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Critical Condition

NRO’s health-care blog.

Keep Your Eye on the Ball



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It’s been a real slugfest, and America’s team is behind something like 60 to 40 with two outs in the bottom of the ninth, no one on base, and a two-strike count on the world’s premier health-care system. Ideology is on the verge of trumping reason, and the huge outfield scoreboard is flashing “ELECTIONS HAVE CONSEQUENCES.” It would have been different had Republicans not strayed so far off base earlier in the decade. Unfortunately, there are no instant replays! But as a famous philosopher once said, “It ain’t over till it’s over.” It will require the public’s collective eye fixed on the ball.

The debate should not be about $900 billion or $1.2 trillion or any factitious estimated figure that history shows will be off by a factor of seven to ten to twenty (see Medicare, Medicaid, and Social Security). It should be about health care, life and death, quality of care, rationing, government control of medicine, careers, and the ability to practice medicine without overbearing bureaucratic control of professional decisions that should be left to doctors and patients.

Similarly, it does not matter if legislation emerges with or without government-financed abortion or a public option or so-called cooperatives (financed by government of course) or triggers that can be added later once there is a foot in the door for the government to control one-sixth of the U.S. economy. Those items and many more will be bartered by politicians later. They are all side issues. Remember, both the Senate and House bills provide for taxes, fees, and mandates almost immediately, with the alleged benefits scheduled to arrive three to five years down the road. This whole process has been completed behind closed congressional doors, with one party negotiating with itself.

Senator Nelson’s decision this weekend to support Democratic health-reform efforts was frustrating, but not much of a surprise. It exemplifies the political maneuvering that the so-called Blue Dogs and conservative Democratic senators have perfected. They pay lip service to moderation, and when their vote is not critical, they often vote accordingly. However, whenever their vote is needed to make or break the liberal agenda, they always come around and support the party line.

Even if Obamacare does not include a public option per se, it will inevitably lead to a single-payer health-care system. The bills call for well over 100 new government committees that will dictate to insurance companies what they can and cannot cover, who they can cover, and how much they can charge. The government will control all levers of the system. It’s simply “public option lite,” repackaged just in time for Christmas, with the political elite calculating that the public is too immersed in the holiday season to notice and, regardless, too impotent to stop it. This mutation might take a little longer to attain the Canadian utopia, but it still sets America on a path toward a single-payer system. This is the health-care model liberals have wanted for generations. It won’t save a dime, and will ultimately lead to soaring taxes, restricted access, poorer care, long waits, and rationing.

Higher costs for worse care is not, however, the ultimate irony. Addressing Congress on Sept. 9, 2009, President Obama said there are 30 million uninsured Americans. If all goes exactly as planned, this grandiose boondoggle contemplates 23 million uninsured by 2019. Naturally, there is no attempt at tort reform or interstate competition among insurance companies — two ways to control costs without upending the entire system.

Virtually no one has read the 1,900-page House bill or the 2,000-plus-page Senate bill — which makes the government takeover of 17 percent of the U.S. economy a little surreal. It’s kind of an Alice-in-Wonderland scenario. No, it doesn’t look good. It will take an unprecedented public uproar to table this turkey. And if all else fails, remember the classical baseball adage: “Wait till next year!”

– Jason Fodeman, M.D., is an internal medicine resident at the University of Connecticut. A former health-policy fellow at the Heritage Foundation, he is the author of How to Destroy a Village: What the Clintons Taught a Seventeen Year Old.



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