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Senate Health Care Musings


Here’s an editorial published in the Wilkes Barre Times Leader in December 2009. In their version, it was edited to make it more “respectable”. Here’s the unedited version with all of its snarkyness baked in for your enjoyment.


So they passed it. Lost among the frantic shopping for a gift for Aunt Rose and Uncle Stashu who announced at the last minute that they would just love to finally accept your standing invitation for Christmas dinner, the US Senate passed a health care bill. Not just any bill, but a completely perverted, crap-package of a bill, bursting with special interest deals (Big Pharma), punishments for the special interests that would not play ball (the medical device industry) and outright bribes to states whose Senators feigned outrage long enough to have their palms greased. Guess whose state no longer has to pay anything for Medicaid ever again? (Not us) In what must be a record for in your face taxpayer-funded bribery, people like Chris Dodd, Bernie Sanders, Mary Landrieu, and Ben Nelson, had their votes bought with billions of dollars of our money. Thank goodness they raised the National debt ceiling again.

Here is a little history. Many liberal Democrats and particularly our President are on record as favoring a government-run, single-payer system for all. Problem is, US citizens, who on the whole retain a good deal of horse sense, can see the disastrous results of such policies in England and Canada. They understand that our current system, though flawed is not actually in “crisis” (except for the government run parts). They understand that with some tweaking such as increasing insurance competition across state lines, improving tax incentives for charity care and maybe, god forbid, a little tort reform, the situation might be significantly improved, at little cost to the taxpayers. But unfortunately, you all decided to elect these very liberal Democrats to high public office. Oops.

Liberals in congress understand that a single payer health care is currently not politically feasible. What’s a “progressive” Senator from Nevada to do? You need to make the citizenry want it…no actually to beg for it. So here’s the plan.

First, you impose on the private insurance industry, regulations that force them to accept and cover all people regardless of their diagnosis. You also refuse to let them price policies based on a patient’s health history and risks. So the evil insurance executives who are beholden to their evil stockholders (people, by the way like you and me), react predictably. They raise rates on everyone to cover all of these changes. They raise them quite a lot according to some estimates.

Here’s the really frightening part. Despite the fact that the US is supposedly a “free” country, you then force almost everyone in the country (except of course, congress and the President) to purchase one of these policies under threat of fines, or even according to Nancy Pelosi, incarceration. Oh and just to make sure that everyone is unhappy, you tax the so called “Cadillac”  health plans (won’t they all be Cadillac plans when the industry gets done raising rates?).

Then you delay the changes to the system for  three to four years allowing all the incumbents who voted for this mess (mainly democrats) to be reelected before anything changes too drastically. You do however force everyone to pay the tax increases in the bill immediately, which buffs up the appearance of the financials significantly for the short term.

You want to talk about a real health care crisis? Wait four or five years.

So let’s say, you’re a small business who dutifully has provided health insurance to your twenty employees. Suddenly your insurance costs skyrocket. What do you do? You can’t drop their insurance, that’s probably illegal. So you drop employees instead.  

People who are self-employed will have to weigh the cost of the fines against the increases in premium costs. Many may just pay the fine and acquire insurance when they become ill, seriously screwing up the insurance risk pool and driving costs up further. How’s that “Hope and Change” working out for you now?

Well, at least in the Senate bill according to HHS secretary Kathleen Sebelius, there’s funding for abortion. Remeber that, all you devout Catholics.

Government will be there to help… with a big fat government-run taxpayer subsidized low cost health plan. Numbed by our misery, we’ll sign on in droves. Death Panels, or perhaps more correctly, Medical Advisory Councils will begin to function, determining which treatment, medication, or device your doctor will be allowed to use, at a particular age and with a particular prognosis. After all, now they’re paying for it.  By the way, don’t smoke, drink to excess, or eat those chicken wings. It’s now your civic duty to keep your health care costs low and perhaps at some age to even “step aside”.

 Do you doubt me?  Then read Principals for the Allocation of Scarce Medical Resources by among other people Dr. Ezekial Emanuel (brother of Chief of Staff Rahm Emanuel). Then read the bill. It’ll be a real eye opener.

At any rate, when the time comes for you to “step aside”, don’t whine. And don’t say I didn’t warn you.

                                                                                   Henry F. Smith Jr. MD FCCP

In retrospect, I was too conservative.With the passage in the final bill, the crisis may come in as little as three years.