Nothing puts the health care debate into perspective better than those scooter commercials that often run on television.
The ads hype the benefits of owning the electric vehicles, designed to transport those who have difficulty walking but which, in actuality, are pretty much available to anyone on Medicare, which pays for the vehicles. The ads always emphasize the same line — "with little or no cost to you" — which is a nice way of saying that it's costing all of us.
Those scooters — and all the other latest medications, technologies and products — are really what the health care debate is all about: Who decides and who pays for the level of health care you receive?
Now that the health care vote is done in the House and President Obama has signed the health care bill, maybe we can start focusing on that issue. You might think this is an odd time to bring up the question, mistakenly believing that the health care debate is over. The reality is it won't be over for some time. And now there's a chance that the real debate might get started.
With long-term legal battles about to ensue and a boring procedural chess game starting in the Senate, we can focus on what's at the heart of the issue: the belief that everyone is entitled to health care and the desire to control costs.
The problem is that those two goals are polar opposites. Sure, the proponents of Obamacare will tell you that the proposal that passed the House Sunday will bring down costs. It won't. Costs have continued to rise in countries that have universal access to health care, even those with single-payer systems. And costs have continued to rise in Massachusetts, which four years ago mandated that nearly everyone in the state have health insurance.
We spend so much on health care for the simple reason that there's so much to spend money on, from scooters to scanners to the latest blood thinner. It's a sumptuous feast catered by unprecedented innovation. What's more, the bill gets sent somewhere else -- primarily insurance companies and the government.
Anyone who believes that more people can be let into the party without costs continuing to rise could use a little medication of their own.
"It's just not going to happen," says Michael Tanner, a health care policy expert with the Cato Institute, a libertarian-leaning think tank.
Tanner got it right four years ago when he foresaw the outcome of the Massachusetts mandate which, in providing coverage for all, also promised to bring down costs. Instead, as Tanner predicted, costs have continued to rise. Now the state is considering Draconian cost controls.
Tanner sees the same thing happening at the national level if Obamacare stays on course. The only way to control costs, Tanner notes, is to provide less health care. So the question becomes, who is going to have the power to say "no" and "yes" when it comes to deciding which medication, services and products you receive?
Most people on private insurance know that insurance companies have had that power for some time. Now we're on the road toward giving more and more of that power to the government. It's time we start talking about ways of giving more of that right to patients.
No, the current path won't lead to death panels, but it will hasten the march toward increased rationing.
It's not what most of us want to hear, but facing that reality would allow us to stop kidding ourselves and focus on the real issues. In the end, that's a healthier approach for all of us.