Modern medicine is founded on an important ancient precept: “First, do no harm.” In my medical experience – which is considerable, from the patient side of things – doctors and other medical-care professionals are very mindful of that precept and take great care to live and work by it. I owe them a great deal for my quality of life.
In more recent days, however, an influence that has little acquaintance with this important precept has intruded onto the medical-care scene. Politics is its name, and carving out vast new areas of influence and financial control over the country is its game. In particular, the Democratic Party has spent much of the past century questing for the “holy grail” of liberal politics: i.e., complete political control over health-care via mandatory, government-designed health insurance. A significant milestone on the path to that objective was the 2010 passage of The Affordable Health Care Act, which essentially oversees 1/6th of the US economy. It passed without a single Republican vote after controversial legislative maneuvers to push it through. Democrat celebrations were long and loud.
Obamacare was not really about medical-care. It was all about politics. Thus, it passed because its framers made lavish promises that they – as well as numerous economists and other analysts – knew could not possibly be kept. These included:
- Health-insurance will become less expensive under the new program;
- Medical costs will be controlled and diminished;
- You’ll keep your current insurance plan, as well as your doctors, if you wish;
- Millions of currently uninsured Americans will be covered;
- “Cadillac plans” offering outrageous benefits will be taxed to “level the insurance playing-field;”
- Healthy young people who have not been insured before will have to buy a policy or pay a fine;
- The much-hated exclusions for “pre-existing conditions” will be eliminated, and every insurance plan will have to provide “free” birth-control drugs and procedures (i.e., abortion); etc., etc.
Shills for the plan claimed that the new medical-care economics would actually reduce the federal budget deficit. It would be a political miracle. (Almost a rapture!)
Most of these promises have evaporated like the morning mist, as the cold fiscal realities of the new program set in during the six years since its passage. Instead of decreasing, insurance costs have soared – including huge new deductibles that must be paid before coverage kicks in. Medical costs have also gone up. Many people have seen their old plans cancelled and access to their well-liked doctors severed. Most “Cadillac” plans have been exempted from tax via political connections. New subscribers are mostly older and sicker people, while young, healthy people are staying away in droves. Pre-existing-condition provisions are indeed gone, and the “free” birth-control drugs and abortions are available – increasing costs for most policy-holders. The much-touted reductions in the federal budget – always considered complete rubbish by serious analysts – have never materialized.
The AHCA is broadly unpopular, and Republicans have now run three electoral campaigns on promises to repeal it. Although they failed to defeat President Obama in 2012, they have succeeded in regaining control of both the House of Representatives and the Senate. Despite this, they have completely failed to modify or repeal the program. Indeed, the 114th Congress – currently in session – has not sent a single piece of legislation to the president that would undo part or all of the law. Republican leaders have clearly given up trying, and members are not of one mind on the issue.
In that respect, the Congress mirrors the general attitude of the electorate. It reminds us that any significant political program is designed with three groups of voters in mind: (a) probable winners; (b) likely losers; and (c) “spectators” unaffected by the proposed program. The chief task of politicians wishing to pass a new program is to ensure that the total population of groups (a) + (c) far outweighs the numbers in group (b). It is a tried-and-true political tactic with a long pedigree. When Social Security was designed and passed in 1935, for instance, economists already knew who the winners, losers and spectators would be.
Social Security winners would produce great political benefit for Democrats because their wins would come early on. They included older people who would pay very little into the system, but realize significant benefits. My own grandparents were in this group. They were already past retirement age in 1950 when the Farmers Extension Act was passed. After paying a minimal amount of FICA tax for 18 months, they began receiving a pension in 1952. My grandmother lived until 1971. Over those 19 years she and my grandfather drew at least $25,000 in benefits. There’s no doubt that they needed the money. They didn’t have a bean. But they and millions of others like them kept Democrats in power for decades thereafter.
The program was a political master-stroke. The beauty of it was that the losers were younger people who wouldn’t realize they were losers until far out in the future, when the flaws in the program began to show up. Indeed, the biggest losers would be people who weren’t even born when this inter-generational Ponzi-scheme was hoo-hawed through Congress. A relatively small group of railroad-employees and government workers were part of the unaffected group who had no skin in the game. The program soon became known as the “third rail of politics” – touch it, and you die. When Barry Goldwater advocated phasing out the program in 1964, his presidential campaign was thoroughly routed. Social Security was invulnerable.
