On Socialized Medicine

Let's start out with some ground rules: opposition to socialized medicine is not opposition to reform, nor does it indicate a diabolical wish to watch millions suffer without medical care. Ideas like that are the stuff of political pornography, poorly crafted urban myths put forth to discredit opposition to the White House. It's wrong, factually and ethically, and frankly, it's downright silly.

If you continue to believe those tall tales, it will do you no good to continue reading. But if you keep an open mind, by all means, pull up a seat.

When it comes to discussing health insurance reform, my experiences are not unique, but I think they're far from typical. This argument has increasingly become a tit-for-tap of anecdotal evidence, almost all of it referring to a friend or a 'friend of friend' with a sad tale to tell. Well, in my lifetime - MY lifetime, not that of someone I know- I've been covered by both good and 'bad' private insurance - and by its public equivalent.

I know what it's like to pay upwards of $500 a month for insurance when you're making $10 an hour, and what it's like to count out coins to pay for your wife's medicine. I've been hit with a garnishment to pay off my daughter's hospital bills. And, I've had private insurance so thorough that I had twenty consecutive weeks of dental work without paying so much as a dime. All true.

I've also known the shame (and, make no mistake about it, the relief) of being seen under the banner of a state insurance card. I've seen how it rations care (not in theory a bad thing), allocating resources to cast the widest net possible while sacrificing both 'quality' of care and the self-worth of the patient. There are exceptions, of course, wonderful doctors going the extra mile for their charge and accomplishing great things. But if the devil is in the details, than at its purest form socialized medicine is as demon free as your nearest place of worship.

I object to Obamacare on several fronts: Politically, I find the expansion of federal power an abuse of our government's purpose, and an unwelcome intrusion into our private lives. Philosophically, I think it is a corruption of the ideals of self-reliance and independence that forged this nation and its people. Economically, I think it is vague to the point of fantasy, and destined to be an albatross around the neck of our nation for generations to come, and Pragmatically, I think it fails to accomplish the purpose for which it was designed.

Unlike other sites that argue for/against the issue, I won't devote much time addressing my first few objections. I have no interest in joining the vast number of bloggers who constantly preach to the choir. (what's the point in that??)

If you believe in Obamacare, then by definition you disagree with me on those early points. You either believe - or have conceded the argument - that the federal government has the right, duty, intelligence, and administrative acumen to assume the planning, orchestration, and settlement of your individual health insurance needs. You are entitled to your opinion, but frankly, I think you're as wrong as you're ever going to be in your life.

I do not believe that it is the Federal government's obligation or right to assume that mantle of responsibility. I think it intrusive, unwarranted, and a poor omen for the future. We are inching closer and closer to a socialist nanny state. I understand that America now approaches that future with far less dread then ever before, and nearly with open arms - how quickly we as a people look for the easy way out! - but that doesn't mean it's the right path.

Governments don't shrink. They don't. They may wax and wane, but City Hall will always be there, and it will always be hungry for more. This generation is vigorously debating an expansion of the Federal Government, and has already acquiesced to a ridiculous bailout of the private sector. Step forward to the time of my grandchildren, and the dustups of today will have been settled for decades. It all will be commonplace, accepted, par for the course. The government will have continued to grow; in power, in size, in 'responsibility'. A perversion of the constitutional limits imposed upon Washington has repercussions down through the ages, and should not be considered lightly.

In my opinion, it should not be considered at all.

If you disagree and push forward, then I argue that the financial burden of this program is still too much to bear.

We are in the midst of a severe recession, one that necessitated (ha!) the bailout of large segments of the private sector, and the use of gimmicky stimulus measures like the Cash for Clunkers program. In this environment, with unemployment soaring, tax revenue at a minimum, military deployment being expanded in Afghanistan, etc. etc. now - NOW - is the time to push this through?

Was there something I missed in the last election? Not Obama's talking points, which were just that. But if 2004 was about Iraq, 2008 was about the economy, stupid. If you surveyed people last November I doubt "health care reform" would have trumped "keep my job" and "keep my house out of foreclosure", and I'd argue the same holds true now. So why now? Easy. Obama thought it would be a cake-walk proposal, and underestimated American opposition to the plan. Now he's obliged to continue the fight or lose face, and so a plan best left for rosier times must now divert attention and money from areas that need it more.

