Near the end of The Wizard of Oz, the reader learns that the wizard is really an ordinary man behind a curtain. He describes himself as a good man but a bad wizard.
In a few refreshingly candid moments in the President's speech last night, we caught a glimpse of the admittedly well-meaning man behind the curtain, as he revealed a few of the secrets behind his magic.
How will medical coverage become universal? To quote:
...under my plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.
So free health care really means mandatory medical premiums. Behold the master illusionist at work.
Also, we learn that
Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse.
Sounds good, but wouldn't the insurance companies have to respond to this change by raising their rates, or even leaving the business altogether? Not to worry:
I will not sign a plan that adds one dime to our deficits – either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
As for insurance companies leaving the business:
But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
But the biggest proposed rabbit in the hat is cost savings:
Second, we've estimated that most of this plan can be paid for by finding savings within the existing health care system – a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier. That's not my judgment – it's the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid.
Agreed. But what does this do for the fears of seniors who a;ready have medicare? It re-stokes the fears that rose to the surface earlier with the phrase "death panels". The wizard addresses this head-on:
That is why not a dollar of the Medicare trust fund will be used to pay for this plan.
Oh. And if that is not reassuring enough:
Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple.
Oh good. I was worried there for a minute. I guess they will save money by using divining rods to find waste and abuse. The President must simply have forgotten to explain this fully.
One more question nags at me. Just suppose that the new restrictions on insurance companies cause some of them to leave the business, leaving people uninsured. Wouldn't the public agency have to pick up those people?
[Insurance companies] argue that [they] can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
Yes, Mr. President, your intentions are impeccable. I applaud you for conceding that the critics would be right if taxpayers were subsidizing the public option. But free goods are invariably over-used, This excess of demand over supply has caused rapid inflation in health care prices since the inception of medicare. So wouldn't congress in the future face political pressure to fund this public option, just as it funds virtually every other program it has ever set up?
Where would that leave us? Socialized medicine? Well, imagine that. Who could have predicted it?
Generations have come and gone since "socialized medicine" was a damning phrase. What, after all is so wrong with the idea?
When government enacts a policy in law, it is protected from lawsuits by sovereign immunity. As it must use force in some form, it cannot let itself be held liable if someone disagrees with a policy that seems to cause harm. Thus, taxpayers and patients cannot expect redress through the courts.
However, there are cases when some statute allows damages to be paid. But with a public provider they are paid by the taxpayer rather than by whoever caused the harm. No one goes out of business, so there is less chance that the general quality of care will improve as a result; there is less incentive even to fire bad doctors.
We depend on civil courts to redress damages in the private sector. A secondary effect is to improve the general quality of services by financially punishing bad providers. Neither effect can be expected to occur when the supplier is in the public sector.
The free market provides an immense spectrum of approaches to health care. This allows the consumer to select the approach he or she is most comfortable with. Inevitably, a public provider will offer a much narrower range of options.
Once such a social program starts there will be no going back for a very long time; witness Medicare. You will not be able simply to cancel and take your business elsewhere. Socialized medicine must ultimately contribute to both of life's certainties: death and taxes.
Socialism is tyranny, whether it affects the whole economy or only some selected portions thereof. It is incompatible with liberty, that is to say, with life.
Further Reading:
Greeks Falling Out of Their Trojan Horse
