Fixing Government Healthcare With Your Money

LAST WEEK the president’s health care reform ran off into the ditch. This week, in a flurry of flashing lights, the Beltway wrecker will doubtless haul it back up on the legislative highway. The mainstream media will take a look and declare the it as good as new. But we all know that after you have run a car up on the sidewalk or into a ditch is is never quite the same again.

It is instructive to watch President Obama talk to the American people using center-right language about choice and incentives—“let me be clear about this.’” But he is talking not about choices and markets but about a comprehensive and mandatory administrative program of staggering complexity. It will not deliver choice and efficiency; it will not deliver more health care for more people with less money. It will further rigidify and constrain health care options and, where it subsidizes use of health care resources, run up the costs.

Some people have started to run the Wizard of Oz clip of “pay no attention to that man behind the curtain” as though all this is mere family entertainment. But what is really going on is classic Leo Strauss.

Can this be true? Could the very Democrats that cast a thousand curses at the neoconservative followers of Leo Strauss really be faithful Straussians themselves?

Leo Strauss, you’ll remember, espoused the notion that leaders must speak with a forked tongue. They must communicate one message to the ordinary people and another message to their supporters. Leaders spout harmless pablum to the masses, but speak a coded, “esoteric” language to the those in the know.

So it is that President Obama tells Americans that they can keep their current health plan. But the insiders know that few insurance companies would stay in business if they were competing against a subsidized government “public option.”

President Obama talks about stopping unnecessary procedures. But the insiders read Peter Singer in The New York Times Magazine, and he tells them that rationing is the only way to go.

And the whole exercise is a classic demonstration of government trying to get out of a jam caused by administrative compulsion and subsidy—with, what else? more compulsion and subsidy.

You know how it works. Government starts a program of subsidy—in this case the subsidized Medicare program for seniors. Not surprisingly, seniors use far more medical services than they would if they were paying all the bills themselves. In fact they spend so much that they threaten to eat the rest of the rest of the federal budget. That is the meaning of the $30 trillion in unfunded Medicare liability.

So government comes up with a cunning plan. It proposes to lure non-Medicare Americans into a “public-option” health plan; then it subjects all Americans, including Medicare Americans, to the expert decisions of the comparative effectiveness research community. President Obama vaguely talks about creating “an independent group of doctors and medical experts” that will “eliminate waste and inefficiency” in Medicare. It will presumably use as its basis for decision the work of the Coordinating Council for Comparative Effectiveness Research set up in the stimulus bill. The council is patterned after the British National Institute for Health and Clinical Excellence (NICE). NICE is not nice. It makes utilitarian calculations about the effectiveness of medical procedures and whether the government should pay for them.

Who knows? Maybe the president’s plan will work. Maybe Americans will bow meekly under the knout of government health compulsion. Maybe. But it is more likely that they will become very angry if they discover that their health care is to be curtailed, particularly after they were promised that nothing would change and no new taxes would be needed.

It is one thing to give Americans Social Security when few Americans enjoyed private pensions. It is one thing to give seniors Medicare when most seniors lacked health insurance. It is another thing to start meddling with health insurance when most Americans already have health insurance and are satisfied with their current arrangements.

And the president is betting against history. The record of all government programs is that, slowly but surely, they run down. The combination of bureaucratic rigidity, political chicanery, and special-interest rent-seeking creates a monster like public education. You get a huge establishment costing vast amounts of money. But year by year it delivers less and less. Until one day it runs off into the ditch. Even America’s favorite government program, manned spaceflight, has followed that trajectory. Forty years ago, a second Manhattan Project put a man on the Moon. Since then, nothing.

Most likely the president will get some sort of a bill out of Congress and declare victory. And then a few months later the think tanks will report that the Medicare unfunded liability is now the ObamaCare unfunded liability, and it just doubled from $30 trillion to $60 trillion.

Hey. It’s just your money.

Christopher Chantrill blogs at www.roadtothemiddleclass.com. His Road to the Middle Class is forthcoming.

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Fixing Government Healthcare With Your Money

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