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About Jack Puglis Jack Puglis, a lifelong conservative, managed engineering development for most of his career and more recently has prepared and presented numerous training courses in leadership, management and organizational development. He is lifelong student of economics, finance, management science, leadership theory and politics. Mr. Puglis holds a BS and MS in electrical engineering and an MBA.

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Past Articles Obama’s Healthcare Experiment: A Leftist Fantasy Run Amok

Jack Puglis
Obama’s Healthcare Experiment: A Leftist Fantasy Run Amok
August 13, 2009
 

In the manner of hysterical, tormented and demented scientists, our elected officials are attempting to create the largest healthcare experiment the world has ever known. In its current incarnation, the proposed legislation, devoid of requisite details, will permit the administration and Congress the latitude to unleash a Frankenstein monster on all Americans. Guided by the legislative straw-man that is the current House version of the bill, the creation and implementation of those details is likely to result in a fascistic instantiation that appalls even liberal Americans.

Relying on the same type of comforting rhetoric that was so extensively used during the campaign, a shrinking minority of upstanding-but-gullible Americans favor the proposed legislation, unaware that they are marching toward perdition. The naïve, the less-informed and the true-believers have come to willingly accept the impossible by clinging mightily to the bizarre progressive notion of a government-provided better world. Imagine their rage and disillusionment when they are body-slammed by the deterioration of their healthcare and their lifestyles.

The government’s true goal is not its ostensible and oft-stated mission to improve healthcare in the United States. As with most other initiatives by this administration to date, it seeks to dramatically increase its power over its citizens while using carefully disguised sound bites, sincere and doleful facial expressions and soothing, impossibly optimistic lies to conceal the otherwise unacceptable reality.

Current polls show that the majority of Americans now do not favor healthcare reform. This majority is increasing and slowly becoming a balm for the realistic-but-agitated conservative. The unsettling notion, however, that Congress may pass and the president may sign legislation to which the people of the Unites States are opposed would lead to the inevitable conclusion that our leadership is behaving like dictators in a totalitarian state. They have a constitutional mandate—given that we have representative government in our nation—to faithfully follow the wishes of their constituents. It is yet to be seen whether they will actually violate his mandate.

The Tragic Destruction of the Best Healthcare in the World

Healthcare in the United States, continuing its record of being unparalleled in the world, attracts foreign citizens to access treatments and levels of care that are unavailable in their native countries. Recent Rasmussen polling gives further evidence of excellence: far more Americans say that they are happier with their healthcare than not.

Viewed objectively, ruining our current excellent healthcare system appears to be an irrational act. Given that modest changes can be made in increments to our existing system if it needs improvement, there is no compelling or valid reason for the proposed changes.

A Demonstrably Failed Healthcare Methodology

Our current, reasonably efficient and mostly-free-market system works. Costs are higher than need be, partly as a result of government intervention or the lack thereof, discussed below. All incarnations of the current legislation, including concepts discussed by Congress, involve economic pressures that will drive private healthcare out and result in a single payer system. This, ultimately, is the government’s intent, in spite of repeated, disingenuous assurances to the contrary from the administration.

A single-payer system will lead to the devolution of US healthcare into a centrally planned system, by virtue of the requirements of the current House bill. However, central planning does not work. It is not possible for a set of human minds to create a system that adequately covers all contingencies, yet the free market rapidly and efficiently sorts these things out. Central planning increases cost and causes waste, confusion and interruption of service in nearly all economic contexts.

Cuba and North Korea, still characterized by their centrally planned economies, are two of the last hold-out communist nations in the world. They remain impoverished, as they have been from the beginning of their failed systems. Macroeconomic theory predicts the tragic results of economic central planning, and empirical studies have consistently borne out that theory. Perhaps the most vivid supporting example is China, where reduced central planning by means of a migration to a quasi-capitalistic system has created a boom. The analogy to the single-payer construct is inescapable.

The Experiment Creates a Massive, Insensate Bureaucracy

Expansion of America’s medical infrastructure is conspicuously absent from this legislation. Forty five to fifty million people are projected to be added to the healthcare system, indicating that existing resources must be stretched beyond desirable and realistic limits.

