The devil is always in the details.  President Obama's proposed "reform" of the health care industry, which comprises approximately one-seventh of the US economy, is no different.

In response to the claim that the President was not providing enough leadership on the issue, President Obama gave a speech to a joint session of Congress last week (a transcript of the entire speech is available here).  The White House also issued a "concise, printable version" of the "Obama Plan for Stability & Security for All Americans".  There are some interesting, devil-containing statements that sound innocuous at first, but become easily more tricky upon further examination.

The first sentence is basically a mission statement:

"It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t.  And it will lower the cost of health care for our families, our businesses, and our government."

Now other than the fact that starting sentences with "And" is a no-no, what's not to like in that?  Unfortunately, the details of the plan, or rather, what are presented as details in the document (no actual piece of legislation is ever "concise") act in such a way to contradict the very essence of the plan's supposed goal.  How?  Let's look at a few.

The first section of the plan is titled "If You Have Health Insurance:  More Stability and Security":

• Ends discrimination against people with pre-existing conditions.
• Prevents insurance companies from dropping coverage when people are sick and need it most.
• Caps out-of pocket expenses so people don’t go broke when they get sick.
• Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money.
• Protects Medicare for seniors and eliminates the “donut-hole” gap in coverage for prescription drugs.

Now, there are many who are in favor of a government regulation prohibiting denial of coverage based on the "pre-existing condition".  But this takes it a step further — "end[ing] discrimination" altogether?  If there's no discrimination whatsoever, then does that mean that I can't be charged more for insurance coverage if I have, say, high blood pressure caused by bad diet, or diabetes?  Not only would this seem to remove incentives for people to act in a more healthy manner (thus lessening their health care bills), but also would serve to increase the costs of health insurance for those that don't have pre-existing conditions.  That hardly seems fair.

In eliminating "extra charges for ... mammograms, flu shots, and diabetes tests", again, the consumer can lose.  Why should I, as a male, be forced to subsidize the cost of mammograms?  Or say I have a strong immune system and choose not to get flu shots, or eat healthfully and don't get diabetes — by mandating no "extra charges" for these items, it means that the costs are spread out among everyone, even those who never use those services, as well as picking and choosing which special interests to serve — what about, say, prostate tests for men?  Or skin cancer screenings?  Don't those also potentially "improve health and save money"?  Some consumers — even women who would be getting mammograms regularly — might prefer to choose a less expensive, less encompassing health insurance plan and either pay for those other services out-of-pocket or through a health savings account.  Why shouldn't we have that right?

Finally, in expanding the Medicare prescription drug plan, it extends the idea that someone deserves to have their prescriptions paid for by the confiscation of property from others, regardless of either person's income level.  Warren Buffet, one of richest people in the world (if not the richest), currently qualifies for Medicare's prescription drug plan.  Why should my taxes go to providing billionaires with health services?

The next section is called "If You Don't Have Insurance:  Quality, Affordable Choices for All Americans".  It contains the following:

• Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.
• Provides new tax credits to help people buy insurance and to help small businesses cover their employees.
• Offers a public health insurance option to provide the uninsured who can’t find affordable coverage with a real choice.
• Offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.

First of all, why does a "new insurance marketplace" need to be created at all?  There's already an insurance marketplace, although it is limited by federal mandates against buying across state lines and the organization of group plans, and mandates on minimum coverages.  Why not keep the current marketplace, but open it up to give consumers more choice by dropping those prohibitions and mandates?  True competition would produce competitive prices — that's how markets work.  But government limitations restrict supply and competition, keeping prices high and choices scarce.

Then there's the so-called "public option" — the government plan.  Much has been written about it here and elsewhere, and deservedly so.  The federal government is not an insurance company, and no amount of mandated bureaucracy can turn it into an efficient, effective one.  Described by advocates as a way to ensure competition, it is perhaps the single most controversial part of the President's proposals, dividing even Democrats.  But just as it isn't competition with the US Postal Service that propels new innovations and efficiencies among FedEx and UPS, health insurance providers don't need a government health plan, especially one designed to eventually swallow private competition.

As always, the devil is in the details of the "Exchange" and the "public option", but the intent is clear.  In seeking to answer Congressman Joe Wilson's now famous cry of "you lie!" during the President's speech with regards to coverage for illegal immigrants, the White House released a set of revised guidelines that contained this gem (emphasis added):  "Undocumented immigrants would be able to buy insurance in the non-exchange private market, just as they do today. That market will shrink as the exchange takes hold..."  Far from promoting true competition on an open, free market, the "public option" will seek to limit it in favor of the government plan.

The final section of the White House plan is titled "For All Americans:  Reins In the Cost of Health Care for Our Families,
Our Businesses, and Our Government".  While just the title is laughable — since when does greater government intrusion result in lower costs? — the text of the section reads as follows:

• Won’t add a dime to the deficit and is paid for upfront.
• Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.
• Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.
• Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.

First of all, kudos to the President for recognizing the importance of medical malpractice reform; malpractice insurance itself is a huge cost to doctors, and of course that cost is passed along to consumers.  The threat of malpractice suits also can result in the ordering of unnecessary tests and procedures as hedges against missing something.  Here, however, the devil is in the lack of details, as there has been little talk about what kinds of malpractice reforms would be employed and on what timetable.  To my knowledge, this area has not been one of much focus for any of the current Congressional plans in the process of markup.

By requiring employers to provide health insurance for their employees, the President's plan raises the cost of hiring workers.  Such added costs would be mitigated by employers in one of two ways:  either by hiring fewer workers, or by paying less in wages.  With the current unemployment rate at 9.7%, is increasing the cost of labor a good idea?

Question:  where in the Constitution is the federal government authorizes to "require" anyone to purchase health insurance?  Whether I can afford it or not, the purchase of health insurance (and of how much) should be my own business, not that of politicians in Washington or elsewhere.

Question:  do you really trust "an independent commission of doctors and medical experts" to identify much in the way of "waste, fraud and abuse"?  Really?!?  I don't.

Finally, that the President's "reform" plan "won't add a dime to the deficit" is again laugh-inducing.  Really?  You're going to mandate more coverage to more people through more government programs and bureaucracies, and do it for free?  Not only does it defy common sense, but it defies the non-partisan arbiter of what government programs will cost:  the Congressional Budget Office.  According to the CBO's "preliminary assessment[,] the provisions of the legislation pertaining to insurance coverage would increase federal deficits by $645 billion over the 2010–2019"; expansions in Medicaid eligibility that some of the Congressional plans advocate  "would probably bring the total federal cost to more than $1 trillion".  Well, the President is, I suppose, technically correct — neither $645 billion nor $1 trillion are a dime...

Those are just a few of the devilish items lurking in the President's plan to reform our health care system.  That's just in a one-page summary of the President's plan, and the various Congressional plans are thousands of pages.  The stakes are too high and the potential damage too great to allow this plan to pass.