Monday, November 16, 2009

Who's your daddy? Uncle Sam...

The health care scheme that squeaked through the House of Representatives will load great new costs on people. But wait until you find out about what you get in return: a new dad.
First the costs. Families would pay up to 20% of their income to buy insurance on new federal exchanges, the Congressional Budget Office said earlier this month. Premiums would more than double for a family of four and would triple for healthy people in their 20s, according to a study using actual data from insurers.
There would be new taxes: on medical devices, on union health plans and a big one on earners in the top bracket. That last puts our top tax rate above France's, and it's fantasy to believe the rich would sit still for it, so the tax increases likely will spread.
Congress' own accountants say the plan will cost taxpayers $1.8 trillion over a decade. Independent observers say that may be mad optimism.
But the plan's partisans err if they assume people object solely or even chiefly to what will be taken. The deepest problem with Obamacare isn't that it takes. It is that it gives, universally and inescapably.
This, say backers, is its virtue. They proudly say it guarantees universal coverage.
Of course, the government now ensures the poor and the old get care. It even pays for the not-really-poor via programs like BadgerCare. But those are special and limited groups. This new plan would touch everyone.
For one thing, the kind of care that can be covered or even offered will be minutely defined by more than 100 new panels, boards, commissions and programs. You will get the coverage and care Washington decides you should be given.
You'll be given money to pay for it: Since premiums will be such a burden, families making up to $96,000 will get federal subsidies. By squashing lower-cost high-deductible plans, Congress makes insurance expensive. Then it spares you with someone else's money. You should be grateful.
That is the problem: The poor and old aside, most of us now buy our own coverage or earn it through an employer. The new normal will be health care as a gift from government.
What can be given can be taken away. Are you eating right? Exercising? You're not still drinking, are you? Authorities merely nag us now. When we owe them our health care, they can start demanding.
Do not imagine they will hesitate to use this power. The House puts the Internal Revenue Service and all its compassionate flexibility in charge of enforcing the insurance mandate. If you don't buy, there will be penalties. Those penalties can include the slammer, Congress itself points out.
They'll go further. At 1,990 pages, the bill has room for dreams of utopia, and so health care reform demands affirmative action in nursing schools (page 1379), calorie lists on menus (page 1510) and inspections (voluntary, for now) of expectant parents (page 1176). These are not, even now, the restrained ambitions of a modest government.
They are signals of a new relationship. When we all are on the take, voluntarily or not, we are no longer exactly free citizens. We are, in part, dependents. And as dependents are customarily told by Dad, "If you live in my house, you live by my rules."
This is not to call instead for rugged individualism. None of us go it alone in this world. We get help from spouse, family, friends, neighborhood, congregation, village - all the voluntary associations of essentially co-equal parties that a free society fosters. But the trend of decades has been for government to replace them, function by function, to the detriment of society.
And government is not a co-equal partner to you if you depend on it. It is, instead, your daddy.
Now government seeks to involve itself intimately with us by giving us all health care. It grants itself an ever more central place in our lives, necessarily displacing, with its generosity, every other support, including our own backbones.
Patrick McIlheran is a Journal Sentinel editorial columnist. E-mail pmcilheran@journalsentinel.com

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