Among the issues most commonly discussed are individuality, the rights of the individual, the limits of legitimate government, morality, history, economics, government policy, science, business, education, health care, energy, and man-made global warming evaluations. My posts are aimed at thinking, intelligent individuals, whose comments are very welcome.

"No matter how vast your knowledge or how modest, it is your own mind that has to acquire it." Ayn Rand

21 August 2009

The Mass Destruction of Health Care

Obama and the Democrat Congress have two main purposes they are trying to accomplish with a health care bill. The very widespread public opposition to aspects of the many health bills which have been discussed, will keep the socialists from getting some of the things they want, but they may very well still accomplish their two principal purposes. These are:
  • To establish the principle that the federal government has the power to regulate all aspects of our health care because current costs seem high and some people do not have health insurance. This will not be spelled out in the legislation itself.
  • To set up the bureaucracy which will give the politicians cover from the severely hard choices of rationing health care which will have to be made as the costs of health care escalate beyond everyone's imagination. An extensive and convoluted bureaucracy will also take some of the responsibility for the high costs off the backs of the politicians.
Whether the public option, or co-ops, or only private companies provide the insurance are very secondary issues, which may affect the length of time it takes to complete the takeover of the entire health care industry, but they are of no fundamental comfort to anyone who believes they have the right to manage and control their own health care choices.

No matter what, the government will require everyone to be covered by a government approved health cost payments policy. Government requirements will be inconsistent with the nature of insurance and will be patterned after the underfunded Medicare and Social Security programs in that young and healthy people are expected to subsidize the older and less healthy people. No longer will it be acceptable for young people to buy insurance which recognizes their actual likely needs and allows those needs to be distinguished from those who are older or who practice lifestyles known to be unhealthy. The essence of the Obama/Democrat plan is to put in place the mechanisms to create a giant further transfer of wealth from the young and the healthy to the older and the less healthy. This is to be added to the already huge similar transfer from the young and the healthy to Social Security and Medicaid recipients.

Now whether these purposes are accomplished with a government option, co-ops, or private insurers matters little. If the government tells a health cost payment entity that it must offer cost payments to everyone requesting it, no matter what pre-existing health problem they may have, no matter that they smoke like fiends, no matter that they weigh 400 pounds, and no matter that they have not exercised since they were young children, the cost of health care for the young and for the healthy will certainly skyrocket. This is because it obviously would do those who argue that government must make health care reforms because people have no insurance because they cannot afford it no good unless they bring down the costs of health care for those people who cannot afford it. The only way to do this is to require a transfer of costs to others. In this case, those others are the young and the healthy, the general taxpayer, and those on Medicare in some combination. Probably in the end, it will be all, but mostly it will always be the young and the healthy.

Of course, there will be some pressure then to pressure those with unhealthy lifestyles to give them up in order to save money. This will be called preventive health care, which it is, but it is also very intrusive into the private lives of people. General rules, which will not recognize the individuality of each person, will be applied to everyone and no one will be allowed to believe that they own their own life. They will not be allowed to exercise freedom in any action which may affect their health. All dangerous activities will have to be suppressed. Skydiving, scuba diving, hang gliding, rock climbing, knee-destroying soccer, and football will be considered too dangerous. Of course smoking, drinking, drug use, and sugar and fat intake will also be prohibited on health care cost grounds. If you do any of these things, you will cost the collective money. No personal choice that results in the collective bearing more costs can be allowed. These programs will not start out being very rigorous about such things, but they will evolve strongly along these lines as the bureaucracy sets up the many tens of thousands of pages of regulations which will tell everyone their mandated duties to the collective health care of all.

Of necessity, since all are bearing the responsibility for paying the health care costs of all, since there will have to be more demand for health care, since doctors and other health care workers are going to be taken advantage of and will leave their professions, and because our population is aging, health care costs will go up ever faster. The system which will be evolving couches all issues in terms of the collective's needs, not those of individuals. As a result, each individual will be judged, of necessity, only in terms of his or her perceived value to the collective. In other words, the government-controlled health care system will have to establish criteria for rationing care which consider that young children with disabilities and old people with expensive health problems should get less care, because they are of less value to the collective. Ezekiel Emanuel, the older brother of Rahm Emanuel, the "Never let a good crisis go unused." chief of staff for Obama, is also a top health care adviser to Obama and has considered such issues already in his publications. He claims to have changed his mind in the firestorm that erupted when his articles were read by those concerned with death panels.

While Obama and the Democrats are saying there are no death panels in the legislation, that is true only if the required end-of-life consultations do not put undue pressure on older people with expensive medical problems simply to give up treatments. It is also only true if the system is not so constrained for income that it has options to pay for expensive late life cures if people want them or it at least allows people to pay for their own health care if they want to. The long lived health care system in Great Britain has committees called NICE which make the decisions on when to cut-off medical care as too expensive given the age of the person in question and statistics on average quality of life after procedures are performed. A human life has a value put on it in Great Britain, it is $45,000 per year. Oregon, Tennessee, and Massachusetts already make decisions to cut off medical care based on such considerations. Consequently, it should not matter that Obama and various Democrats claim that no death panels are set up by the legislation they are considering, because such panels are implicit in the assumptions of any such collective health care scheme. They must come in time.

In the name of equality and so-called social justice, all government controlled health care systems deny individuals to pay for medical care which is not offered by the government system to all. This has also happened in Great Britain and in many provinces in Canada.

All economic goods and services are rationed. They are rationed by supply and demand. Advocates of the government option and generally of a government-controlled health care system use this as an argument. They just want to change the terms of the rationing. But it is exactly the terms that are of critical concern. In the Democrat scheme, rationing must be done by political means, while in a free market scheme, limits on medical care are established by the voluntary actions of individuals. Individuals can take care of their health, they can save money to pay for their increased needs for health care in their older age, and they can love and care for their family so well that their family wants to help them when it is needed. All of these options are always denied by the government controlled health care systems. In addition, if doctors are not treated as slaves in the health care system, as they are not in the free market, many of them are likely to give generously of their own time and services. My grandfather did this always, especially during the Great Depression. In government run health care, doctors are not allowed to donate their services, since they are supposed to give all their service to the government-run system. Finally, peoples who are allowed to be productive and to enjoy their lives, always share their good fortune with others both by making everyone more wealthy and through their charity.

Do not allow the Democrats to get away with the claim that their system will not produce death panels. It will and it must. Such panels are a necessary consequence of any government-run plan to provide health care to everyone while trying to hold down costs. Of course they will fail to hold down costs and they will fail to deliver quality health care to everyone. They will have death panels. They will also drain the People of their productivity and their charitableness.

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