, the president’s remark is as wrong as it was arrogant.
Health care experts across the spectrum can agree that there are three main problems with the health insurance industry in America today: community rating, which forbids insurance companies from charging premiums based on an individual consumer’s health status; the practice of defensive medicine, under which doctors order numerous costly and often unnecessary tests to cover themselves against the possibility of malpractice lawsuits; and employer-based coverage. Each of these problems, which together contribute most to the “mess” in health care delivery, were all either brought into existence, or are perpetuated by Democrats.
Employer-based coverage came about during World War II as a consequence of the National War Labor Board’s decision to institute wage and price freezes in an attempt to prevent production shortages due to labor unrest or inflation. The NWLB exempted fringe benefits like pension plans and health insurance from the freeze, meaning employers could compete for the dwindling pool of skilled workers by offering ever-increasing health insurance coverage. Workers grew accustomed to receiving health benefits as a condition of their employment, and the system of employer-provided health benefits became an American institution.
Although the NWLB decision may have sprung from the best of intentions at a time of war, it grew from the progressive tendency toward control. The consequence for today’s health care debate is that generations of Americans were separated from the cost of the medical care they received. As costs grew, and businesses were forced to cut back on benefits while increasing the employee’s cost share, workers began to feel the increase in costs for the first time. Two of the main drivers of those cost increases have been the practice of defensive medicine, and community rating.
