Human Exceptionalism

Obamacare: The Unfortunate Call to Emulate the Netherlands

The other day, President Obama referenced the Netherlands as a splendid example of how the “public option,” that is a government plan, worked well with a private system. To The Source contacted me and asked me to reflect on the president’s use of that particular example.

First, the president drastically understated the matter when he stated that the Dutch government was merely “involved” in the country’s health care system.  Yes, there is a dual government/private system, but the private sector is regulated to the point of being handcuffed.  From the piece:

Everyone must purchase insurance from heavy regulated private insurance companies that offer plans with benefits set by the government. While the plans compete with each other on price, each company’s plans must be sold at the same price to everyone regardless of their age and state of health. It is illegal to refuse to sell anyone insurance, to create deductibles, or to refuse to fund treatments that a doctor has determined to be medically necessary. Employers pay 50% of the premiums and citizens 45%, and the government subsidizes people who can’t afford premiums.  Long term care is paid by the government, as is chronic mental health treatment and end of life care, services that are financed through taxation. Insurance companies that have heavy payouts are compensated by the government and a competition regulator ensures that the companies don’t act against the consumer’s interests.

That’s a lot more than just being “involved.” In a country the size of the USA, instituting such a heavily regulated, universally mandated two-tiered system would, to say the least, be an administrative challenge.

But given widespread fears that Obamacare could lead to death panels and the more realistic worry that rationing boards that will cut care for grandma, using the mother of all death cultures as an example for us to emulate was really maladroit.  I go through the Dutch euthanasia horrors: expanding categories of the euthanized to and including the depressed;  non voluntary euthanasia, infanticide, etc. Does this mean we will “fall off Euthanasia Cliff” if we follow Obamacare?  Not necessarily, but the money issue could prove relevant given Oregon’s offering to pay for assisted suicide while denying chemotherapy to cancer patients on Medicaid.  Also, Derek Humphry calls the cost saving potential for widespread assisted suicide the “unspoken argument” for legalization.  I conclude:

Don’t get me wrong: There is no evidence that Obama plans for assisted suicide/euthanasia to become a means of easing our strained health care budget.  But his proposal would mark a major change in American law and morality. Thus, if Obamacare breaks down Hippocratic medical ethics—as I think it would—if its proposed centralized cost control board imposes health care rationing and a concomitant duty to die—which, given the views of his closest health care advisers, it very well might—and if assisted suicide/euthanasia ever becomes merely another medical treatment choice—it is now legal in three states—the Netherlands may turn out to be more of a model for American health care than even the president may now suppose.

Obamacare is one of the most serious domestic public policy debates of my lifetime. I think it would accelerate other unfortunate cultural shifts that we are experienced–resulting in a social disaster, particularly for the weak and vulnerable.

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