I'll admit it's hard to get a handle on numbers here, as the White House spins its totals and everyone else does the same, but this isn't going to be cheap. No matter what plan (if any) gets passed, it will necessitate, at a minimum: the creation, staffing, and housing of a new cabinet level body, one massive enough to administrate a plan capable of needing a 1000 page Congressional bill. Local offices will have to be established at the state and city level. Add in the cost of doing business - the accountants, lawyers, claim specialists, clerks, staples, paper, and whatnot, and you'll have to wonder exactly how we'll pay for it.

The answer? I don't know if ANYONE has the answer.

So, despite all his promises to the contrary, we go into (deeper)debt to make this concept happen. Again, if it has to happen - why now?? Is it worth extending the recession just to ensure a President doesn't walk away with his won/loss record blemished?

No, it's not.

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I feel the most compelling argument against ObamaCare, in any of its shifting forms, is the simplest: it will not accomplish its intended goals.

I wish I'd had the courage to write about an experience I had last summer, but at the time I feared embarrassing my father-in-law. He had surgery and was hospitalized at our local VA Hospital. Start to finish, he was seen, treated, care for by, and had his bill paid by the government. Great right? No.

The hospital was overcrowded and dilapidated. The halls were in need of painting and, disturbingly, featured large home made posters reminding the medical staff to follow elementary hygiene procedures. My father-in-law was housed in a dormitory with multiple patients, as if I was watching a movie about the polio epidemic. The equipment was outdated and flat-out looked ancient.

His incision became infected. Worse yet, this: months later, the surgery has to be repeated. Why? Because the VA admitted the surgeon had incorrectly installed the knee replacement.

All this, from a government institution politically untouchable from both sides of the aisle. That,my friends, is socialized health-care. At the time, I wondered out-loud if it would not have been better to scrap the entire VA system, and simply grant the vets carte blanche insurance to go where they wished. I still think that's more cost effective than paying for building upkeep, payroll, etc, and maybe someday Congress will take the hint.

But what would happen if there was nowhere else for them to turn? What if every hospital was under the same pressure, the same guidelines, the same cost constraints? It would be a disaster.

You see, I think everyone should have health insurance. I just don't think the federal government is the best vehicle for achieving that goal.

Why? A hundred reasons, but chief among them: we are a huge and populous country, with vast demographic differences. It is one thing for the U.K. to try to finagle the NHS for a population of 61.4 million, or Canada with its minuscule 33.5 million;California alone has 34 million, New York 19 million, and Texas 22 million people. All told, we have more than 300 million people to insure, five times more than the U.k.

And once again, that is a heterogeneous population. 19% of Florida residents are elderly. The predominantly male population of Alaska is legendary. The bratwurst friendly Midwest has different health issues than health conscious California, and so on.

Can you imagine one insurance plan that could effectively cover all the needs of that population? I can't. But I can guarantee you that Congress, when dispersing funds, would feel compelled to answer to their own constituents - thus making sure that so called flyover country would get the short end of the stick from a Hill dominated by the media and population rich coastal states.

No, federal insurance is not the answer. Heck, the perpetually endangered Medicare program should be proof enough of that.

Do I have all the answers? No, not by a longshot. I don't even pretend to claim expertise. But having run a company where the staff was burdened by excessive insurance costs, I have some ideas.

One, deregulate to allow small business owners to join together and use their combined leverage to obtain lower rates.

Two, when an individuals health history skews the cost of the plan and places an unfair burden on his co-workers, there could/should be supplemental government insurance which restores a competitive balance to that plan.

Three, tort reform. If a doctor is negligent or incompetent, by all means go after him. But medicine is not a perfect science, and the cost of lawsuit-avoiding but meaningless tests places a large burden on the system. The garnishment I spoke of earlier? The hospital kept YaYa overnight for several days, running tests when it was clear she had a stomach virus. At the time, we were first-time parents to a five month old and didn't see the legal reasoning behind the 'necessary' tests. We paid for it in the end; millions of us pay for it each year.

Four, if we are doomed to resort to government health care, keep it at the state level, geared specifically for and paid by the residents of that state. While I have no doubt federal funds would seep their way in, and issues of residency fraud and whatnot would need to be addressed, I think this is the best means of involving government in health care IF THEY NEED TO BE INVOLVED AT ALL. Government works best when it is close enough to feel your heel on their throat; you have a better chance of managing a state run system than you do tackling Washington.

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Just as I don't pretend to have all the answers, I also don't finish this thinking I've changed any one's mind. I've stated my case, just as many of you have stated your own. I promised Lisa I would document some of my thinking on the subject,and I've lived up to that promise.

Let's hope our leaders in Washington live up the promise of our Founders, and continue the fight.