Government Health Care “Reform:” The Culmination of Incrementalism

By Frank S. Rosenbloom, M.D.

The opening words of HR 3200, the initial solution to the health care “crisis” in the United States, read: “A Bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.” I haven’t yet heard President Obama or Congressional leaders comment on those “other purposes.” However, let us be completely honest here. The only words in that opening statement that have real meaning are those last four words.

The most recent Senate version, the “Baucus Plan,” is not about providing affordable, quality health care for all Americans. If it was, the evidence of the past 44 years would be enough to dissuade even the most ardent supporter of government-subsidized and -controlled health care from increasing government control over Americans’ lives by creating another health care entitlement program. After all, it is government manipulation and control of the free market that has caused unsustainable cost increases in every social program the government has undertaken.

When Medicare was passed in 1965, it was advertised as “insurance” to prevent retirees from becoming destitute due to medical costs. Initially, retirees were told they would be able to keep their private medical insurance if they were satisfied with it. Does this sound familiar?

However, shortly after the federal government instituted Medicare and Medicaid, retirees were no longer able to purchase private medical insurance unless Medicare was their primary insurance. Immediately upon Medicare’s passage, the federal government controlled 30% of the health care industry. It controls 60% of medical care today. In addition, projections for the cost of Medicare were, as is generally the case with government programs, unrealistically low. In 1970, government officials assured the American people that Medicare would cost approximately $7 billion by the year 1990, yet it reached $69 billion.

Americans were promised that Medicare costs would be sustained by the payroll taxes of American workers. However, this has never been the case. Medicare has had to draw from general funds since its inception, and that draw has increased substantially over the years, as can be seen by reviewing Chart D here.

Medicare will be bankrupt by 2018, yet no one in the current administration or in the Congressional leadership is talking about how this prototypical government health care program is a complete failure. Albert Einstein said that insanity is “doing the same things over and over again expecting different results.” If he was correct there is a lot of insanity afoot.

The myth of the 47 million uninsured has been the banner under which Congressional leaders have proceeded with this current health care plan. The number of chronically uninsured United States citizens was really between 8 and 13 million. The Fraser Institute reported that the percentage of people who were “effectively uninsured” was 6% in Canada and 7.9% in the United States, despite Canada’s universal health care. The cost of health care in Canada has been rising at a significantly higher rate than in the United States. Yet, in his comments on health care, President Obama refuses to use actual Canadian statistics or to address deficiencies in socialized medical care systems.

No, it is not possible that socialized health care programs have as their purpose the provision of lower cost, higher quality health care and cost containment. Government-controlled health care is all about “the other purposes.” If Congress really wanted to lower costs and improve access, it could pass some simple reforms such as letting Americans buy health insurance across state lines, equalizing the tax treatment of employer-purchased and individually purchased health insurance, and making Health Savings Accounts more easily accessible. Instead, proponents of government-funded health care are ignoring simple free market solutions to health care reform in favor of increasing government intrusion into and control of one of the most personal and important aspects of our lives””our medical decisions and care.


Frank S. Rosenbloom, M.D., is Board Certified in Internal Medicine, General Internal Medicine and Hospital Medicine in Portland, Oregon and is a guest contributor to Cascade Policy Institute, a nonprofit, nonpartisan free market public policy research organization.

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  • ThinkOregon

    Frank … The problem with the GOP/CPI/OC crowd is that you can’t escape being the party of no. No reform. No open debate. No linking to alternative opinions (wink wink Jason). No real policy alternatives. You’re reinforcing one central idea the we get whacked on consistently.

    So take the ThinkOregon challenge: craft a comprehensive alternative that you can present in detail versus carping from the sidelines. You’re in a echo chamber … and your message, while it maybe on point, dies before it has a chance to take flight.

    BTW … I have a dog in this fight. I’ve seen my person premiums go up from $600 to almost $1,000 in less than 6 months … by no fault of my own. So start producing some solutions.

    • Frank S. Rosenbloom, M.D.

      I do have specific comprehensive alternatives. Read some more of my articles on American Thinker for specifics. The government is the cause of our expensive healthcare and they have seen to it that attention from that fact is diverted toward blaming the free market. If we really had a free market system, your premiums would be less than $400/mo.

