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Tuesday, November 15, 2011

Plan 9 from Washington Space

As the ObamaCare Mandate winds its way up to the Supreme Court, which will decide whether we still have the freedom to look after our own health in our own way without compulsion from the authorities, it's still only the tip of the positive rights iceberg.

When entitlements are transformed into positive rights, this creates a universal reciprocal obligation, first of all to pay for them, and second of all to participate in a planned economy that provides those entitlements as cost effectively as possible. The Mandate is a typical consequence of the process.

The health insurance industry will provide affordable insurance for those who need it most, in exchange for the government delivering recalcitrant consumers who aren't interested in buying their products. The same principle can be used to make checking accounts more affordable if banks agree to remove minimum balance requirements in exchange for the government compelling everyone to sign up with a bank. The industry gets captive customers and the government gets to write off another social problem.

The big lie about the "mandate" is that anyone who doesn't have health insurance is already a burden on the system. But the only people who could seriously believe that run public or private health insurance. What the "mandate" actually does is two things. It compels people to buy medical services through the  health insurance company, rather than directly from doctors, which is why doctors supporting it is up there with local stores supporting a government mandate to buy at Wal-Mart. And it drives people who don't need medical services in gross, to subscribe to them anyway, making the "mandate" into a tax on the young and the healthy.

It's an arrangement that's entirely justifiable from the "greater good" angle of solving social problems by compelling everyone to participate in a planned economy for the distribution of goods and services, and completely unjustifiable from the "freedom and individual liberties" angle of the United States.

The evolution or devolution of the United States from a vast open frontier with port cities, to vast cities with a vanishing frontier made the old ethos harder to sustain in the face of a progressive state eager to tackle urban social problems and to apply those solutions on a national scale. One system for everyone. The reformers began in the slums, but their solutions didn't stay there, neither did the consequences of their solutions. 

The mandate is notable for the same broken mix of socialism and crony capitalism that brought on the mortgage crisis and the student loan mess. It begins with the government deciding that an entitlement is to be available as widely as possible for the "greater good" and then creates or funds national entities to distribute that entitlement to as many people as possible, combining the worst of the public and private sector for double the corruption and inefficiency. By the time the entities have been privatized and the cost has gone sky high, and the congressmen and CEO's have gotten paid, it's time for the whole thing to implode and for a new social problem to be born.

Neighborhoods with empty houses and student debt that will depress consumer spending for decades to come and inflate their debt are just the beginning. The real cost of the social engineering is often unexpected and emerges in unexpected ways. And the game of "Whack-a-Problem" that follows makes everything worse. Worst of all is the unlimited government power that's a byproduct of the process.

A planned economy is based around centralized control. Its notion of efficiency is to control as many factors as possible. Brush aside some of the ink and that spells absolute power and total tyranny.

Take national fitness, long an obsession of Democratic presidents, from JFK to Carter. It's not some Triumph of the Will drive to create the Ubermensch, nor is it the benevolence of a government that cares. It's the planned health care economy applied from cradle to grave. Teach children to exercise and eat right, and they'll cost less for the government to take care of. It's the work of policymakers who don't see a six year old, they see a statistical project of health care spending for that child.

Tax junk food, ban corn syrup, nudge calories onto fast food menus, seize obese children from their homes and compel everyone to participate in the "soy marketplace", euthanize the elderly and maybe three decades down the road, nationalized health care will be economically feasible. Once you start looking at people as numbers, then it's tempting to fiddle with the numbers until they come out right. Which really means fiddling with people.

Accepting an entitlement, also means a reciprocal obligation to be one of the gears in the machine, to sit down when you're told and stand up when you're supposed to. To exercise twice a day, eat lots of vegetables and agree to die with a minimum of fuss when the quality of life board decides that your condition would cost them too much money.

Once you accept free health care, then your weight is the government's business. Even worse it's everyone's business. You are now a public charity case, just like everyone else. Collective benefits mean collective obligations which are universally owed. Public subsidized health care means that you are no longer paying for your own health care, no matter how much you do pay for health care or how big your tax bill is, everyone is paying for your health care. The end of personal autonomy and the rise of a collective society is just icing on the cake for the planners of the planned economy.

The defenders of the mandate have shouted endlessly that the health care marketplace is unique, and can be universalized. Insofar as a nation in which so many oppose the kind of conventional health care offered by insurance companies on religious or personal grounds, can be universalized. But like the Commerce Clause used to support it, there are no true limits on what a planned health care economy can affect.

There are countless environmental, social and biological factors that affect health which means that a planned health care economy means universal jurisdiction over everything. Do fast foods cause obesity? We can save 200 billion a year by outlawing them. Are car engines leading to a rise in asthma? Another 50 cents per gallon in taxes will reduce car use. Is a particular area home to a high cluster of one disease or another? Compel people to leave. When you have a health care hammer, every problem starts looking like a nail.

