Health Care Behemoth

There was a report in the morning's Dallas Morning News about the health care bills winding their way through Congress. The bills are all mind numbing in their complexity. More significant is the wording in the various bills. The proposals being put forward all contain the words "must", "have to", and "required to." As much as the bills proposed are portrayed as simply seeking to provide health care to people who need it, they increasingly represent an attempt to coerce health care agencies, insurance companies, and business into meeting the political goals of Washington. Washington has decided it wants to provide health care to all. It cannot fulfill its promise because it cannot afford to do so. Congress therefore is seeking instead to coerce the insurance companies, the health care industry, and the private sector, into making good on its promise.

Employers with payrolls over $500,000 would be compelled to provide insurance to their employees. Larger companies likely will raise prices in order to offset the cost. For those unable to raise their prices, the costs will have to be absorbed. If it is not possible to absorb the costs, then they will have to be reduced in other ways, such as trimming the payroll or outsourcing jobs. There is no free lunch.

The "rich", those making over $500,000 a year, will have their income taxes raised. This is always a popular proposal with the "middle class." But it should be remembered that when the federal income tax was first enacted, it too was limited to the "rich." Now, all but the very poor pay it. A maze of federal regulations is being discussed on how to manipulate the tax code to assist the middle class in meeting the obligations that will be imposed upon them. The problem here is that the tax code can always be manipulated. In the future, as the cost of health care rises, and it will, there will be pressure to raise and expand those taxes. It is inevitable that the health care taxes imposed on the "rich" will someday be extended to the middle class.

With a health care system run by the secretary of health and human services, it is also inevitable that politics will be injected into health care. No good can come of that. Treatments and procedures would all acquire a political significance. Abortion, while the most salient, would not be the only one. Different lobbying and special interest groups would all demand a say in coverage, treatment, and the allocation of federal funds.

If it could be guaranteed that federal involvement in health care would be limited to underwriting health care, the prospect of its involvement would be less menacing. Such a guarantee is impossible. Even if the government today promises to stay out of the managing of health care, it cannot be guaranteed that this will not change in the future.

Where government money goes, government follows. Where government goes, politics follow. It is a law of nature. No politician can argue otherwise. No person should believe otherwise.