For those of you not familiar with Andrew McCarthy, in addition to being a featured writer for National Review, he is a former Assistant US Attorney who prosecuted the ‘blind sheik’ responsible for the first World Trade Center bombings. His work prosecuting, exposing and warning America about radical Islam is seminal. But Andy is not a one-trick pony. In many respects, he is the “white Thomas Sowell”, having a field of expertise but also being very well versed and prescient on many different aspects of American socio-politics, so as to be recommended for background and perspective on many topics.
Andy’s latest output at NRO has to do with Obamacare, the coming Supreme Court case about same and why it as at once crucial that it be decided well, but at the same time warning the decision is not the be-all, end all of the way forward. One of McCarthy’s points in the piece is that, regardless of SCOTUS’ ultimate rendering, decisons, habits and practices are already being changed. They are being changed in anticipation of the law going into full force in 2014, but also in recognition that, even if all or part of Obamacare is struck down, the landscape will have changed so much from 2010 to 2014 that socialized medicine, i.e. rationed care, instead of leaping forward, may continue at just a more measured pace. As McCarthy says, Obamacare is being ‘regularized’.
In light of this, think tanks, consultants, non-profits, advocacy groups and Big Health itself have been conditioning the populace for a much less compassionate, much more regimented and much more spartan health care scheme in the US in the wake of passage of the Patient Protection and Affordable Care Act. Recall that from the outset, in pushing for universal healthcare in the US, Obama and other proponents have harped on two crucial aspects. One is that there are 30, 40, 50 million uninsured Americans. This of course is false, because for those who are not covered by individual or group health insurance plans, there is Medicare and Medicaid. If you want to argue that there are still segments not covered, one could say yes, but they can still walk into any Emergency Room or street clinic in America and get health care, so get real. This question of insurance is one which will be decided by the Supreme Court, but once again we chant “INSURANCE IS NOT HEALTH CARE, YOU IGNORANT ****!”
What probably will not be decided by The Court, is the whole issue of “cost”. That was the second major talking point around Obamacare. Health care costs too much. We still shake our heads at the logic fueling the debate, which is that it assumes health care is a constitutional right, but that it is so costly in its delivery that it should be rationed. We can only ask, is there any other Constitutional right whose proponents believe that it should be rationed? Oh, yes, panels will be set up and only that free speech which the data supports as likely to have a good outcome will be approved. Uh huh. Health care is not a right, any more than waking up feeling like a king is a right, but so it goes. Health care is a need, and needs are taken care of in America.The follow-on questions of course are: To whom is the cost excessive? And, If the cost is to be reduced by deciders, who will do the deciding?
Comes now from USA Today a piece by a functionary at the California Health Care Foundation (CHCF) informing us of groundbreaking achievements in controlling health care costs. Here is one example:
Vast amounts of money are at stake. The Banner Health
system, which has hospitals in seven states, has instructed doctors they can no
longer use a certain product designed to prevent abnormal scarring during
cesarean sections, saying it does not improve patient care. The effort has saved
more than $1 million so far
Note that it wasn’t the government who told the doctors they couldn’t use the product, it was the private health care company. They have been advised by “data” which told them that nobody died or got violently or chronically ill as a result of being denied the product, so it wasn’t unethical, to them at least, to ban it. But the key word, which is glossed over, is “abnormal”. There is scarring in every Caesarean Section. All surgical procedures involve scarring to some degree. But the doctors, and of course the patients, are now just supposed to live with “abnormal scarring” if it occurs, no matter how “abnormal” because the deciders say they’re no longer getting the protective barrier product.
So. Not a life or death situation, you say. Saved a million bucks. Again the question – who saved the million bucks? How many women had “abnormal” scarring, how “abnormal” was it, and would any, some, or all of them paid out of their own pocket to have allowed their doctors to use the protective barrier? The article doesn’t tell us, but it doesn’t matter because they’re not getting the barrier. Nor does it tell us about other types of surgeries and “abnormal scarring”.
Now proceed to the next example.
In the Bon Secours system, heart surgeons helped create new
blood transfusion guidelines about three years ago at hospitals in Virginia, New
York and South
Carolina, Priest says. Since then, the share of heart surgery patients
receiving transfusions fell to 42% from 66%, and the average amount of blood
transfused dropped by nearly two-thirds, he says. The system saved $1.1 million
as a result.
“The complication rate went down and the length of time
people spent in the hospital went down,” he says.
Well, yes, if you tell doctors who they can transfuse and who they can’t, your transfusion rate is going to go down, by golly! And if you don’t transfuse ’em, yes, it’s likely to be less complicated , and you don’t have to keep them there if you’re not going to take the time to transfuse them. Hooray for you. What’s missing from the computation folks? No “DATA” on how many people D-I-E-D. But that has no effect on the narrative, you see, because another million bucks was saved! …………….ka……..ching.
Remember, these are not the dreaded “death panels”. Those are yet to come. These are private health care concerns gearing up for 2014. Now, we will get a lot more positive coverage and propaganda about the benefits of rationed care, denial of service and procedures as this goes along. But here’s the thing: If we are not going to probe too far into the weeds on survival rates or life expectancies of your basic life-or-death heart surgery cases, we’re pretty much going to laugh at you and your “abnormal” scarring issues, aren’t we? And the possibilities are endless. “So you’ve got a little limp, so what? Deal with it. We gave you a cane!” “Sorry about the residual cancer in there! See, we’re on this kick about minimally invasive surgical procedures. Gotta get you back on your feet in a jiffy, you know! Time is money, and besides, there might be….complications.”
Just two examples. You could think of a couple dozen more before lunch. What you need to consider, though, is that when people tell you that Obamacare must be repealed because of the individual mandate, because if the government can force you to buy something, it can force you to do anything, or prevent you from doing anything, they are of course right. Further, if Obamacare is upheld, regardless of the individual mandate, there are other mandates, hundreds, maybe thousands of them, in the bill that support the anti-Obamacare argument that the government will get between you and your doctor. (Your doctor? How quaint!)
But as a practical matter, Obama, and the people behind socialized medicine won the war with the simple passage of the act by a two-vote majority, because the conditioning of the public and the practitioners began at that moment, continues in earnest til this day, and will proceed full throttle up until that hot summer day in 2012 when the Justices speak to us. At that moment, there will either be a counter-revolution, or the verbiage of the Supreme Decision will mean little, because all the little apparatuses and procedures will have been put in place and the private sector will sing to the tune of the entrenched government bureaucracy, regardless of whether USC, Title X, Section Y,Paragraphs A through ZZZ contain Obamacare or are blank, as happens in any good socialist system. Obamacare was always about a lot more than socialized medicine. And if the counter-revolution does take place, it needs to be about a lot more than socialized medicine as well.