We Won’t Get Fooled Again!

Change it had to come
We knew it all along
. . .
I'll tip my hat to the new constitution
Take a bow for the new revolution
. . .
Meet the new boss
Same as the old boss

— The Who

B y the time you read this, the attempt of our federal legislators to create a universal healthcare system may have triumphed. If so, those of us who take health into our own hands may have rough waters ahead . . . to say the least. Why? Because, far from merely providing competition for the insurance companies, the plans proposed (and instituted by now?) will surely drive these poorly profitable businesses (with profit margins at a meager 3%) out of existence, with no alternatives but the government “option.” Government doesn’t have to make a profit to survive, so it can “out-compete” insurance companies, and—for that matter—nutritional supplement companies too.

If the plans win the day—as Nobel Prize winner Friedrich August von Hayek suggested by the title of his 1944 book—we may indeed be on The Road to Serfdom. Back at the end of World War II, the power of Hayek’s ideas succeeded in transforming the political landscape, shifting how millions of people thought about socialism, which, after all, is centralized government planning that ultimately extends to everything. Socialism always starts out with the “good” intentions of rectifying some alleged injustice, and ends up making all private decisions into public ones. This is the essence of socialism, whether it be of the nationalistic or “communitarian” variety. The nutritional supplement industry cannot survive the kidnapping of choice, the right to make our own healthcare decisions.

The Individual is Where Health Starts and Ends

“Whose life is it, anyway?” some of us may ask. What the coalition of politicians has proposed in its healthcare plans is not a subsidy to enable people to get the care they need. Rather, it is a attempt to transfer decision-making authority from individuals to government bureaucrats. Why?

Healthcare is too costly, we’ve been told. Plus it’s “unfair.” However, the time before pre-significant-meddling-by-the-government (pre-Medicare) was a period of fewer problems and worked a lot better than what we have today. Just like our political system, the medical system is broken with gloomy prospects at this point, and for the same reasons.

The Board of Decisions

In the newly proposed plans, Federal boards will make all the ultimate health decisions. Will they examine or see the patient in question? That’s unlikely, especially given its disdain for physicians. Will the decisions be timely? According to Dr. Ronald Dworkin, an anesthesiologist writing in The Wall Street Journal, the plans include reducing the reimbursement for anesthesia by 50%.1 That alone translates to allocation problems and prolonged decisions. Dworkin is especially concerned because, “In surgery, people die in days and weeks—a doctor has time to fix a mistake. But in obstetrics and anesthesiology, they die in minutes and seconds.” Beware, beware!

But now, there is hope that the word is getting out, particularly among seniors, an influential voting bloc. In a July 29 Washington Times editorial,2 a key adviser to the advocates of centralized planning on cost-efficient health care, prominent bioethicist Dr. Ezekiel Emanuel (the brother of White House Chief of Staff Rahm Emanuel) has written about rationing health care for older Americans, under what he calls the “complete lives system,” a form of rationing that is fundamental to the health planners’ goals. In effect, if you’re 65 or older, you’ve had more life years than a 25-year-old. Justifiably, the younger party is more deserving of cost-efficient health care than the older one. Quoting Dr. Emanuel directly from a medical journal, this is justified because … “Unlike allocation by sex or race, allocation [of medical care] by age is not invidious discrimination; every person lives through different life stages rather than being a single age.”3 That’s enough to make a lot of fine former people roll over in their graves.

Ignoring the Consequences of Collective Decision Making

It is important to stress that when Congress returns from its summer recess, what they are really deciding on is rationing, which is a fundamental part of the eventual master healthcare plan, whether called government “option” or, more recently, a government “co-op.” Make no mistake. The executive and legislative proposals are a continuation of a no-growth, redistributionist mindset, joined by a collectivist, elitist, and authoritarian philosophy of government. If we buy into these ideas—which we can only do by ignoring the consequences they’ve produced elsewhere—we end up favoring humanity over individual humans, and closing our eyes to the tremendous costs that such utopian visions inflict.

In these centralized planning proposals, individuals are unimportant and no longer have the freedom to contract as they see fit nor to make their own best judgments. Bureaucrats will evaluate whether one is young enough to warrant dementia medicine or a pacemaker or a new hip, or whether hospital readmission can be justified. Under the proposals put forward, medicine as an art would be transformed into nightmare of Kafkaesque bureaucracy, in which the peril of disagreeing with the government’s approved “effective treatment” could very well be a direct risk to a physician’s career.

Promoting our Own Life and Happiness

As Americans, we believe that individuals have rights and among these is the right to be able to decide for oneself—without interference from government—as best as each is able, conducive with promoting one’s own life and happiness. There is nothing more important than the ability to control one’s own health.

While it is unfortunate that everyone is not equal when it comes to ability or willfulness or the necessary knowledge to solve the problems of life—including taking care of one’s health—this should not place a liability on achievers. For those less fortunate, America has always been a land of private charity, pitching in to help those who, through no fault of their own, are needy from time to time. The political proposals to make health security into a bludgeon and use the real problems that exist as stalking horses to achieve very different goals are awful. Centralized planning, should it take hold, will alter the course of America from what it was and what it should be. Paraphrasing Benjamin Franklin, “Any society that would give up liberty to gain security deserves neither and will lose both.” Let’s not let that be the case.

Live long and prosper,

Will Block


  1. Dworkin R. An Anesthesiologist’s Take on Health-Care Reform: Expect a two-tier medical system and needless ER deaths if Congress and the White House have their way. The Wall Street Journal, August 19th, 2009.
  2. Editorial: A euthanasia mandate—Bureaucrats could decide who lives or dies. The Washington Times, July 29, 2009.
  3. Persad G, Wertheimer A, Emanuel EJ. Principles for allocation of scarce medical interventions. Lancet 2009 Jan 31;373(9661):423-31.

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