First, a little history –
With regard to health care, we got to where we are today (i.e., in one helluva mess) essentially through the following sequence of misguided governmental interventions:
1. During World War II, the FDR administration imposed stringent wage and price controls which effectively prohibited companies from paying wages high enough to attract sufficient skilled workers.
2. Roosevelt’s War Labor Board, in its wisdom, decided that employers could offer prepaid health insurance to prospective employees in lieu of actual wages without violating the strictures mentioned above in #1. Also, the employee would not have to pay income tax on the value of the aforesaid insurance premium. Wowee … whatta deal.
3. Over the next two decades the number of people enrolled in health insurance plans grew from around 20,000,000 to over 142,000,000, and by 1960, 3/4 of all Americans had some form of health insurance coverage, mostly as a part of employer group plans. It is instructive to note that during this period significant efforts were made by the Truman administration to create a system of “national health insurance,” but the idea was fiercely opposed by such diverse groups as the Chamber of Commerce, organized labor, the American Hospital Association, and the AMA. You don’t often see business, labor and organized medicine all lined up on the same side. Gives one some sense of how unpopular gov-controlled healthcare was even back then.
4. Over the next several decades, despite some shortcomings (waiting periods, deductibles, etc.,) employer-based health insurance wormed its way into the American psyche and pretty much became institutionalized in the minds of most citizens.
5. In the mid-sixties, Lyndon Johnson, never one to be “out-liberalled” by anyone, especially some rich eastern wheelchair jockey, pushed programs through a dubious Congress that came to be known as Medicare and Medicaid. Both were relatively modest public relief efforts in the beginning … but that would change quickly and dramatically.
6. In the early to mid-eighties a new and profoundly maleficent “fillip” was added to Medicare – a new twist wherein the gubmint would pay fixed amounts for various maladies – and they (the gubmint) got to decide how large or small that amount would be! How many of us would like to shop at a store where we, as buyers, got to decide what we would pay for merchandise? This charming flimflam was euphemistically referred to as “prospective payment” and meant quite simply that medical remuneration was no longer tied in any meaningful way to the quality and quantity of services rendered .
7. AS Medicare and Medicaid reimbursement rates dropped (and drop they did, like Anthony Weiner’s boxers), hospital and doctor charges skyrocketed as fiscally strapped health providers scrambled to make up critical revenues lost – ushering in the era of the $90 aspirin tablet, of which the stories are legion. And by the way, insurance rates also shot up as a result of more and more patients chasing fewer and fewer health care opportunities. This is what happens when markets are artificially interfered with – the term “death spiral” comes to mind ….
8. And so we come to 2010; installed in the Highest Office in the Land is the Grand Poobah of Progressivism, nurtured at a number of neo-Marxist breasts, blessed with a golden teleprompter, and Scion of Hope and Change. “I am here,” he announces, “to give you all the stuff those nasty, grasping rich people (you know, the ones who have jobs, and work and pay taxes and all) want to keep for themselves – especially their health care. And don’t you all worry – I’m going to make them pay for it too!” And he tosses a bunch of silver – about 30 pieces to be exact – to Bennie “The Troll” Nelson, and LO! it comes to pass a couple years later that millions lose their private insurance, several Canadian computer geeks get extremely rich by building a web site that doesn’t work, and the only acceptable health insurance left belongs to members of Congress and key members of the administration.