The draft Senate and House bills require that a bureaucracy be created, which organization will be tasked with sorting out priorities. There is no blueprint for the creation of so massive a healthcare system, nor are details for building this entity identified in the legislation, so it’s obvious that the government’s experiment is actually being created on the fly. Devoid of forethought, this is a path to disaster.

This places Congress in a position to appoint people who will cut-and-try, making it up as they follow uncharted path dictated by this experiment, and they will have to respond concurrently to political directives rather than build a system based upon efficiency, common sense and medical professionalism.

But why should they be concerned with effectiveness and controlling costs? The government, as a management entity, offers no incentives for crisp, low-cost, high-output performance. The free market, despite its imperfections, offers strong incentives and inevitably works far more productively. In the free market, nascent systems are driven to maximize efficiency or, in the absence of distortions caused by government intervention, they fail.

As a result of the distant bureaucracy’s lack of awareness of the complexity of individual patients’ circumstances, a vast number of people will be denied critically needed, time-sensitive care. Dehumanizing rules and regulations will be developed, altered at arbitrary frequency by a harried group of appointees as the experimentation goes on. Professional experience, compassion and common sense cannot prevail under the proposed bizarre system. The Medicare bureaucracy, described by some as a "Frankenstein Monster,” gives us some concept of what the nationalized healthcare organization will be like.

Intrinsic delays are nearly assured, in part because government workers can be expected to depart at the end of their workday, irrespective of the severity of any person’s medical situation. History suggests that in a futile attempt to control costs, the experiment will be understaffed, exacerbating systemic overloads and worsening a badly-functioning bureaucracy.

To get a hint of the mind-boggling levels of incompetence inherent in non-market-driven, government funded and highly bureaucratized systems, consider our VA hospitals. After a ten-year program and increased funding to reduce waits and improve quality, they continue to struggle. With existing resources stretched much further than in the VA hospital system, and with none of the long experience of the VA, the nationalized medical system can be expected to be far worse, and a vastly larger government bureaucracy will be inherently more difficult to control and much less efficient.

The Travesty of Estimating Costs and Apportioning the Funds

The current healthcare legislation contains mandates: it indicates what must be done. Nowhere does it define how those things will be accomplished; no detailed plan exists. Nationalized healthcare will cost far more than the most pessimistic Congressional Budget Office estimates: since the details of the envisioned system remain wholly undefined, the Congressional Budget Office’s must invent assumptions that cover things that they cannot possibly know until the experiment takes shape. Any estimates are therefore, by definition, deeply flawed. Only the most perfunctory cost estimates for nonexistent plans or processes can be developed.

Payments to drug companies, physicians, medical equipment providers and hospitals will be dictated by the government, as will all rules and regulations related to healthcare. Since the bills are absent clear detail, it is difficult to determine how the funds will be apportioned and how much any given interest group will receive. Or is it?

Careful examination of the government stimulus package reveals that the preponderance of the funding has nothing to do with stimulating the economy, but rather is a potpourri of paybacks to special interests. Based on that experience, it is naïve to expect that the unknown details of the proposed healthcare legislation will be fair and reasonably balanced. The present administration and Congress have shown that they will shamelessly, and in full public view, reward those in their favor and that they will do this with no regard to harm caused to individuals. This already-demonstrated behavior will drive costs up further and have the effect of further diluting care.

The Experiment and the Law of Unintended Consequences

The law of unintended consequences, present in every experiment, will result in unpredictable effects that also cannot be priced into the estimates. For example, enrollments in medical schools are likely to decline, since the government-controlled payments to physicians will drive our brightest young people to opt for more lucrative careers elsewhere. Drug companies will no longer find it as economically feasible to research, develop, test and market new drugs, since the government will remove incentives with artificially lowered prices. Medical equipment providers may go out of business, offshore their work or simply cheapen their products.

Recent federal government mismanagement includes, "Cash-for-Clunkers,” an ill-planned program that ran out of money in days; a bailout that many economists believe was unnecessary, but which needlessly nationalized financial and manufacturing companies; an inexplicably large increase in US debt and money supply; and a foreign policy that has irritated our allies and shown weakness in resolve to our enemies. There can be only one conclusion: any healthcare system created by this administration and Congress will be a badly planned, wasteful blunder into the unknown, funded by unwilling taxpayers.

