Health Care Camel

What seems to be lost in the debate over health care reform is the politicization of health care that would inevitably result from a government run health care plan. We should keep in mind the old adage that once a camel gets his nose under the tent, the rest of him will soon follow. Once politics is introduced into health care, political pressure would soon be brought to bear. Would national health care cover abortion? Cosmetic surgery? Sex change operations? If so, there would be pressure from the right. If not, there would be pressure from the left. There would be debates over which diseases would have priority and which conditions required more federal coverage. Some diseases and conditions no doubt would be more politically fashionable than others.

Like every other federal program and entitlement, pressure will be applied as each disease, condition, and injury would generate lobby groups to advocate on its behalf for more federal coverage, and treatment. It is unlikely that the federal government would be able to withstand the pressure brought against it by drug manufacturers, health care organizations, and advocacy groups. AIDS groups would find themselves in a political contest with breast cancer groups for federal coverage and treatment. A bureaucratic jungle would be created to manage and distribute federal dollars to this or that region, and treatment for this or that disease or injury. Whose disease, condition, or injury would be more important and worthy of federal coverage and treatment? Mine or yours?

Every federal bureau and agency is replete with horror stories regarding mismanagement, incompetence, and red tape. (One only need look at the federal response to hurricane Katrina.) With all the complexities regarding medicine and pharmacology, do we really believe the government is competent to manage health care? Moreover, it is extraordinarily unlikely that the government would able to resist the lobbying efforts of health care groups, patient rights groups, and the different health advocacy groups for more or better coverage; let alone master the intricacies of medical treatment and care. The result would inevitably be a federal behemoth under which all would suffer, from taxpayers to those sick or injured. That is, for all but those able afford private insurance. While Obama might try to reassure the public that the government would not involve itself in health care beyond underwriting and supervising, this is extraordinarily unlikely. Welfare, medicaid, and medicare, despite the beneficence and altruism of their motives, all have political components and are regularly subject to political debate and posturing.

It is the nature of bureaucracy to expand. What's worse is that where government goes, politics follows. Why would health care be any different? I am reluctant to take the assurances of the administration that the health care plan it proposes will be limited and no threat to existing health care insurance. Like many, I fear that once the camel gets his nose under the health care tent, the rest of him will soon follow.