Beware The Health Care “Nudge” » The Foundry

Beware The Health Care “Nudge” » The Foundry: "The White House public relations team has a problem. Where on earth did people get these ideas about government rationing health care? They ask. Why do people imagine they will lose their private health insurance coverage or doctor? After all, the President repeatedly says that will not happen. Period. Why is there such fear out there?

The White House media folks need to look no further than across the street to the Eisenhower Executive Office Building where top Presidential appointees, Peter Orzag and Cass Sunstein hang out. Both have expressed an interest in behavioral economics. Professor Sunstein is the co-author of Nudge: Improving Decisions About Health, Wealth, and Happiness, an interesting book, which emphasizes the official presentation of information in a manner that “nudges” individuals to make certain decisions.

The giant House bill is chock full of “nudges” and restrictions. Low-income individuals will not be eligible for private health insurance, they will go to Medicaid instead. To the federal government budgeteers, expanding Medicaid is always “better” because the states pay providers 20-25 percent less than private health insurance. Of course, any state Medicaid director will concede that this leads to access problems. Subsequently, 30 percent of ambulatory visits to hospit"