But soft! Gaze carefully at the chart above. And that is but one portion of how the Federal government is involved in health care. Don't think for a minute that what we experience today is anything closely resembling a free market health care sector. Health care costs out of control? In the private sector only?
Apart from the near trillion dollar Medicare system, let's look at several other ways the government is involved in health care:
--The US Military system (of which I was a part of until I got out of college), which covers millions of active duty personnel, retirees, and dependents of the Defense Department. Members of Congress, the Federal judiciary, and the Executive branch also can take advantage of the system. If one is in the US Coast Guard, Merchant Marine, or a uniformed officer in NOAA or the USPHS, there are Public Health Service Hospitals. I make no judgment on the quality of such care, I simply note its expensive and a significant public sector player in our health care system.
--The Veterans Administration and its associated VA Hospitals, the likes of which should send most of us running in the other direction when the words "Public Option" are mentioned. Review any of those "Fair and Balanced" non-Fox News specials on the shortcomings on the VA Hospital system.
--The FDA--the slow, inefficient arbiter and czar of approved drugs. And a major factor in the price of drugs and the lack of new drug therapies on the market. Even more strange; our far more socialist allies in Europe have been able to get drugs to market faster and in greater numbers than here in the United States.
--The National Labor Relations Board, an entity captured so severely by the labor movement in the post WWII environment that the entire country wound up with the concept of health insurance tethered to employment, rather than it being portable and individualized in the same manner we choose auto, hazard, and other forms of insurance.
--The supply of hospitals, the quantity of which is controlled in every State of the Union by local and statewide hospital authorities. Ostensibly, these gatekeepers were created to make sure competition in any geographic area did no harm, a backhanded attempt to prevent broad failures from cutthroat free market activities. All too often these entities restricted competition, favored legacy institutions, and opposed competing interests to government owned hospitals.
--Public hospitals make up 1/6 of the total number of hospitals in the US. Further, 2/3 of all urban hospitals in the US are "non-profit", meaning only 1/6 of all urban hospitals in the United States are truly "private sector".
--Federal employment law which dictates who and how employees get covered by any employer that chooses to provide health insurance.
--Federal and state laws (in cahoots with insurance companies) that prevent physicians from charging anything other than the same fixed price to everyone for any specific procedure. Five years ago, when serving on a committee that eventually led to the creation of the Community Care Clinic of Dare, I discovered that a family doctor could not discount services to an indigent patient--he or she had to charge the patient the same amount as anyone else, or provide the service pro bono under the guise of a community clinic.
--Laws that require Emergency Rooms in hospitals to function as family doctors, turning away no one. The bills are paid through Federal and state taxes as well as passed on to paying customers and insurers in the form of higher premiums to cover the losses on these services.
Still not convinced? Check out this article in Policy Review entitled "The Forgotten Entitlements", published in the Feb/Mar 2009 issue. Two Federal programs most of us have never heard of, Social Security Disability Insurance and Medicaid Long Term Care, now constitute 6% of the Federal budget. In the past ten years alone, SSDI added 2.5 million additional recipients and costs $93.5 billion per year. MLTC takes $63 billion from the Feds and an almost equal amount in matching funds from state governments, totaling $111 billion in 2006.
There are other arguments to be made, centered more on true ideological differences, such as how does one make what is known as a "claim right" on another's labor and expect said labor market to grow, improve and attract the best and brightest. Let us also not forget the trillions of dollars spent since the 1960's on public education, the War on Poverty, and the War on Drugs. What have been the fruits of any of these massive expenditures?
Still hesitant? In June, 2009 the World Health Organization declared swine flu a pandemic. Four months later, President Obama got around to declaring swine flu a National Emergency (on October 29).
And from the Washington Post, a "real" news network according to members of the Obama Administration, we found this on October 27th:
In July, Obama administration officials said companies could make 80 million to 120 million doses by mid-October. They outlined an aggressive response to the pandemic, spending more than $2 billion to buy 250 million doses of vaccine and promising enough to inoculate every American.
Of course, Obama blamed to drugmakers, as the article points out. Unlike Bush and Katrina, Obama and the Feds get a relative break from the Post on this swine flu mishap, but then again, Obama isn't Bush and there was no media interest in nationalizing hurricanes at that time. Any major coverage of the Obama Adminsitration failing to deliver the goods on swine flu vaccine would not only make his Administration look bad, it might give pause to citizens contemplating turning over their entire health care to Uncle Sam.
