Debra J. Saunders: On Pelosi and Obamacare

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House Minority Leader Nancy Pelosi explained this week the reason Washington had to pass Obamacare. Even if everyone in America “loved” their health care plans, Pelosi argued in an appearance at San Francisco’s Commonwealth Club, Congress had to pass President Obama’s Affordable Care Act if for no other reason than that American health care was “unsustainable financially.”

Yes, Pelosi actually believes Washington had to get involved in health care to reduce its cost.

The Democratic leader then listed some of Obamacare’s new benefits: “free” annual checkups and preventive care and adult children can stay on their parents’ policies until age 26.

Josh Archambault, director of health-care policy of Boston’s Pioneer Institute, expressed the frustration felt by health-policy wonks who know the new benefits “are not free.” The cost of physicals and services doesn’t go away.

“It’s OK to decide that we should offer something as a preventive service, but we must understand the trade-off of cost,” Archambault noted. “We all pay more as a result.”

Obama also has made the dubious claim that preventive care “saves money for families, for businesses, for government, for everybody.” Problem: It’s not true.

Congressional Budget Office Director Doug Elmendorf warned in 2009: “Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.”

Elmendorf cited a 2008 New England Journal of Medicine article that reported that fewer than 20 percent of preventive services save money, while the rest drive up costs.

Pelosi also told the Commonwealth Club that the Affordable Care Act would mean as much for Americans’ economic security as Social Security, Medicare and Medicaid. Her analogy brought to mind PolitiFact’s award of its 2010 “Lie of the Year” to the Republican assertion that Obamacare represented “a government takeover of health care.”

PolitiFact based its conclusion on the grounds that, under Obamacare, most consumers continue to receive their health care through private carriers and that the new health-care law “relies largely on the free market.” Yet here was Pelosi putting Obamacare on the pedestal she reserves for Washington’s three giant government programs.

There is a difference. The federal government taxes people and pays for those programs. Obamacare, on the other hand, mandates benefits, then passes the costs on to employers.

“Government is not operating the mechanisms in the market,” Archambault noted, “but they are setting the rules of the game.”

Be afraid. Under Obamacare, Congress can take credit for providing consumers with more health care while forcing employers to pay for it. Pelosi, the once and would-be future speaker, actually believes those benefits are free and will cut costs.

Debra J. Saunders is a columnist for The San Francisco Chronicle. Write to her by email at

Also seen in RealClearPolitics and Press-Telegram.