Obama-care: A Mixed and Heavy Bag

No.: 
60

President Obama’s national health care agenda is big, bad, and bold. It is also better in various important respects than what we have currently. However, it is fatally flawed. The seriousness of the flaws outweighs the plan’s efficacies and virtues. As a result, the U.S. Congress should reject this legislation and address the fact that the nation consumes too much expensive but ineffectual health care.

Prepare for profound government growth and a shrinking private sector apart from health care. It won’t be long until the majority of our economy is staked on deficient education, ineffectual health care, predatory financial services, big bureaucracy, monetary redistribution, imperialist defense and surveillance style homeland security. We will be highly dependent upon foreigners for much of the rest, weakened by excessive immigration, debt and hedonistic habits. We are the new Rome at the old sunset, our tipping point reached, perhaps, in late 2008 when our national political leadership chose to underwrite the rescue of banking elites blinded by greed.

The $900 billion Obama national health care plan is essentially bailout number two — this time for a failed Medical Street. Like the Wall Street bailout, Congress will make wrong choices because the pressure to act is great and there is no momentum for a wise alternative. The Republican options simply cater to a different set of special interests. The common good cannot be well served when both sides are endeavoring to grease the palms of key constituencies.

Our nation needs to move beyond a polarized debate and investigate this policy crossroads. Obama pledges a revenue neutral plan, but that idea is as specious as the one a decade ago that projected massive federal surpluses far into the future. Today’s economists have a knack for looking through dark glass and seeing whatever they want. It is an age of delusions as evident in religion, education, sex, consumerism and speculation. So, what can we expect from politics when it is front-loaded with vested interests?

President Obama’s national health care speech on Sept. 9 was eloquent and stirring, but not equal to the best presidential speeches of the pre-television era — speeches written by statesmen and articulated without teleprompters. We are left hoping that an elocution that matched some of President Reagan’s best performances does not prove to conceal such seriously errant projections as camouflaged by Reagan’s oratorical skills. Reagan did not anticipate the enlargement of debt generated by his supply side initiatives. Nevertheless, it was that debt that pulled the nation toward unsustainable economic growth.

While the Obama camp shows political adeptness in moving away from some of the discredited language of universal health care, Americans are left with important questions. One key question is this: How can an administration dramatically expand societal access to “get as much as you can take” medical care while maintaining care quality, choice in accessing preferred providers, and a reduction in national health care expenditures? Like the old saw goes: If it sounds too good to be true, it probably is. We’re still experiencing fallout from the previously fashionable idea that housing values take a one-way trip up.

There is so much to be enjoyed in life that many people will pull out all the stops to get every bit of technologically advanced medical care they can obtain for themselves and loved ones. Since care costs are often socialized, little conscience is left about the intemperate use of health care benefits. Indeed, doctors and hospitals have little incentive to consider the alternative costs of societal expenditures on health care, especially in an environment where it is unfashionable to put any limitations on the value of an American life. Granted, there is an ethical reality here that deserves exploration as well as a cost and benefit equation. However, both considerations rest outside the typical range of politically viable dialogue.

The cold truth is that medical technology and drug innovation has outstripped the nation’s ability to pay for everyone to experience “the full health care life.” The political rhetoric is that in a rich nation, no one should have to go without health care. Granted, we can’t afford to give everyone a McMansion, a Mercedes Benz, and a month on a Parisian holiday. But, dang, if some people don’t shout “social injustice” at the mere vocalized doubt of whether every American can be afforded a government checkbook if their health heads downhill.

According to data at Bankrate.com, the Federal Reserve estimated the median American household net worth at about $86,000 shortly before the financial crisis struck (2007). While the median value is less than the average, we’re left with the problem of how to give everyone full quality end-of-life medical care when that care involves at least five times greater costs than encountered before the last year of life. Indeed, at a time that financial advisors are encouraging well-heeled couples to put aside several hundred thousand dollars to pay for Medigap insurance premiums, is anyone considering where this kind of money comes from? Should the nation’s entire net equity be consumed on health care? Obviously, something must give.

A hospital can generate $150,000 of services for a heart patient, only to release in many cases a person whose days are numbered. It is a lot easier to spend $150,000 on medical treatment for an ailing body than to manufacture and install $150,000 of solar power equipment. With treatments running several thousand dollars a pop, a needle stick here and a few pills there can eventually add up to more than the cost of a student’s university education. Where should a nation’s priorities be when human bodies are born to die and health care has invented countless ways to make the dying process infinitely expensive?

The raw truth is that nationalized health care in its planning stages is a far-reaching tax scheme that rewards moral hazard and redistributes wealth. (The current insurance environment is even less defensible!) Those who carefully maintain their health through self-discipline and moderate lifestyles must subsidize the behavioral proclivities of those who put a premium on intemperately maximizing self-gratification or foolishly failing to demonstrate basic competency in self care. How does this strategy build national greatness? Indeed, we will soon tax the families of those who die courageously (i.e., without heroic measures to prolong degraded life) so we can do homage to those who expect others to subsidize their inability to let go.

If people want to prolong their largely unsustainable lives by every means on their own earned dime, that’s their business. But when they take government money (other people’s labors) and exploit medical technology to do it, that’s social injustice — regardless of whether they’re rich or poor.

President Obama is correct in arguing that something must be done to mitigate risks that people face of being wiped out financially when a simple medical procedure in a hospital turns into a six-figure trauma due to a surgical infection or complications. Middle class lifetime savings should not be risked by stepping through a hospital door. We need a new generation of medical practitioners who can provide low cost services that are both physiologically effectual and affordable to working class people. This means moving away from the ‘pop-a-pill’ regime to a holistic medical philosophy that allowed many of our responsible grandparents to live fairly full lives into their 80s and 90s, and with relatively little medical intervention. In short, we are well-advised to resize the health care sector from 16% to 10% of GDP, while trimming the federal government’s role from over 30% of GDP to less than 20%. Properly designed, government need not be big to be effectual.

Let’s applaud President Obama for recognizing the social injustice of combining high cost medical care for simple procedures with high cost health insurance. But let’s also applaud those who insist that a reformation of lifestyle choices, dietary habits and reproductive assumptions must rationally accompany successful reform of health care. There must be rewards for those who succeed in doing good and penalties for those who slack off.

We’ll get change shortly, rest assured. We’ll also pay dearly for the changes just as we pay exorbitantly for our current madness. At least with the change we’ll be out of the fire and into the frying pan — whatever that’s worth.