The redistribution of your health
By Richard E. Ralston
For most of the history of our republic, the purpose of taxation was to provide funding for the functions of government that are basic and necessary. Decades ago we began to depart from that and move aggressively in another direction.
The government is now using tax policy in the process of transforming medical care to conform to governmental control of the rest of the economy.
During the election of 2008, Barack Obama was asked why he wanted to increase taxes on capital gains when history shows that such increases actually reduce income to the government as the level of capital investment falls. He said it was because higher taxes would be more "fair."
We are in a whole new world when the purpose of a tax is not revenue but redistribution of wealth even when it decreases government revenue.
Politicians must now have the power to determine the medical care, as well as the income and property, we are each permitted to keep. While government control is proclaimed in the form of a fascist, socialist or other ideology, it is always an excuse for more political power.
For the entire history of civilization, those in power who take what is "fair" from the rest of us always determine fairness by what will sustain a spoils system to satisfy their friends and political clients.
That is the agenda of the statement of Donald Berwick, the former head of Medicare and Medicaid, a "recess appointment" of President Obama unconfirmed by the Senate: "Any health care funding plan . . . must redistribute wealth from the richer among us to the poorer and less fortunate. Excellent health care is by definition redistributional." For politicians after power, that is the purpose--taking from some to give to others: once the money is taken, citizens are subject to seeking government permission for whatever medical care the government decides to permit.
That can take the form of a powerful panel of presidential appointees--the Independent Payment Advisory Board, which is exempted from judicial or congressional review and permanently provided with funding without the need for congressional appropriation; or of a "comparative effectiveness" bureaucracy that determines whether any medication or procedure is permitted based on whether it benefits everyone in the same way; or of permitting only government- approved insurance that forces you to buy many types of coverage (thanks to lobbying of Congress and state legislatures) rather than affordable coverage for unexpected accidents or major illness.
For seniors, Medicare provides even fewer options. Of course, those with their own money would have the option of paying for more care--but their physicians will be kicked out of Medicare if they provide services not covered.
Speaking of physicians, they are ignored or powerless in this process. But then, the New York Times a couple of years ago made the point that physicians are responsible for the rise in medical costs because they--instead of politicians-- decide what treatments are appropriate. That makes them "unabashed profiteers" who must be forced to follow political decrees.
The driving priority of politicians will never be the cost, quality or availability of medical care--but their hold on the power to decide what care is permitted and to whom it is distributed. If we want to preserve any freedom to make our own health care decisions, we must understand that the big problem is not a shortage of care but an excess of power- hungry government. Without that understanding, politicians will be free to seize your wealth and your health and redistribute it to serve themselves.
Richard E. Ralston is the executive director of Americans for Free Choice in Medicine, Newport Beach, California. Copyright © 2012 Americans for Free Choice in Medicine. All rights reserved.