      • Sergio Bana

        You’re wrong and I’m going to tell you why, first off the bottom line for any private corporation is very clear: TO MAKE MONEY! Regardless of who they screw over. They (private health care industry) are willing to go to any heights to protect there interests. Rather than have businesses compete over prices and market, they agree on a set price so that neither one of them risks losing money; then divide the market. If this isn’t true than why are most all the prices the same for all insurance companies for virtually the same coverage? Do you mean to tell me that it’s really worth over $3000 to have a few cracked ribs checked out, after having many tests done that where most likely unnecessary? In the end they didn’t even do anything to help because they really can’t, oh yea, they sent her the bill. How much are a few x-rays and an MRI? Well two-to-three times as much if we have a private business (in this case the clinic to which my girlfriend went to) as an intermediary trying to make a profit off of someone else’s misfortune. In any case, who can afford $400/month? What world do you live in? So $4,800/ year per person, maybe you’ll get some kind of discount for having your entire family: yourself, your spouse, two to three children; does $12,000-$15,000 sound about right? The median income in this country is about $27,000, and the average household income about $52,000.
        https://en.wikipedia.org/wiki/Household_income_in_the_United_States
        Let’s do the math: 52,000-12,000-(25% for taxes of your total income)13,000= $27,000.
        We have even begun to add expenses: $27,000-(average monthly rent, $684/month x12=8208)8208=$18,800
        https://www.census.gov/prod/2004pubs/H150-03.pdf
        This is an average, if we were to keep in mind that there are different areas, some more or less violent, closer or farther away from schools and supermarkets etc. That’s about the amount I pay for just my room every month just so I can go to college.
        We’re left with $18,800/ year and we still haven’t added the fact that you still have to feed your two to three kids and pay the rest of the bills.
        Now, I can see that you have the letters MD in your name so I’m not going to even pretend that you know what that’s like.
        All this is also keeping in mind, I’m give you the benefit of the doubt and premiums are going to be “as low” as you say they will be, not including any preexisting conditions, pre-approved treatment (like an ambulance ride after an accident) and/or so called experimental treatment; like getting radiation for breast cancer treatment to save someone’s life (this happened to a colleague of mine at work who may have to file for bankruptcy). How much is all that other stuff going to cost?

        The bottom line is we can’t afford private insurance! This debate has been going on since the in-statement of the HMO’s during the Nixon administration and has been going on ever since.
        Despite the GOP’s efforts to try and convince everybody that everything is good and well, the people know the truth.

        Universal health care does work in other countries such as Canada. The entire rest of modern world has universal health care, the US is the only first world country that does not have it and it’s filled with issues. We are able to sustain universal health care in Spain with %20 unemployment and you mean to tell me the great US can’t afford something so basic for it’s people? After the ex-orbiting amount of taxes the US people pay in comparison? Stop your bullshitting!

        • Frank S. Rosenbloom, M.D.

          Sergio,

          You are being disingenuous. I did not always have an MD after my name and I spent a lot of years as a struggling student. Your argument is from emotion and ideology, not logic. This and that happened here and there so you know all about this.

          If you think universal healthcare works in Canada go there and get a real disease. Then wait in a queue until you drop dead. Or, check out the practice of leaving emergency patients in ambulances for up to five hours in the United Kingdom. Universal healthcare is a disaster in other countries but you are drinking the Kool Aid Obama wants you to have. You have not researched the situation for yourself.

          What about freedom? Is that an important concept for you? Your right to have me pay for your healthcare infringes on my freedom not to. This country was founded on freedom, not on forcing people to pay for things they should have the responsibility to pay for themselves.

          Yes, you may believe that I owe you: housing, food, healthcare. But, you are wrong. You have the responsibility to provide them for yourself. So, stop whining and do it.

          • Sergio Bana

            Sounds like you’re getting a little emotional yourself. By the way, I never asked for you to pay for food and shelter and neither is this health care reform bill. You’re right though, no one should pay taxes for anything including education and financial aid. After all, why should I care how dumb your kids are? You´re blowing this way out of proportion and trying to make this look like communism. So now tell me this, are you writing in this blog as a doctor or a member of the GOP?

            By the way, there is not a single Canadian, British or any other European citizen who who give up there universal health care insurance card for your HMO. You can search deep for those one or two incriminating cases in Canada or in the UK that makes them look bad but much worse things happen in the US with much more frequency and yet those cases are somehow censored. If universal health care were ever privatized in Europe there would be a revolution.

            Freedom means much to me, and so does the right to life, liberty and the pursuit of happiness. The right to live…kind of hard exercise when you’re dying on a hospital bed because you have no way of paying your hospital bills. Same goes with the pursuit of happiness. Freedom also entails lack of oppression and when people have to sell there homes to pay there bills after working there whole lives just because United Health Care said so, because they insisted on there profits, that to me shows
            much of it.

            Going back on your comment: “This country was founded on freedom, not on forcing people to pay for things they should have the responsibility to pay for themselves.”