An Orwellian Nightmare

Imposing the changes mandated by the House and Senate bills means that the government will be given decision-making power as to who lives and who dies as they triage scarce care. The triage system contains elements of a paper written by three authors, including Dr. Ezekiel Emanuel, Rahm Emanuel’s brother, and a key player in the current legislation.

That type and quantity of unconstrained power is unacceptable in itself, but the criteria upon which those decisions are to be made are an affront to the sensibilities of most Americas. An important concept in Dr. Ezekiel’s paper is the withholding of care from the infirm elderly or severely and terminally ill citizens on the basis that the scarce resources can be better applied to younger, healthier people.

Peter Singer, a professor of bioethics at Princeton University elaborates clearly on the choices, and his tone follows the pattern of Ezekiel Emanuel’s. President Obama is well aware of these sick notions and supports them. That the government will cause the scarcity of resources appears to be immaterial to the administration.

The bills also contain provisions that pave the way for a transition to a government sponsored eugenics program. Such small inroads can be expanded easily in years to come, effectively giving the government control over the breeding of American citizens.

A nearly freakish irony is that the people of America had a vigorous debate that took place over several years regarding Dr. Jack Kevorkian’s advocacy of assisted suicide. Dr. Kevorkian eventually was convicted of murder, in spite of the fact that those that he helped were frequently terminally ill, in intractable pain and had requested euthanasia. With this legislation, the government is writing equivalent actions into law, with different words that are presented in a different context, but the power of choice for the individual is missing. Americans appear so confused by the complexity of the issues that these portions of the legislation have not yet surfaced as a major discussion points.

The Irrationality of ObamaCare

On the surface, and taking a logical and pragmatic view, the entire legislative healthcare package appears uncalled for, and is nonsensical and irrational. It will drive quality down, costs up, cause large delays and its terms are inherently contrary to American values. The changes to the healthcare system are predicated on the assertion that there are large numbers of people who are uninsured, but analyses of that number show that those estimates are deeply flawed.

On July 21, 2009, Congressman Rodney Frelinghuysen (R-NJ) identified certain key statistics that bring the claimed need for healthcare reform into better focus. Of 46 million who are labeled uninsured:

▪ 9.5 million are non-citizens,

▪ 12 million earn less than $25,000 per year an qualify for healthcare benefits under other programs, and

▪ 7.3 million earn more than $84,000 per year and can afford to purchase benefits, although many choose not to do so.

Congressman Frelinghuysen’s conclusion was that there are only 7.8 million lower income Americans who truly need healthcare assistance!

There have been recent reports that the Democrats will attempt to use a tactic known as reconciliation to pass heath care reform. This would permit them to stop any filibuster or amendments to the bill, and would require only a simple 51 vote majority to pass the legislation. Although the reconciliation provision was created to break budgetary deadlocks and had no deceptive underlying purpose, I can think of little that is more nefarious than abusing it to pass the current legislation. Those who would act in this manner are morally bankrupt and are not fit to govern our nation.

There is no valid reason that is in the interest of the American people to attempt to pass this legislation in a gasping, heated and frantic rush. However, given the plunging popularity of this president, this Congress and this legislation, it’s unsurprising that the administration and the congressional leadership are in a desperate rush to force this legislation to a vote. That they are frightened and rushed is a strong indication that they are fully aware that they are attempting to enact this legislation against the will of the American people, which is utterly unacceptable and inexcusable.

Given that the claimed reasons for universal healthcare are both weak and invalid, it is reasonable to conclude that the true motivation for this legislation has nothing to do with healthcare. The deferred cap-and-trade legislation was judged to ultimately result in higher, rather than lower worldwide emissions as a result of carbon emitting businesses—and jobs—migrating offshore. It was a disguised tax increase that would give the government significant power over America’s entire energy industry. The nationalization of auto and financial companies also increases the government’s power over industry. The single most likely reason for the current nationalized healthcare legislation is to place approximately 16% of the gross national product of the United States under complete government control, a further increase in power.

The apparent irrationality of this legislation can be best explained as yet another mechanism to increase the government’s control over Americans. The trend is unmistakable and with each steps, the freedoms that Americans have enjoyed for more than 200 years are further degraded. This was not the intent of the founding fathers, nor is it the will of the American people.

