Care or catastrophe?

By John Frary | Mar 31, 2010

I spent all day yesterday gazing deeply into my crystal ball and am now prepared to prophesy. PelosiCare will result in longer wait times, fewer doctors but more bureaucrats, a huge expansion of the IRS, and an explosive growth of the national debt

The great thing about prediction is that it makes debate redundant. Readers may accept me as a true prophet, accuse me of wild exaggeration or denounce me as a malicious reactionary. None of that is germane. Events will resolve the question. I am content to have it so.

The polls all agree that American opinion is sharply divided on the reform bill, although not all agree on the proportions or meaning of the divisions. The newest CBS poll asks this: "Should Republicans continue to challenge the health care bill?" It reports that 89 percent of registered Republicans, 41 percent of Democrats and 66 percent of Independents say yes, i.e., 62 percent of Americans favor continued challenges.

Now "challenge" is kind of ambiguous. Many people may support the general objectives of the bill while objecting to specific measures. Some may wonder about the advisability of providing Viagra to child molesters. Others may object to taxing prosthetic devices for wounded vets or children's orthopedic devices. The fact that Congress's senior leadership staff is exempted from purchasing health insurance from health insurance exchanges must rankle even left-liberals.

The latest Rasmussen Reports finds that 41 percent of likely voters favor the health-care plan and 54 percent oppose it. The breakdown: 74 percent of Democrats favor the plan; 87 percent of Republicans oppose it; 59 percent of unaffiliated oppose it.

I have no special expertise in reading polling results and will attempt no judgment except to say that opinion will surely harden or soften in the months ahead. As a critic — better say "loather" — of the bill, I can suggest some reasons for opposition to it.

On philosophical grounds conservatives (40 percent of the public according to the latest Gallup poll) object to the bill as an enormous expansion of dependency. While liberals and leftists appear to believe that everybody should be responsible for everybody else and nobody responsible for himself, conservatives see personal responsibility and freedom as inseparable. Can't have the one without the other.

The Congressional Budget Office analysis projects that the bill will ultimately lower the budget deficit by $143 billion over the first 10 years and $1.2 trillion dollars in the second 10 years, but 57 percent of those surveyed in a recent poll don't believe it. The skeptics include most Republicans and independents. The believers are almost all Democrats.

That looks like a philosophical divide, but it's really a pragmatic one. I'm pretty certain that no CBO projection of future entitlement costs has ever been accurate and the errors have all been underestimates. I might be wrong and anyone who doubts me should get to work on Google and identify an exception to this rule. Future events will prove me a reliable prophet, but I'm always open to factual correction on details.

The expectation of longer waiting times is, likewise, empirically, not philosophically, based. Wait-list rationing has been a feature of all national health-care systems.

The fear that the bill will produce a shortage of doctors is based on a New England Journal of Medicine survey showing that half of the region's doctors would consider abandoning their profession if the bill's burdens were enacted. Some liberal pundits dismiss this finding on the grounds that, what the hell, these doctors are trapped in their professions and are just bluffing. The proof of the pudding, as always, will be in the eating. Ideology has nothing to do with it.

An enormous expansion of the IRS is already budgeted. No room for debate there, except on how much more expansion we can expect in the future.

Finally, a belief in the efficiency of an expanded federal bureaucracy is beyond fantasy. It can only be explained by a kind of mental disease. It can be diagnosed, but not explained.

Professor John Frary of Farmington is a former congressional candidate and retired history professor, a board member of Maine Taxpayers United and an associate editor of the International Military Encyclopedia, and can be reached at: jfrary8070@aol.com

 

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