At the same time, said insurer is constantly badgering me about my health and demanding that I take part in health screenings and other programs. That’s the way HMOs operate. They badger and bewilder you in the name of taking better care of you, but the end result is that you use less, not more, health care, and claim fewer benefits you are rightly owed. And if you think dealing with your HMO is a hassle now, wait until the government’s in charge of health care.
My friend who used to be an HR pro says I am being unfair. All that badgering and bewilderment and those officious “personal care consultants” really do help contain costs, she says. But containing costs is not the same thing as providing care, and you’ve got to be careful which you’re in the business of, I say. This is particularly true of Obamacare – the bill making its way through Congress right now.
Essential to the approach government-run health care takes is that certain people – the old, the disabled, those with life-threatening diseases – should be persuaded to not ask for everything that could be done to treat them. And if they are selfish enough to ask, anyway, then they will find that the answer is No. There is no point in going all-out for them.
Critics of government-run health care rightly point out that rationing creates scarcity. People in Canada and Britain routinely die while waiting for care that is immediately available to people in the US. Many of those who do not die suffer needlessly due to the inherent inefficiencies of a health care monopoly run by bureaucrats. But we’re not just talking about inefficiencies. We’re talking about counseling people on “end of life” options that include physician-assisted suicide. We’re talking about creating a climate that fosters the idea that some lives (maybe, your life) are of less value than others, and where it will ultimately be your patriotic duty to die and get out of the way of those who have more productive years (by some apparatchik’s definition) remaining to them. In other words, this isn’t a bug, it’s a feature.
There’s a term for this. It’s called “human sacrifice.” Shirley Jackson updated the ancient pagan rite in her story, The Lottery. The whole community gathers every spring and lots are drawn to see who will be stoned to death, to fructify the fields and insure the survival of the community.
But isn’t this just insurance by another name? No. Insurance was developed in the Mercantile Age to spread risk. People paid into a pool; the unlucky ones, whose ship foundered, or whose house burnt, or whose breadwinner died young, or whose health deteriorated, were compensated from the monies available from the lucky ones, whose ship came in, whose house still stood, who lived to see their families grow up, who stayed healthy. In this way, the lucky paid for the unlucky. That’s efficient – even benevolent. But in Obamacare, the unlucky pay for the lucky: those who are old, or disabled, or diseased will be provided for less and less in order to benefit those who are younger, stronger, healthier. That has a specious kind of efficiency to it, but nobody could call it benevolent; rather, I think we need to call it what it is – morally wicked.