            Who decides what “should” be my responsibility? Or yours for that matter? Even though I make minimum wage working at the bookstore on campus and don’t pay nearly as much taxes as you do, I still pay them. And I will never complain so long as they as it is going to things that are useful for the greater good of the society that I live in. I’m not whining, I’m looking out for the greater good.

            Our founding fathers never stated what we “should” or “shouldn’t” pay for. They did say we shouldn’t be paying for taxation without representation. As long as it’s being used to represent our best interest, the interests of the people, it’s good to go.

            Like I said, stop your BS. By the way, the majority rules. Another facet of freedom. When Obama signs the the health care legislation, I don’t want to hear you’re whining.

  • John in Oregon

    I was going to comment about costs. BUT, Think Oregon (TO) made a comment that is worth discussion.

    > *Frank … The problem with the GOP/CPI/OC crowd is that you can’t escape being the party of no. No reform. No open debate. No linking to alternative opinions (wink wink Jason). No real policy alternatives. You’re reinforcing one central idea the we get whacked on consistently.*

    Interesting line of thought. No reform. No open debate, No … alternative opinions, No real policy alternatives. I swear to god that from this you would think that only Progressives have any ideas at all. Everyone and everything else is just a roadblock to be demolished.

    When Senator Baucus stands in front of the cameras and says the Conservatives have no ideas. When Obama says the party of NO. Is that true? Based on the sileance in the legacy media Democrat echo chamber it must be.

    Well it’s not true. Senators Tom Coburn and John Barrasso as well as the GOP in general have presented lots of ideas.

    So the TO challenge is accepted. Just take the Coburn / Barrasso / GOP proposals and unveil them in Blue Oregon and the Oregonian. That is my challenge. Just try. Then tell me just who is the party of NO.

    Recently Richard North an innovative blogger developed what he called the Tiger Woods Index. What he did was measure interest in a subject using Google. Three example subjects he used were Tiger, Afghanistan, and Climategate. The number of pages then served as a proxy for interest level. He found;

    Afghanistan 143 million pages.
    Climategate 28 million pages.
    Tiger Woods 22 million pages.

    Richard then did a search of news coverage for number of articles for each subject. From that we can calaulate that

    Tiger Woods generated 20.5 news stories per 10,000 pages of interest.
    Afghanistan generated 10.8 news stories per 10,000 pages of interest.
    Climategate generated 1.03 news stories per 10,000 pages of interest.

    Obviously this shows Climategate is significantly under reported by the legacy media. The web page wattsupwiththat.com has generated its own hockey stick of page views for the climategate subject.

    I didn’t bother to check the numbers. The interest in health care alternatives is high. At the same time TO points out the obvious low coverage of GOP alternative ideas. I will leave to the reader to show if that is due to lack of Conservative / GOP ideas, or is it because the legacy media serves as the PR arm of the progressives?

    BUT, is NO actually a bad thing?

    Recent polling suggests Obamacare receives a bare plurality of a shrinking number of self identified Democrats with outright rejection by large percentages of Independents and Republicans. Polls are one thing, picking up the phone to say NO to a congress critter quite another.

    In 1989 an earthquake struck Loma Prieta California. The quake did real damage and shutdown the telephone system. What few know is why the phone system failed. All around the country people wondered about mothers, sisters, aunt Tillie, and friends. Many attempted to call and check. The phone system failed not because of damaged facilities, but rather the phone system was not able to handle the call volume into California. Telephone company figures place the call volume at some 20 million call attempts for two hours.

    Since 89 the Telcos and service providers have added capacity. Why do we care? Simply this, this last summer and fall the Washington DC phone system experience similar loading from high call volumes. Making or transferring local calls, well that just didn’t happen. Why you ask?

    Most recent was the Saturday night Senate which like a thief in the night came to steal health care. The people rose up to say no, NO, and hell no. For days at a time during business hours the calls kept coming. Call after call. Running between 10 to 1 no and 40 to 1 no. NO. Hell No.

    So if the callers to DC were only 20 or 30 million that’s 10 percent of the voting public calling. That’s huge. Really huge numbers that call to say no. Congress needs to get that message not leave the phone off the hook and divert the calls to auto purge voice mail as Senator Reed instructed the Democrats last week.

    As to alternatives, I say we need not have a shrinking piece of a smaller more costly pie that Obamacare proposes. Look at that cell phone in your hand. Cell phones, blackberries, and I phones. A product that did not exist 15 years ago brought to us by a free market that provides a small compact device which provides connectivity at only pennies a minute.

    Would any argue that such wonders could be produced by a Government public option? Or, do you prefer the free market that actually delivered real product?

    Why not allow the free market to provide health care. A novel idea that we have blocked for several decades now. Why not give that a try?

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