Obamacare was constructed with these same three groups in mind. It was rolled out on a schedule that disclosed the program’s “losers” over several years – with a weather-eye to Congressional and presidential elections. This piecemeal infliction of pain provided time for the program to become a national institution. Undoing it would become nearly impossible, as frustrated Republicans would soon realize.
The “losers” group in the Obamacare game is actually quite large, although many in it don’t yet know that they will be losers. Many have already taken financial hits from the program, but the pain seems manageable and bearable. Others have taken very hard blows – mortal, in some cases. I want to relate an account about one such person that has come to my personal attention. His story is pretty depressing.
I heard the story from a talk-show host who broadcasts in the Washington, DC, area. He is very conservative, and has often joked about his old friend who was far over on the liberal side of politics. They agreed on very little about culture, business or politics, said the host, but they were still solid, long-time friends.
When his friend fell seriously ill, the radio-host became concerned and urged him to go to the hospital. But he didn’t go. Weeks passed, and on each visit his friend seemed sicker. At one point the friend confided that his Obamacare policy carried a $9,000 deductible. He didn’t seek hospital-treatment because he knew he couldn’t afford to pay the bill. Finally, seeing that his friend was in dire straits, the radio-host took action. He drove to the friend’s house and said, “Come on – we’re going to the hospital, and I’ll pay the bill.” He got his friend admitted. In the movies, this would be the rosy, fadeout ending we all look for and expect.
But real life – as I’ve often noted – is not a movie. It was too late, reported the talk-jock – his voice obviously choked with emotion. The doctors could do nothing. Last week the radio-host was present as doctors disconnected his friend from life-support. He died instantly. The host said no more on the air, but he didn’t have to. There are some real losers to this disastrous program. This was just one of them, but it’s hard to match for sheer wretchedness. Watching a friend die because he couldn’t afford the insurance deductible – is that where we are now? God help us!
Critics will say this story is only an “anecdote” – not really a statistical measure of the Affordable Health Care Act. They’ll be right, of course – at some level. But the event was real, searing and terrible to those who loved that young man and had to see him sacrificed to a misguided social program. He would certainly have received timely care before Obamacare closed off his avenue to the treatment he needed. Government killed him just as surely as if some official had pointed a gun and pulled the trigger. No one intended to kill him, but the program was constructed such that it was bound to happen. Remember him when you hear someone preach that government can actually “solve” our problems. And pray that you’ll never have to trust government to solve yours – especially if it’s a medical problem.
The horror of the radio-host’s emotional report was like an arrow through my soul. It made me re-examine my failures to look outside my own small concerns – especially against the backdrop of a recent tragedy closer to home. Last fall a young man in our extended family suddenly collapsed and died from an intestinal ailment that no one knew he had. His wife found him on the bathroom floor when she returned from a midday errand. Medical technicians could not revive him. In retrospect, we suspect that he probably didn’t realize, himself, how serious his condition was. Instead of seeing a physician for treatment, he was trying to self-medicate while maintaining his demanding work-schedule.
Dave was only 28. He had been married for just a year. His death crushed his wife and his parents, and shocked his many cousins – some of them close to his age. How could someone this young die? Old guys like me are supposed to die, not a vital young guy like Dave with his whole life ahead of him. What about all those glowing reports of how Obamacare would furnish such wonderful medical care for everyone? Is there anything we can trust to help us?
These questions get right to the heart of the matter. The truth is that government cannot really take care of us. Perhaps it can, in the macro-sense of national defense and the like, but not at the individual level. Individuals must take responsibility for themselves, and families must pay more attention to their younger people who simply haven’t lived long enough to know what they need to know.
I am filled with remorse for having neglected to ask Dave’s parents about his health. I’m not a doctor, but when I last saw him I could see that he wasn’t well. Could I have helped him? I don’t know, but like most Americans I’m reluctant to interfere in another family’s affairs. My sister is a nurse. She admits that she also saw that Dave was ill, but she didn’t inquire either. Ultimately, Dave failed to look after himself, but we all failed him, too. I’ll always regret it.
I imagine the radio-host is wracked with the same remorse: kicking himself for not paying enough attention; regretting that he didn’t act in time; grieving for the loss of his friend. I second that motion, so I have vowed never to let such a thing happen again if I have any ability to help. Life is far too short, too fragile and too precious to entrust it to a faceless, emotionless government. The responsibility is ours. We need to embrace it.