We're already surrounded by the social engineering gimmicks of the planners, most of which don't work so well. After generations of promoting exercise in schools, childhood obesity remains high. Higher taxes to fund entitlements helped lead to a lower birth rate and a worker deficit to fund those entitlements. Universal home ownership led to underwater homes and a wrecked economy. Student loans for everyone led to piles of student loan debt that wouldn't go away.

But the planners are playing a game and they can't stop, certain that a few more moves will unlock the puzzle and then everything will come together. The Commissars of the USSR thought the same way until enough of them were shot and the rest gave up and began faking the numbers to make it look like the system worked. Every move they make takes away from freedoms from a country that has already gone a long way in the wrong direction.

High taxes have depressed the economy leading to class warfare. A depressed economy means more people who need health care and can't afford it. That means higher government health care bills and higher taxes. That cycle alone could wipe out the economy for good, but it's only one of many cycles that feed social problems which feed the cycle.

The reciprocal obligations are piling up.Whatever we get from the government has to be paid for in more ways than one. It has to be paid for in taxes, in fees and in freedoms. The universalization of government benefits also universalizes public obligations and public duties. A planned economy requires universal participation and behavior modification programs. And when like a Rubik's Cube, the planners realize that they have no solution, only a hopeless jumble of color, they won't give up. Instead like the commissars, they will settle down to stealing and faking the numbers to make it look like the system works. If they haven't done it already.

7 comments:

Master of Obvious said...

The right should come up with a list of their own mandates should this precedent be upheld.

Everyone must own a gun for the common good of public safety.

Everyone must purchase a copy of the Constitution for education of citizenship purposes.

Etc...

John K said...

"The reformers began in the slums"

Basically the poor looked at their options to get ahead and decided that pressuring the government for benefits was better than work.

Anonymous said...

Obamacare will lead to less medical research,innovation and disease solutions -lowering our improvement of care,revenue from inventions and reduce the US's world standing in care.

Just as it will improve care for medicaid recipients, and the only class that really has zero coverage illegal immigrants,whom still use hospital ER Dr's as personal physicians.6 hospitals have gone bankrupt treating illegals.We will be paying for and treating people who contribute zero to the system and economy.This number will grow as premiums rise.

Obama plans on paying for the "uninsured" with new taxes on healthcare premiums,thereby raising individual's costs.

In the end we will receive mediocre care at exorbitant costs,while improving care for illegal immigrants,single parents and the chronically lazy.All of which can't and never will pay for their care.

And how will a fined be levied for being uninsured when someone is dying of cancer? Garnish their Disability or welfare?

Our healthcare system is already a mess: quality of care is poor,fraud is rampant and many Dr's run little more than legal drug dealing clinics.

Do we really need to make it worse?

Think it is good now ? I spent 11 years,8 of which i could not walk,seeing 47 Dr's who could not diagnose me.
I lost my job,insurance and marriage.
A physical therapist suggested i request a muscle biopsy.In 34 years not one doctor noticed i was born with muscular dystrophy.Even though i exhibited every sign.

Will higher costs,lower quality,standardized care and more taxes improve this?

Keliata said...

Maybe in this generation, John. If we were talking about the Great Depression era it was out of desperation. People were in survival mode back then and willing to accept any lifeline, even if it was from liberals and ultimately harmed them.

Obama care will result in an increased use of "physician expanders" aka Nurse Practitioners and Physicians Assistants.

Defintely not top level health care.

Anonymous said...

"The devolution of the United States from a vast open frontier with port cities, to vast cities with a vanishing frontier made the old ethos harder to sustain in the face of a progressive state eager to tackle urban social problems and to apply those solutions on a national scale."

Exactly. These changes are irrevocable, irresistible, and permanent. Democracy, liberty, freedom are possible only under limited conditions no longer extant in a technological world of seven billion people.

Richard of OZ said...

If you want to know crazy for health insurance, come down to Australia.
I am in a private health fund, so cannot use the public health system. I need to be in private because of the use of ancillary health professionals - podiatrists, dentists dieticians etc. which are not covered by "Public" to treat my T1 diabetes.
At Tax time, I am given a 30% rebate on my charges for the fund, but I am slugged 1.4% on my GROSS income, i.e. Salary, rental income, benefits tax for a company car, et al. I pay for the "Public" system, but cannot use it. Also, the "Private" fund does not pay all costs, and has annual limits on use as well.

morty said...

The current system works for some but not for many. Insurance companies refusing to cover treat people with existing conditions or cancelling their polices for technical errors when they get sick is obscene. If the insurance companies acted more resposibly Obama's plan would never have gotten traction. You can't have 35 million people whose only option for health care is the emergency room. And frankly, I don't see a problem with encouraging people to be fit or to eat healthier. If yuou ever step into Wal-Mart the sheer human tonnage found their boggles the mind. Clealy, no one is starving. I agree with Mr. Greenfield's positions on Islam. But the private insuance system as it exists in the U.S. is seriously broken.

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