Uncle Sam’s Protection Racket

Meet the Press set, November 1975.

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George Will, that persistently pedantic pundit of politics, now chooses in today’s Joplin Globe (3/14/11) to peruse the constitutionality of mandatory health insurance, i.e., the Affordable healthCare Act, a.k.a., ObamaCare.  I enjoy watching George on television, but his writing, not so much.  He always drives me to the dictionary.  But anyway, his subject is an important one that affects all Americans and he is a smart guy, so I am inspired to try to simplify his words.

Big Brother 2000 (UK)

Image via Wikipedia

What George is pondering has to do with whether the government has the right to force Americans to pay for health insurance, whether they want to or not.  The Obama administration and Democrats believe they do because of the government’s right to regulate interstate commerce, even though what is being regulated is the act of choosing NOT to purchase something, i.e., health care premiums under the ACA. George, bless his conservative heart, calls such reasoning “Orwellian”, so I guess we all know how he feels about it.  However, in my opinion we crossed the line of government’s right to dabble in our private affairs a long, long time ago, and now we are simply arguing over how much to move that line.

I was prompted to reply about a similar topic to a commenter on another blog-post this morning.  “Jane Reaction” was waxing possessive about the word “entitlement” as applied to her Social Security benefits and opining that nobody should think that her benefits were some kind of gift for which she should be grateful.  After all, she had paid into the system with money she had earned herself and she had every right to such benefits.  Here was my reply to her:

Reaction, I hope you haven’t bought into the notion that all the money you paid into the SS system was being stored for you in a big bank vault somewhere. If so, it wasn’t. The truth is that there is very little relationship between what you paid in and what you get out, any notion of FAIRNESS notwithstanding.

The following paragraph from a Wikipedia page applies:

“In the book How Social Security Picks Your Pocket other factors affecting Social Security net benefits are identified: Generally, people who work for more than 35 years get a lower net benefit – all other factors being equal. People who do not live long after retirement age get a much lower net benefit. Finally, people who derive a high percentage of income from non-wage sources get high Social Security net benefits because they appear to be “poor,” when they are not. The progressive benefit formula for Social Security is blind to the income a worker may have from non-wage sources such as spousal support, dividends and interest, or rental income.”   (More at this Link.)

You are certainly right that you deserve the benefits because you did pay into the system, and it is in the same sense that I use the term, “entitlement”. You are entitled because you paid, not that you had any choice in the matter. But the benefits do not come from the money you paid in. That money was spent as soon as you paid it. Where did it go? Part of it went to people who had already retired and the rest was spent by Congresses of Christmas past, gleefully if not gratefully.

Some people have compared Social Security to a giant Ponzi scheme, and that is valid except for the fact that, unlike a Ponzi scheme, Social Security has a reliable source of future funds, i.e., the pockets of current and future taxpayers. (Warning, some future tweaking may be required.) Anyway, the “benefits” you eventually get are all part of a progressive scheme to provide you, well, a government-guaranteed base of security that will keep you from starving and hypothermia if you have neglected to save for your own old age.

Then, it occurred to me that there is similarity between Social Security and the ACA.  Both are mandatory programs forced on the public by government. If the Supremes deem it unconstitutional to force people to buy health insurance, might it not also be unconstitutional to confiscate their earnings for the Ponzi scheme that is Social Security?  In this regard a federal law known as EMTALA is pertinent.

Whereas Social Security is compared to a Ponzi scheme, EMTALA might be compared to extortion.  Why?  Because EMTALA essentially says to medical providers, “You must provide medical treatment of standard quality to anyone asking for it, regardless of their ability to pay for it.  If you don’t, we will disqualify you from receiving any reimbursement from MediCare or MediCaid, thus depriving you of over 50% of your current income.”  Thus, to reason that “deciding not to pay for a necessity” is unjustifiable government regulation is no greater a leap, IMHO, than to reason that “extortion”, i.e., EMTALA, is also unjustifiable government regulation.

So, if the Supreme Court finds ACA to be unconstitutional, as George Will wants and expects, then how can EMTALA be exempt from the same reasoning? And if EMTALA goes, can Social Security be far behind?

See, this is what has happened.  Medical science has been leveraged by public funding into providing more, and more-sophisticated, technologies and medicines, which are now considered necessities but which we as a society do not wish to afford.  We want collective benefits but do not have the political will to collectively pay for same. It’s not that we can’t afford it, we choose not to through the political process.  The medical community is caught in the middle, unwilling to give up its public income but also swamped with skyrocketing costs.  The ACA improves the system by forcing additional payments but does not address the root cause, i.e., the lack of capitalistic controls, a.k.a., supply and demand.

