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Equal misery for all

By Richard E. Ralston
web posted June 13, 2011

Americans benefit from the freest and most accessible medical care in the world. Gradually over the last fifty years, however, that care has become increasingly hampered by government controls. The last traces of free-market medicine could soon be gone -- replaced by the brutal intrusion of arbitrary government power at both the state and federal levels.

The final result will likely not be a "socialized" system but a fascist one. Politicians, most of whom love anything that expands the reach of government and their own power, are drawn even more to the creation and manipulation of a political spoils system that allows them to pay off their friends and punish their enemies.

To that end, much political debate in recent years injects egalitarian ideology into the discussion.

For example, Barack Obama, in his candidacy, advocated an increase in the capital gains tax even though such hikes suppress economic activity due to reduced capital investment, and decrease revenue to the government. He said he supported the increases anyway -- because it would make taxes more "fair."

In other words: better that all be worse off than anyone be better off.

More recently, under the pretext of "equalizing burden" and preventing "salary discrimination," Obamacare mandates that insurance premiums must be based on the policyholder's income level -- forget the objective value of the services covered or the health liability of the individual insured. But since the actuarial nature of insurance and the realities of long-term cost management cannot be ignored, the effect is that those with above-average incomes will be subjected to inflated premiums relative to costs.

Note that this provision has not been highlighted in the avalanche of advertising paid for by the government in its praise of Obamacare. These tactics will further the demonizing of private insurance and facilitate the end goal of imposing a single-payer system, under which services are not supplied and priced according to what a competitive market will bear, but rather by what an overbearing government agency will allow.   In fact, the powers of the new "Independent Payment Advisory Board" (IPAB) are so intimidating, and their power to issue unpopular decrees so vast, that Congress attempted to protect it by stating that any repeal or amendment of that power must be ruled "not in order" by the presiding officer of the House or Senate. This attempt to restrict the action of all future Congresses is of course blatantly unconstitutional. And it reflects the willingness of the authors to force all into submission to their agenda.

Perhaps the most immediately harmful application of egalitarianism to our medical care will be the host of new agencies given powers to impose standards of "comparative efficacy," "best clinical practices," and the power to "reduce health disparities across health care disparity populations." Any new drug that can improve or save your life can be forbidden if it does not benefit everyone in the same way. The only hope in such cases is to belong to some favored group. The unique needs of individuals as determined by their physicians are now irrelevant. Individuals will become disparities for which unique treatment is without efficacy.

Many years ago, Winston Churchill, in response to complaints that the benefits of capitalism were shared unequally, pointed out that the "virtue" of socialism is its equal sharing of misery. The virtues of a capitalist medical system -- the hallmark of which is to alleviate pain and suffering -- are vanishing, in favor of a government system that is more effective at spreading pain than healing it.

Our politicians are now a few steps away from the likes of Danton and Robespierre. Individualism is the greatest threat to their status. We must restore the principles of freedom and individualism to medical care at the first opportunity. ESR

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine, Newport Beach, California. Copyright © 2011 Americans for Free Choice in Medicine. All rights reserved.


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