Come for the Politics, Stay for the Pathologies

Monday, August 31, 2009

Obamacare 2.0: Let the Rationing Begin

Once again Charles Krauthammer presents us with much unpleasantness to think about. This time in the form of a grim alternative to Obamacare: Obamacare 2.0.

First the good news. The public option? Out, it scared people to death. End of life counseling? Ditto. Comparative effectiveness studies for use in determining treatment? Also scary, no longer a focus. Cost cutting? Sounds too painful, drop that claim, we can’t do it anyway. After all those concessions you might think Health Care Reform was over for now. Wrong, according to Krauthammer. As is often the case with politics, it comes in through the bathroom window:

Promise nothing but pleasure -- for now. Make health insurance universal and permanently protected. Tear up the existing bills and write a clean one -- Obamacare 2.0 -- promulgating draconian health-insurance regulation that prohibits (a) denying coverage for preexisting conditions, (b) dropping coverage if the client gets sick and (c) capping insurance company reimbursement.

What's not to like? If you have insurance, you'll never lose it. Nor will your children ever be denied coverage for preexisting conditions.

The regulated insurance companies will get two things in return. Government will impose an individual mandate that will force the purchase of health insurance on the millions of healthy young people who today forgo it. And government will subsidize all the others who are too poor to buy health insurance. The result? Two enormous new revenue streams created by government for the insurance companies.

And here's what makes it so politically seductive: The end result is the liberal dream of universal and guaranteed coverage -- but without overt nationalization. It is all done through private insurance companies. Ostensibly private. They will, in reality, have been turned into government utilities. No longer able to control whom they can enroll, whom they can drop and how much they can limit their own liability, they will live off government largess -- subsidized premiums from the poor; forced premiums from the young and healthy.

It's the perfect finesse -- government health care by proxy. And because it's proxy, and because it will guarantee access to (supposedly) private health insurance -- something that enjoys considerable Republican support -- it will pass with wide bipartisan backing and give Obama a resounding political victory.

Sounds pretty good. Is there a catch? Of course. It’s the ultimate bait and switch plan offered by a cynical group of Washington insiders who believe we are stupid enough to swallow it:

Government-subsidized universal and virtually unlimited coverage will vastly compound already out-of-control government spending on health care. The financial and budgetary consequences will be catastrophic.

However, they will not appear immediately. And when they do, the only solution will be rationing. That's when the liberals will give the FCCCER regulatory power and give you end-of-life counseling.

But by then, resistance will be feeble. Why? Because at that point the only remaining option will be to give up the benefits we will have become accustomed to. Once granted, guaranteed universal health care is not relinquished. Look at Canada. Look at Britain. They got hooked; now they ration. So will we.

Predictable reaction from the far left decries Krauthammer’s objection to OC 2.0, claiming we’re already rationing. Thus demonstrating yet again the danger of deconstruction: it renders words that used to mean something meaningless.

Just like censorship, which originally meant the government determined what was fit to print, see or say. But it has devolved now to the point that people talk about private schools “censoring” books, AT&T “censoring” the internet, and ABC, NBC and FOX “censoring” their ads. These are all private enterprises. They are entitled, according to our Constitution and Bill of Rights to “censor”, by which I mean “choose to decide what to promote”.

It’s the government, stupid, that has ultimate power, and therefore is restricted by the Constitution. And that’s why they can’t, and we can “censor” as we see fit. But in the deconstructionist construct, ABC deciding not to run an ad is the same as Hugo Chavez closing down an opposition newspaper.

Rationing presents the same issue. Before deconstruction became the favorite parlor game of the elite left, rationing, in the sense it’s used today, referred only to how governments allocated scarce economic resources. In a free market economy goods and services are distributed by price, as dictated by supply and demand. Because the left wants to say that medical services are already being rationed by health insurance companies doesn’t make it true. It may make the medical procedure more, and possibly prohibitively, expensive to the individual, but it’s not “rationed”.

But now, like censorship, people claim that companies can ration( e.g. evil insurance companies), families can ration (generally known as budgeting), and individuals can ration (for fiscal, dietary and social reasons). The extension renders the term meaningless. Just because an insurance company doesn’t reimburse for a procedure doesn’t mean you can’t have it. It only means it will cost you out of pocket to have it done. I grant you, not everyone can afford it, or will chose to pay for it, but it is available for a price. But with universal healthcare, when the government says you can’t have the procedure, you can’t have the procedure. Ask a Canadian. (Don’t tell me they can come to the US because a) they won’t be able to if we follow their lead into nationalized healthcare hell, and b) that’s like saying China doesn’t prohibit the reading of The Tiananmen Papers, it’s just that you have to go to France to do so.)

Tune in tomorrow for Part II, why Krauthammer’s vision of Obamacare 2.0 will result in everything you fear most about Obamacare 1.0.