Commentary
by Joe Blanchette

Medicaid for all?

Despite the absence of detailed analysis of the proposed health plan overhaul being advanced by our central planners in Washington, Vermonters are doing their homework and realizing that a massive government takeover will prove to be their worst nightmare, especially for the elderly and most vulnerable. Those physicians begging for ObamaCare will rue the day it arrives once their medical decisions are micro-managed by faceless government bureaucrats, their compensation slashed, fraud investigations become rampant, and their access to best technologies is restricted. And the rest of us will soon learn what folks in Canada and England have learned: government health insurance may be okay if you stay healthy, but it’s horrific once you become ill.
One of the “gotcha” questions we’re urged to ask our central planners is “will your family forgo the rich health benefits you presently enjoy and jump into the big health care life boat with the rest of us?” Senator Bernie Sanders, a proud Socialist, has already voted against joining the plan he hopes to impose upon us common folk. Regardless of how Bernie, Pat Leahy or Peter Welch answer this question, however, it’s safe to say they will not be standing in line behind the rest of us waiting for their chemotherapy, hip transplant or dialysis. Neither will any major government official, sports figure, entertainer or corporate leader. Those with considerable wealth or political power and connections will just pick up the phone, make the right calls and quietly move to the front of the line for their care. This is what happens with government health care in Canada, England and elsewhere, despite bold claims of equal access and quality care for all. And be assured that our Congressmen won’t be seeking their care in Cuba or one of the 36 industrialized countries that the left contends have better health care systems than the U.S.
Let’s focus on the core problem. Contrary to popular belief, the most predominant force driving health care costs and problems with quality and access hasn’t been the failure of the free market; it has been the ever expanding role of state and federal government into health care. The free market isn’t working in health care because it hasn’t been free for decades. Over the past 50 years, dozens of government agencies, hundreds of legislative benefit mandates, tens of thousands of bureaucrats, and countless regulations dealing with virtually every aspect of health care delivery and financing have driven up costs and eliminated any meaningful market influence. Government health care programs presently account for almost half of all health care spending in this country, and none of the promised economies of scale have been achieved. The opposite is the case. Government makes up most of the rules that employers, doctors and insurance companies must follow. So if you’re unhappy with the cost of the present health care system in the United States, thank your state and federal politicians.
So let’s not divert discussion about ObamaCare with questions that beg for disingenuous responses from our wealthy central planners about what health plan they’ll enjoy. Let’s rely on one of the great truths in life. “If something sounds too good to be true, it’s probably untrue.” With straight faces politicians tell us that this 1,100-page plan will guarantee access to high quality care for all, freedom of choice, no reductions in coverage, and it will save money. Even the Congressional Budget Office has repeatedly renounced such transparent foolishness. Hopefully, we don’t need the CBO as a substitute for common sense.
Here is the key question Vermonters need to ask themselves, not their politicians. Given that massive, government-run programs like Medicare, Medicaid, the VA health system and Social Security all have been run into the ground and now face insolvency under the watchful eye of central planners in Washington, why in the world would you trust these same people with deciding whether your spouse, child or parent will get the cancer drug or surgery they need, when they need it? Let there be no doubt. When government controls health care financing, it must control the benefits and access to care.
Canada’s Fraser Forum published this telling story of a Hungarian economist and high school teacher named Gabriella Megyesi who spent her fall term teaching in Canada. Shortly after arriving in Canada she published the following stark observation. “I have been in Canada for just two weeks and already I feel at home. I feel at home not because of the landscape or climate. Nor do I have family here. But public policy in Canada reminds me of growing up under the Communist regime in Hungary during the 1970s. When the socialists were in charge, we kept hearing nice promises that everyone would get free (or cheap) and good-quality goods and services. The only problem was that the three features never worked at the same time. If something was free and available for everybody, it was not good quality. If something was free and good quality, it was not available for everybody. If something was of good quality and available for everybody then it wasn’t free or cheap.”
The experiences of our neighbors to the north, in Europe and in communist countries, offer profound testimony on the failure of socialized systems to deliver quality and affordable health care. Our own partially socialized approach in the United States over the past half-century should be similarly instructive. We have only to look around to see what not to do – what mistakes not to repeat. Hopefully, from there we can focus on solutions that may actually make things better.
Joseph P. Blanchette

Mr. Blanchette was a Howard Dean appointee as a consumer and labor representative to Vermont’s Health Policy Council and later to the Public Oversight Commission in Vermont. He also co-managed Vermont’s largest, self-funded, labor/management health insurance pool, the Vermont Education Health Initiative.