The Baucus Health Care Bill

As a former Physician's Assistant with over thirty years experience in the American health care industry I can honestly state that, in my personal opinion, Senator Baucus' proposed America's Healthy Future Act of 2009 is the least objectionable of the seemingly never-ending stream of repugnant ideas to have recently emerged from the national capitol. My objections to this particular piece of legislation are legion, but fall into three basic categories.

The first of these is my sincere belief that the proposed legislation's reliance on "cost cutting" and "increased efficiency in health care delivery" are, at best, illusionary and not based in fact. Mr. Baucus, along with his colleagues, are of the opinion that we can "save money" through unproven means such as centralized case management; where "impartial" government functionaries will "monitor" the health care industry to insure "cost-effectiveness." In thirty years of clinical experience I believe that I saw every scheme, both honest and of questionable legality or morality, that claimed to be some form of cost containment. I offer the observation that, since the cost of health care continued to rise, such techniques were failures.

In the same vein, Mr. Baucus tells us that we can "save money" by raising excise taxes on such unhealthy products as tobacco or foods high in carbohydrates and sugars and then by denying or reducing health care benefits to those who "abuse" such products.

Secondly, Mr. Baucus and colleagues seem to forget the lessons of history in that they believe that federal bureaucratic micromanagement is the solution to every problem; be it real or imagined. Did micromanagement in the form of wage and price controls control inflation during the Nixon-Ford- Carter years? Did Lyndon Johnson's micromanagement of the Vietnam entanglement save American lives? I say to Mr. Baucus, et al, why do you think that such nonsense will magically work now?

Mr. Baucus tells us that the bill under discussion will penalize those who fail to purchase available health care insurance, but that such penalties are not a "tax in disguise." If we define a tax as "a sum of money that is extracted, under penalty of law, from the individual" then it would appear that if this proposed penalty "looks like a tax, walks like a tax, sounds like a tax, and smells like a tax" then it is in fact a tax! Taxes that will remove money that would have been available for individuals, and families, to spend in the general economy and thus promote a recovery from a recession that was brought about, in large part, by "public servants" such as Mr. Baucus!

My third objection to such legislation is that I honestly fear that, given the federal government's demonstrated tendency to see itself as our benevolent and all-wise protector and benefactor, what legislative safeguards will be included in such "reform" legislation that will limit governmental involvement in personal health care decisions such as the right of the individual to accept or decline a proposed course of medical treatment? We hear accusations that one side or another supports "right to die" or "assisted suicide" or even "right to life." What guarantees will there be that some bureaucrat will be given the power to decide who should receive, or be denied, a given course of medical care? Are some lives more valuable than others? Perhaps Orwell was right: All animals are equal but some animals are more equal than others.

As for myself, I care very little about the ultimate outcome of this debate simply because my days upon this small world are growing short and, relatively soon, I hope to enter a better world, one populated by pleasant people, where the weather is always perfect, the beer is always cold and free, and there's nothing but Jimmy Buffett music on the jukebox. In other words, I could care less what happens!

In closing, allow me to preemptively answer the inevitable question "Then what's your plan to improve health care?" In sincerity, I must paraphrase Mr. Mencken and reply with "Just because I have no answer to the problem does not mean that your answer is correct. It merely increases the probability that yours is a fraud."