By Doug Magill
In any bureaucracy, the people devoted to the benefit of the bureaucracy itself always get in control, and those dedicated to the goals the bureaucracy is supposed to accomplish have less and less influence, and sometimes are eliminated entirely. Jerry Pournelle – Pournelle’s Law of Bureaucracy
The recent imbroglio concerning the targeting of conservative groups by the Internal Revenue Service should not be a surprise. Presidents in the past have tried to use the agency to either pressure or punish enemies (Roosevelt, Nixon). The IRS deftly avoided being the tool of the administration in those cases, but the nature of the bureaucracy has changed. Now, it is more ideological, with its own unions and the desire for self-aggrandizement greater than any concern about the welfare of the citizens they are supposed to serve.
In fact, the term “public servant” is certainly becoming a cruel joke, as government workers tend to make more money, have better benefits, better job security, and less accountability than any other group of workers anywhere in the world.
And Congress passed a law that requires an ideologically-driven bureaucracy that already has immense power to be the custodian of our health care. Kafka himself could not have imagined a worse nightmare for those of us remaining as citizens.
Already destructive of the concept of health insurance, further government regulation and control of the industry means its ultimate destruction, and the concomitant loss of jobs. As well as the ability of citizens to pick coverage they want and only pay for what they need. The mandates and community-rating and guaranteed-issue requirements of Obamacare – long the dream of anti-free market liberals – have unsurprisingly caused rates to skyrocket, which will cause fewer people to have insurance. Which will naturally lead to more demands for total government control.
And will diminish us all in the shadow of the resulting monstrous, ideologically-driven, and unaccountable bureaucracy.
A telling story is the recent decision of Aetna to pull out of the Obamacare exchange in Connecticut. As Joseph Rago explained in a Wall Street Journal article, “this is like L.L. Bean quitting Maine or Apple leaving California—for the moon.”
As is now the usual case, state insurance regulators wanted drastically lower rates for Connecticut citizens in return for allowing Aetna to offer products in the state. A state, by the way, where Aetna was founded in 1819 and has its headquarters. The effect of course, is the same anytime government tries to impose price controls – which is what the Obama administration desires. Counteract the increases in rates because of Obamacare by controlling prices and screwing the insurance companies. With, the predictable result of the company deciding not to offer its products in a market where it has no control and no opportunity of turning a profit.
Insurance companies have a lot of experience with actuarial analysis, and Aetna believed that its costs for participating in the exchange in Connecticut would not be covered with the rates the regulators were attempting to jam down its throat. So now Aetna is the second company to drop out of the state market. There will be more.
This is how government control inevitably works. Control prices under the politically popular guise of helping some group touted as being disadvantaged. The net result is less choice, and less business. Price controls distort and destroy markets. Everyone loses – except the bureaucrats.
Cost management will become the god of the bureaucrats, and the wailing and gnashing of teeth outside the glass-walled façade will not be heard. People will be killed for the sake of a political experiment that was never fully discussed, was not thought out, and will be incredibly destructive to our economy and society.
The snickers of the media when Governor Sarah Palin called the Independent Payment Advisory Board a “death panel”, were loud and long. But, her prescience is now being observed in Oregon, as liberal states often tend to be the laboratories for liberal autocratic schemes.
The state’s equivalent of the IPAB is called the Health Evidence Review Commission. A truly liberal abomination – of course it is a panel of experts who are supposed to have the wisdom to manage decisions that used to be made by mere citizens. A preview of what is to come with Obamacare. Of course they claim to only care about what is effective, but what it means in truth is that the HERC will not allow newer, costly treatments. The dark ages of medical decisions are already being felt where control boards rule the land. Coming soon to the federal government.
The recent decision was that the government will not cover cancer treatment for patients with less than two years to live. The claim by the Oregon HERC was that “in no instance can it be justified to spend $100,000 in public resources to increase an individual’s expected survival by three months when hundreds of thousands of Oregonians are without any form of health insurance.”
The unspoken question is how bureaucrats can say with certainty that a cancer patient truly only has two years to live, or, that the same patient might indeed survive longer than presumed with the right treatment.
Other recent decisions by the HERC included an attempt to limit the number of times a diabetic could check his blood sugar to once a week, as opposed to three times a day as currently recommended by the American Diabetes Association.
