If ever we're threatened with another Ice Age, the defense is already at hand: millions and millions of words about health care, just this year, producing vast quantities of heat — and, better still, next to no light, which would upset another delicate equilibrium somewhere in the system. Expect a few more joules in the next several lines.

So far as I can figure, the Obama administration seeks to take the second-worst health-care system on earth and turn it into the worst, by supplementing (or supplanting — take your pick) the existing crapshoot in which various corporate gatekeepers have loaded the dice, with a parallel (or parasitic — take your pick) crapshoot in which various government gatekeepers have loaded the dice. The notion that a package simultaneously extremely useless and extremely expensive can somehow be sold as an improvement demonstrates entirely too clearly that too many of the people can be fooled too much of the time.

Among the fooled you'll find The New York Times, which is actually claiming there's a moral imperative involved:

Health care reform is vitally important both to cover tens of millions of uninsured Americans — a moral imperative — and to bring down the relentlessly rising costs of care. Those costs are straining not only the government's budgets for Medicare and Medicaid. American businesses are struggling to provide insurance for their employees. Millions of Americans are struggling to pay high medical bills and rising premiums; many are just a pink slip away from being uninsured.

The Times is invited to read Exodus 20:1-17, that they may observe actual moral imperatives.

George W. Bush, who's presumably read Exodus, at least at one point took the bit about "thou shalt not steal" seriously; he proposed, in his 2007 Inaugural Address, a modest plan to increase availability of insurance without dipping substantially into the Treasury. Congress, which doesn't do anything without dipping substantially into the Treasury — it would be a violation of all they hold sacred — basically ignored it.

Still, Bush loses points for characterizing this move as something resembling "free-market" health care. It's not. It somewhat opens up the market for insurance purchases, but it does nothing to ensure a free market. And it's just as well, because if you really wanted a free market in health care, you'd have to do something like this:

1) [T]otal repeal of all government controls over medicine; the removal from the Internal Revenue Code those perverse incentives which enslave all Americans to third-party payors for their medical needs; the repeal of Medicare and Medicaid; the dismantlement of the Veterans Administration system to be replaced by GI BIll-style grants to be spent by the veterans themselves on their choice of medical care and providers.

2) The elimination of all mandatory and coercive controls over providers of medical goods and services, the weakening of the FDA to a purely advisory role somewhat like the Microsoft Windows logo certification program.

3) Constitutional amendments forbidding state or federal intermeddling in private, consensual transactions involving no infringements of third-party rights, coercion or fraud.

No, you can't have a free-market health-care system. Not yours. The government would never stand for such a thing. The government won't even stand for you're having a health-care system on par with that Congress has for itself. In fact, reading the government proposal in advance is not to be encouraged.

In the meantime, in the words of the late Walter Cronkite, "America's health care system is neither healthy, caring, nor a system." I expect to be just as dead as Cronkite before anything genuinely useful is done.

The Vent

  21 July 2009

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 Copyright © 2009 by Charles G. Hill