An Unaffordable and Irreversible Experiment

The United States has just borrowed and plans to borrow amounts of money that stagger the imagination. While the administration claims that its nationalized healthcare program will not add to taxes, it is inconceivable that it will not. Larry Summers, the president’s chief economic advisor, has already opened that door. Worse, tax revenues have dropped by amounts not seen since 1932.

The simple fact is that the United States cannot afford nationalized healthcare at this time. Congress and the administration has wasted nearly two trillion dollars of taxpayer money and borrowed lavishly to cover this catastrophe. They are now scrambling to find a means to fund their new trillion dollar healthcare tinkering, but with the light of public opinion shining on them, they don’t dare borrow more or overtly raise taxes. Small, obscure tax increases have already begun, but they’re woefully inadequate.

No money exists, and there is no economic trade-off: the few possible benefits will be overwhelmed by harm that this socialized healthcare plan will cause, and the ultimate cost will be horrendous. The truthfulness of the administration’s claims does not stand the test of experience: the administration has a robust record of lying about many subjects.

This legislation will force structural changes to our present system that will be very difficult to reverse. Insurance companies will very likely be driven out of business, physicians will leave the medical profession, infrastructure will shrink, and the proposed healthcare program will take on a life of its own, as have Medicare, Medicaid and Social Security.

Any future administration that attempts to dismantle a program of this enormous size and scope, once it has metastasized throughout the nation will face a politically difficult and very likely impossible task. The administration and the liberal Congress know this and are depending upon it. As support for universal healthcare shrinks, they see an opportunity that they’ve worked for decades to create vanishing before their eyes. Their distress likely comes from the loss of all that power and the ruination of a major step toward true socialism, their ultimate goal.

The Progressive Entitlement Mentality

Since the inauguration of Franklin Roosevelt, a progressive entitlement mode of thought has increasingly become acceptable. The mainstream media, highly liberally biased and fully exposed as such during the last 2-3 years, uses an approach that gives entitlement-based thought the appearance of desirability, commonality and wide acceptance.

No one has a fundamental right to any entitlement, which, by the nature of the beast, rewards people based on their need rather than their worth. Socialism breeds decline, and each government policy that levels economic incentives with no regard to performance de facto threatens American vitality. Nationalized healthcare is purely socialistic, and ultimately forces those with a strong work ethic to fund the benefits of those who have little or none. Can there be a stronger motivation killer?

Fix the Problems that Need Repair

A significant cause of our escalating medical care costs is the lack of medical tort reform. Estimates of annual savings range up to $1 trillion, yet this topic isn’t even under serious consideration by Congress. The inescapable conclusion is that trial lawyers have had a lobby that is sufficiently powerful to halt efforts at correcting the medical malpractice blight. It appears that Congress will happily borrow or tax our way into universal healthcare but steadfastly refuses to take on this relatively small special interest group.

Medical school admissions have been artificially limited for about 100 years by the AMA, using the simple mechanism of limiting the number of medical schools that they approve. They maintain a very powerful lobby and have been remarkably effective in retaining that power. Physicians in most other nations earn less than half of the income that American doctors enjoy. The savings from significantly increasing medical school admissions is apt to be in the hundreds of billions.

The Best Alternative

President Obama and the Democrat Party have entered into a stunningly risky strategy. Can this be unwitting?

For inexplicable and potentially otherworldly reasons, the administration and Congress have casually, mindlessly and recklessly "outed” themselves in terms of their desire to reconfigure our nation into a socialist economy and a place of fascistic policies. The United States remains a largely conservative nation and the right considers big government, intrusive controls and central planning to be highly repulsive and un-American to the point of traitorousness. The liberal minority may ignore this at their peril.

Increasingly informed public opposition, uncontrollable costs, the draconian provisions of the legislation and constituents’ growing awareness of the loss of freedoms that this legislation will bring are creating a groundswell of opposition. The incredible strength and rapid growth of the ongoing taxpayer backlash may ultimately do irreversible damage to the present administration and Congress and point to a potential political suicide by the Democrat Party if they succeed in enacting it.

Simultaneously, the enactment of this legislation would be a watershed in influencing the nature of our government, but more importantly and despite any anticipated backlash, passing the healthcare initiative will provide at least the appearance of political success and strength. However, if the legislation is defeated or seriously weakened, the president and the liberals in Congress will suffer a crushing blow to their effectiveness from which they may not recover during this president’s term.