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About Jim Wheeler

U. S. Naval Academy, BS, Engineering, 1959; Naval line officer and submariner, 1959 -1981, Commander, USN; The George Washington U., MSA, Management Eng.; Aerospace Engineer, 1981-1999; Resident Gadfly, 1999 - present. Political affiliation: Independent, tending progressive as the GOP recedes from its Eisenhower roots.
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11 Responses to Uncle Sam’s Protection Racket

  1. jwhester says:

    I disagree with so many of your points and arguments that I cannot begin to list them all. But let me say this about the subject of your post. If raising one’s taxes based on what one refuses to buy is unconstitutional (and that is all that ACA does), then that would imply that lowering one’s taxes based on what one buys is also unconstitutional. Our tax system is full of such tax credits and deductions.

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  2. Jim Wheeler says:

    Actually John, I’m not really advocating for anything in this post, with the single exception that a broken health care system should be fixed. Somehow. Conservatives like George Will would probably like a pay-as-you-go system and liberals would like a socialized-medicine system like Canada’s. I would be somewhere in the middle.

    You are of course right about our tax system already being full of “tax credits and deductions”. That is the same kind of thing – basically a redistribution system. I believe I said as much when I said:

    “However, in my opinion we crossed the line of government’s right to dabble in our private affairs a long, long time ago, and now we are simply arguing over how much to move that line.”

    But the point of the post, and I realize it’s probably too rambling, is to try to sort out some basic issues as the Supreme Court prepares to rule on them in the ACA case. Those 9 people are going to decide those issues for you and me. Stay tuned. And thanks for your comment.

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  3. wingwiper says:

    As it works in practice today (14 Mar 2011):

    This morning I received my Medicare booklet, requiring me to choose or not choose to enroll in Medicare Part B (premium currently $115/month to be deducted from my Social Security Retirement check, and rising). The “opt out” moment arrived.

    Everyone who ever paid into Medicare is automatically enrolled in Medicare Part A, no matter how long or short they have been contributing. In my case, I involuntarily paid into that system since it began on Day One. If I do get really sick, then even the huge amount I paid in will not begin to cover the cost of necessary care. I know that. Do they?

    Mention was also made of Medicare Part D (for medications), Medicare Advantage and Medi-Gap coverage; for those folks who have disposable income over and above Social Security retirement income. Nobody alive who receives ONLY the latter could possibly afford anything beyond Medicare Part A and still be able to cover their rent/mortgage, food, fuel/transportation, clothing, necessaries and utilities; the costs of which are constantly rising but not accounted for by government when calculating the annual COLA. Even when a COLA is granted to SSI recipients it and more is eaten up by the inevitable annual increased premium for Medicare Part B even if that is the sole supplemental coverage one has.

    Mention, too, was made of the “Affordable Care Act” – mostly in the form of declaring all the nice benefits that retired persons should expect in the way of exams; under the fine print of certain circumstances.

    It was stressed that there is a substantial and escalating penalty for refusing to submit to the extortion of having Medicare Part B premiums deducted from one’s SSI payment. I believe they might one day soon (roughly after the year 2014, perhaps?) demand that everyone be signed up automatically for Part B. If they don’t, then their calculations as to funding Part B – what they euphemistically term “Medical” as contrasted with “Hospital (i.e. Part A)” coverage – will fall severely short.

    Most people who have only SSI for income will also qualify for both Medicaid and Food Stamps; not because they are mis-managing their funds, but because the cost of it all is simply out of reach.

    In the end, all of it is nothing more than a paper shuffle generated by automated clicks of computer keys – very rarely is any actual cash exchanged, and I seriously doubt that anyone involved has the full picture of just how badly we are in trouble.

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  4. wingwiper says:

    Something to bookmark as a favorite, if one is truly interested in the blow-by-blow description as our demise slowly blossoms…

    http://obamacarewatcher.org/portal/

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    • Jim Wheeler says:

      I approved your link, Wing. Freedom of speech, may it ever prevail. On the other opinion, I believe I can paraphrase this link as “bitch, bitch, bitch.”

