Obama's health care 'reform' illusion tells us what we want to hear, not what we need to hear

"What we need from the next president is somebody who will not just tell you what they think you want to hear but will tell you what you need to hear."

— Barack Obama, Feb. 27, 2008

WASHINGTON — One job of presidents is to educate Americans about crucial national problems. On health care, Barack Obama has failed. Almost everything you think you know about health care is probably wrong or, at least, half wrong. Great simplicities and distortions have been peddled in the name of achieving "universal health coverage." The miseducation has worsened as the debate approaches its climax.

There's a parallel here: housing. Most Americans favor homeownership, but uncritical pro-homeownership policies (lax lending standards, puny down payments, hefty housing subsidies) helped cause the financial crisis. The same thing is happening with health care. The appeal of universal insurance — who, by the way, wants to be uninsured? — justifies half-truths and dubious policies. That the process is repeating itself suggests that our political leaders don't learn even from proximate calamities.

How often, for example, have you heard the emergency room argument? The uninsured, it's said, use emergency rooms for primary care. That's expensive and ineffective. Once they're insured, they'll have regular doctors. Care will improve; costs will decline. Everyone wins. Great argument. Unfortunately, it's untrue.

A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency room use remained higher than the national average, reports an Urban Institute study. More than two-fifths of visits represented non-emergencies. Adult respondents to a survey said it was "more convenient" to go to the emergency room or they couldn't "get (a doctor's) appointment as soon as needed." If universal coverage makes appointments harder to get, emergency room use may increase.

You probably think that insuring the uninsured will dramatically improve the nation's health. The uninsured don't get care or don't get it soon enough. With insurance, they won't be shortchanged; they'll be healthier. Simple.