This is not new. Already, the wonderful bureaucrats in Britain’s National Health Service use the soon to be commonplace statistic of Quality Adjusted Life Years to determine whether to spend money on the treatment of a patient. Sometimes they obviate the need for it by leaving patients to starve, postponing treatment in the hope that a patient might die, delaying even basic, “necessary” treatments until the symptoms become unbearable. All to save money. Soon to be seen in the U.S.
And, by the way, administration experts are not only proposing the use of Quality Adjusted Life Years, but the “instrumental value” of an individual to society. Guess who gets to determine that? And guess who will come up on that list a lot higher than you or I. The bureaucrats and politicians that run your life.
And, already we are seeing “experts” in this country advocating rationing, even so far as to adopting the British standard of not paying more than $31,000 to $47,000 per year of life gained. See how easy that sounds? The problem is that medicine is not exact, and one physician’s guess as to the amount of life to be gained by treatment, and the efficacy of such treatment relative to his perception of the quality of life may be vastly different than another’s.
Oh yes, we are investing godlike powers in medical personnel, bureaucrats, and politicians (who will be swayed to demand treatment for this or that depending on the political noise a particular group is making). Those decisions just won’t be allowed to be made by individuals.
The other constraints of Obamacare mean that individual physicians will be practicing in groups, not individually, and, by the way, they generally will be salaried employees. Which certainly means the old doctor-patient relationship will drift further into the mists of memory, and they won’t really care about individual patients. They won’t be paid to.
And, by the way, lest those of you who have saved for retirement think that you can use some of your own money for treatment, Obama administration officials are already proposing a fixed cap on private medical spending. So if the government won’t do it, you won’t be allowed to either.
Younger people, and those less able to afford extensive coverage tend to buy basic plans which the residents of New Jersey used to be able to do. Because of the mandates of Obamacare, over 100,000 of them will lose their coverage.
Many of the provisions of the Affordable Care Act are poorly written, and create the universal results of liberal legislation: perverse incentives. So, spouses of UPS employees will not receive coverage under Obamacre. And, because of the way cost mandates are written under the plan, it may be more cost-beneficial for some employees to have their spouses and children not be covered under their employer health plans, instead dumping themselves onto the exchanges for subsidized coverage.
Medical bureaucracy is not new, it has grown to keep pace with malpractice issues and concerns, along with misguided regulatory demands. So, bright people come up with more ways to torture patients to protect hospitals and doctors. Expect it to get a lot worse.
The National Journal does not tend to be friendly to conservatives. But, even that generally liberal publication is starting to wake up to the fact that medical insurance costs, even on the exchanges and subsidized, will be more expensive than the current costs.
When confronted with all of the inconsistencies, mendacity, and illogic of Obamacare, liberals tend to sputter and moan about trying to do the right thing and finally, getting their courage up, whine that it’s the law of the land and we should get over it. That has been heard before, and discarded for the nonsense that it is.
It is now well known that many companies are reducing the hours of workers to avoid the costs of Obamacare. This is the European model, where to have a full time job is rare, part-time employment is the best that can be hoped for, and the unemployment rate of younger workers remains sky high. Statistics show that under the Obama administration the growth in part time jobs has vastly exceed the growth of full time jobs for the first time in history. The long-term effects will be enormous.
During election season last year, the administration bragged in its usual way about cracking down on mortgage fraud. Once again, our top law enforcement officers lied.
The stoking of resentment and envy is certainly one of the more distasteful aspects of this administration. Once in a while we need to be reminded of what it takes to build, and sustain a successful corporation.
Too often stereotypes drive political discourse. And not to the benefit of our society. Yet, once in a while stereotypes illustrate ugly truths. One of those is that it sometimes is better to be on welfare than to work.
Lest we forget: Benghazi was a disgraceful display of indifference, incompetence, and cowardice on the part of our president and secretary of state. Now that same former secretary desires to be perceived as an accomplished leader who could lead our country. Not if Pat Smith is allowed to be heard.
In the wake of the Trayvon Martin trial, and the subsequent disdain for stories about the devastation in the black community wrought by black youth, it is hard not to question why some people are invested in racial disharmony, and wish to increase rather than still racial controversy. Oberlin is a local cauldron of liberal smugness and idiocy. And yet, once again, liberals there are found trying to create racial problems.
Doug Magill is a cancer survivor, consultant, freelance writer and voice-over talent. He can be reached at email@example.com