      In less emotional words, why does the right offer so little (read, nothing) as a viable alternative? I will give you the answer for free. Because any alternative will involve one or both of two things:

      1. Rationing.
      2. Some people paying for other’s health care in addition to their own.

      The Obamacarewatcher site plays on people’s xenophobia and fears, IMO. We would do better to craft an alliance rather than paint villains.

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  5. wingwiper says:

    Jim,

    “In less emotional words, why does the right offer so little (read, nothing) as a viable alternative?”

    That just is not so. Conservatives, at every single stage of the process while the Act was being created in hearings and otherwise, on a daily basis ad nauseum, DID offer all manner of proposals, wordings, measures and amendments so as to bring the proposed draft into some sense of compromise. Almost all of those ideas were categorically rejected as either not germane or undoable, from the Democrat viewpoint. I know this happened because I faithfully watched as many of those tedious hearings and speechifying as C-Span would broadcast, day after day after day, for months – including all votes taken in both houses.

    Conservatives did repeatedly ask a few things (all rejected, of course) which stand out:
    tort reform, allowing purchase of coverage across state lines and etc. They even warned again and again that the States simply will not be able to afford enormous increases in their Medicaid costs, again and again and again.

    To state that they had no alternatives is one of the more horrendous propaganda shibboleths that people should be ashamed of repeating. The record does not support such a statement, whatsoever, and I am very surprised that you, of all sincere people, would fall for perpetuating it.

    Allow me to please remind you and your readers that the controlling political party in Congress passed that Act without having read or understood it – even to the extent that the House Speaker claimed we needed to pass it to find out what is in it.

    Does that resemble responsible legislation?

    You may make fun of the Obamacare Watch web site, but to tens of millions of your fellow citizens who care at least as much as you do about our country and health care, for them that information is vital – because nobody else is telling, or even seeking, the facts much less sharing what they know.

    What Democrats need to get a grip on is that many millions have finally gotten sick of being bullied by Leftist idealism – and, we are not about to let it resurface again in this nation IF we are lucky enough to reverse most of the damage that has been done.

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    • Jim Wheeler says:

      Wing,

      You mention the only two “alternatives” that I can recall the GOP offering also, i.e., tort reform and purchase of coverage across state lines. I know of no serious analyst who thinks either of these even begins to address the problems of the system. To hang their righteousness on such flimsy offerings is, in my opinion, just demagoguery. And by repeating the Pelosi quote about passing the ACA to find out what is in it, you are IMO showing that you have bought into the demagoguery. Certainly she got trapped in a bad sound bite, but what I believe she meant was that the ACA was too complex to be easily or briefly described, but that people would find much to admire once it was in effect. And I think that is true to a great extent. But buying into the GOP’s suggestion that the whole ACA law was some kind of sinister trick is buying into that demagoguery. It is important to look deeper than sound bites into such things.

      It’s just too bad the ACA didn’t do more for affordability, but that wasn’t politically achievable by either party. The electorate does not want to face fiscal reality, so neither does Congress. I think it’s just that simple.

      Like

  6. wingwiper says:

    “It is important to look deeper than sound bites into such things. ”

    Yes, Jim, it is.

    Like

  7. ansonburlingame says:

    To all,

    Such simplicity made so complex.

    He that PAYS for care MUST be the one to choose the care provided. Then let COMPETITION prevail to seek the best and lower (not necessarily lowest) cost, again, by the one PAYING the cost.

    When doctors and facilities lose patients because they, the doctors and facilities, charge too much, guess what happens to those charges?

    I don’t know how much simpler anyone can state the SOLUTION which seems to me to be so obvious.

    Unfortunately it is a capitalistic solution which will cause liberals to denounce it right out of the gate. They will cry for variations of a socialist solution, which I in turn will admantly object to as well.

    And thus we are stuck with NO SOLUIONS that are politically viable today. POLITCS must change to create the solution, one way or the other. In the meantime costs of medical care go up, and up, and…… with the curve bending evermore in the upward direction.

    Anson

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  8. Jim Wheeler says:

    As a matter of general interest in the Affordable healthCare Act and the GOP’s symbolic effort to abolish it, a politically-safe move, it occurred to me to look up the American Medical Association’s position on that.

    In January the AMA was against the repeal of the ACA and it’s not hard to understand why. Repeal would diminish patient through-put in the system, thus reducing the overall income of doctors and hospitals. If the AMA had thought the GOP would follow such repeal with meaningful reforms that would improve the system, wouldn’t one think they would have supported it?

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