The Most Important Essay Ever Written About Obama and Health Care

Bama clearly is not backing away from health care. In New Hampshire today he was emphatic that health care reform is the only solution to solving this nation's long-term economic woes.

He went so far as to say that almost all of the forecasted deficit is a result of the increasing cost of Medicare and Medicaid. This is sort of silly, as it implies our tax dollars are earmarked for everything but these two costly programs, which is untrue. To a different audience, Bama would be just as likely to claim Defense spending is the cause of the deficit, and I would be equally justified in claiming Social Security is the villain.

For the sake of argument let me take the Campaigner-In-Chief at his word. The first question that needs to be asked is, What are Medicare and Medicaid? The answer: Federal Health Insurance programs. In theory, Bama and his Democrats already own these programs, so if they are the problem, then he is justified in implementing his solutions. No other facet of health care needs to be touched. So what's the hold up? To use one of Bama's own arguments, why give someone a heart transplant if all they really need is a bypass?

Bama doesn't want to reform Medicare or Medicaid. He wants to expand them to include all Americans. He sells it using words like "free", and phrases like, "at no cost to you." He must have said each of these half a dozen times during a 5 minute response to a question after his speech. Bama is clever. He knows that these are terms his constituents want to hear, regardless of context. In fact, the context is only relevant as far as he can go back to it when arguing against critics, but, knowing people will hear only what they want to hear, he willfully and insidiously uses these tactics to make it seem to the public that he's giving everything to everyone, and at no cost!

It is critical to examine his substantive proposals in this light. How does he actually plan to reduce costs? His entire basis of cost savings relies on the idea that a "panel of experts" is necessary to review the basis for and plan for care for every patient. The rationale being that right now most patients in the health care system undergo tests they don't need ordered by specialists they didn't need to see in the first place. Under Bama's plan, patients will first be seen by a primary care physician who will then forward initial findings to a panel of experts for review and issuance of a plan for treatment. Only then might the patient be sent to a specialist.

Bama's "waste", which he estimates will be a Trillion dollars by 2020, is derived almost completely from these "needless" visits with specialists and costly tests, which today, he implies, are simply ways for hospitals to extort more money from its patients.

There are so many problems with his theory its hard to pick a starting point.

Let me start first with his "panel of experts" requirement. I hope it's obvious that introducing a bureaucratic layer between the primary care provider and the specialist that you accomplish two things with absolute certainty: 1)You increase the time it takes to provide care for a patient. 2)You create another layer of cost - someone has to pay for the expense of expertise and time for each member of the panel. You may be able to justify the 2nd absolute if the panel determines a specialist or expensive tests are not necessary, but only if you can prove unequivocally that they would have been ordered otherwise. The 1st absolute, however, can never be reclaimed. If someone dies because they had to wait for approval from a panel of experts, that person cannot be brought back from the dead.

Next, every American needs to be aware that this country is already facing a health care crisis more dire than escalating costs. It is a fact that there are simply not enough primary care physicians to see everyone who wants health care. In many areas of the country, clinics have one MD or even none, so all patients are served by PAs, and may receive a lesser quality of care as a result. It is common sense that if you increase the burden on primary care physicians, quality of care must suffer as a direct result. Either people will be forced to wait longer to see someone from the existing pool of physicians, or the bureaucracy will have to find a way to make more primary care personnel. How do you do that? By encouraging more young people to enter medicine, and since it's unlikely that one of those measures of encouragement is more pay, the only other options are fewer education and training requirements at lower cost. The inevitable result is less experienced, less qualified, and less competent primary care personnel. How can that be good for anyone? I believe this will shift the burden back toward specialists, so I don't see how this requirement saves any cost at all.

We must then consider human nature. If cars were free, wouldn't everyone want the most luxurious car possible? And you wouldn't bother getting it repaired if anything ever broke. You'd just trade it in for a brand new one, and you might do it every year anyway just to have it. After all, it's free! If we were to go with Bama's ultimate preference of a single-payer system, anyone with a sniffle would be in to see their primary care physician. Why suffer when you can get someone to check you out and give you drugs? And who's going to tell Americans they can't go to the doctor when they think they're not feeling well? Again we're presented with two realities. Either people will be willing to congest the system by waiting to get health care for every little thing they think is wrong with them, or the government will have to stop people at the door. Good luck with that.

Now think about the fact that by 2020, when Bama figures he'll have saved America through better, less costly health care, there will be 400 million perspective patients! Where on earth are we going to find doctors for 400 million people? How will the government possibly enlist qualified medical personnel to fill its "panels of experts" to review 400 million cases? We're staring down the gun barrel of the biggest bureaucracy in this country's history! Today, local hospitals review case studies and determine the course of care. In Bama's proposed system, all this would be fed into a nationalized system, which must continually be reviewed for consistency and uniformity of care. That might be ok if every case and every person was the same, but the reality is every patient must be evaluated individually with respect to their history and condition. Its obvious the federal government is in no way capable of conducting any such agency in a way that both reduces cost and improves quality of care. That is an impossibility of the first order.

Finally, health care is a self-perpetuating industry. You partake of health care so that you can live longer, which ultimately leads to you needing more health care the older you get. People should not be required to live to 100 just because technology may be able to keep them alive that long. This is where Sarah Palin was exactly right in labeling Bama's policy as "Death Panels." Because of the reasons enumerated above, the government will decide who can receive care and who can't, and to what extent. As a society we will have little choice in the matter. What is it called when the government decides who among its citizens lives or dies? I would call it a political oligarchy.

Since Bama has been so keen to blame Bush and Republicans for all of his woes, he should chew on this - it was Democrats that created Medicare and Medicaid and Social Security, three of the four biggest burdens on the Federal budget. Now propose real solutions, not just those that consolidate Federal power and create more Federal bureaucracy. Democrat proposals, if passed and unchecked, can only lead to a greater burden on the American taxpayer and an escalation of government spending and control. Believe me, Communism is not so absurd a future reality.

So what is the solution? How do we save America? It seems clear that Social Security, Medicare, and Medicaid need to be abandoned. I propose a cutoff age, say 50 years old and older for those who can expect to get a check and receive care. Everyone else is on their own. I'm dead serious.

How can I say this? Because I believe in something Bama and Democrats do not - the ability of a free market economy to adapt to the consumer. If there is a demand for health care, truly free markets will generate industry to fulfill that demand. It is inevitable and absolute. The alternative - the path we're on now - is certain disaster for this country, and nothing they propose will do anything to stop it.