Obamacare Delenda Est

A hill to die on.

Long before the Pax Romana, centuries before Julius Caesar, long even before there were any Roman emperors, the republican nation of Rome was just another regional Mediterranean power threatened by enemies on all sides.  With two millennia of hindsight, the rise of Rome seems natural and inevitable; at the time, it was anything but.

Perhaps the greatest threat Rome faced during its long rise to power was the Carthaginian Empire.  Carthage was a city on the North African coast where Tunisia is today.  It ruled most of the land surrounding the Western Mediterranean as a merchant and naval power.  Rome at that time had more of a land-based military as Rome was vulnerable to attack by land powers such as the Gauls and the Mongols.

The conflict between Rome and Carthage played out over a hundred years or so, separated by historians into the Three Punic Wars.  Just as happens today, the citizens of Rome grew tired of war and, after successfully completing the last one, were not so eager to start paying for the next.

Enter the statesman Cato the Elder.  He had fought in the earlier stages of the wars and rose to power in Rome based on his reputation for hard work and honesty.  Like any other politician with a long career, he took prominent positions on any number of issues, but his signature issue was the ongoing conflict with Carthage: he believed that it was absolutely vital for Rome to see the fight all the way through to a successful completion.

Being of a practical turn of mind, he realized that the war wouldn't be over until the loser admitted that it was over.  Since the Carthaginians were a pretty determined bunch, he realized they wouldn't say "Uncle" until they'd been destroyed to the last man.

Therefore, to make the world safe for Romans, Carthage had to be utterly destroyed.  Cato felt this so strongly that, after every speech no matter what the topic, he closed with the following phrase (or some variation thereof):

Carthago delenda est.

which is Latin for "Carthage must be destroyed."  Why?  Because he felt that Carthage was such a threat to Rome that all other issues, while important, would be irrelevant if the utter destruction of Carthage couldn't be achieved.

Today, we have a similar situation.  Despite the overwhelming opposition of the American people, the Democratic majority seems determined to pass Obama's healthcare bill.  You'd think yesterday's astounding loss of what they loved to call Ted Kennedy's Senate seat would be a wake-up call to Democrats, but thus far, all the chatter from on high is how they'll still ram their bill through by hook or by crook, preferably the latter.

There's a good reason for this: Obamacare has been artfully designed to bring about permanent changes in the American system which will, if allowed to take root, fundamentally change the relationship of government and people.  In a very real and profound way, if Obamacare becomes a permanent part of the American landscape, our country won't be America anymore.

We've published countless articles about why socialized medicine won't work: how it rations care, how it destroys quality, how it ends research into new medicines, how it eliminates consumer choice and freedom, how it increases government power, and how it boosts costs.  Set all those aside; we are dealing with more fundamental questions here.

Pay to Live?

The various Obamacare bills have so much wrong with them that it's hard to keep track of it all amidst arguments over the "public option," abortion coverage, and so on.  The biggest change, indeed, is the one that engenders almost no controversy: the so-called "individual mandate," in which all Americans are required to buy health insurance or pay a hefty fine.

Economically, this not only makes sense, it's an absolute must.  The only way insurance works is by requiring you to buy it before you need it.

Obviously, you can't buy fire insurance while your house is actually on fire; you can't buy car insurance after you've crashed into a tree.  You have to do it in advance, when neither you nor the insurance company knows whether you'll ever need it or not.

This works for you, because you don't have to worry about a financial disaster.  Even if your house never does burn down, you'll sleep easier knowing that if it did, you'd be covered.

For the insurance company, it also works: they don't have any idea exactly whose house will burn down, but statistically, they know that out of 1,000 customers, they'll have to pay for two or three new houses.  Divide that cost by 1,000, add profit and overhead, and there's your insurance rate.  Of course the details are somewhat more complex, but you get the idea.

Extend this philosophy to health insurance and you'll instantly see why insurance companies must refuse insurance to people with pre-existing conditions.  If you show up at the insurance sales office to buy a policy when you already need a heart transplant, you're like the guy who tries to buy fire insurance after his house has already burnt down.  How is that fair to the insurance company?  What company could possibly operate if they were required to allow that?

The problem is, health problems are not like a house fire or a car wreck.  Those misfortunes happen at a particular point in time, and then they're over.

In contrast, health problems can last months, years, or a lifetime.  If your house burned down last year, that doesn't make it any more likely that it will burn down again this year unless you are an arsonist, which is a different matter entirely.

If you had a heart condition last year, however, that makes it extremely likely that you will not only have a heart condition this year too, but that you'll need a very expensive surgery in the near future.  Insurance companies know that and up until now they have used this knowledge to weed out potentially expensive customers before they incur the expense.  That makes people mad, and understandably so.

To address this problem, Obamacare makes it illegal for insurance companies to refuse coverage to people who are already sick or to charge them more than they charge people who are well.  This creates a new problem: health insurance is expensive.

If you know that, by law, they have to sell you insurance even if you're already sick, why not just save the money and wait until you are sick?  Except that this would lead to instant bankruptcy for the insurance companies as everybody but the very sick and extremely costly canceled their insurance.

Enter the "individual mandate."  It seems fair - if everyone is required to buy insurance, nobody can game the system.

This overlooks the foundational principles of limited government.  Since when does the government have the authority to order you to buy a product from a private company?  Where, exactly, is that found in the Constitution?

Yes, governments require you to buy various products if you want to do certain things - but you don't have to do them if you don't want to.  Most states require you to buy car insurance if you want to own a car - but nobody requires you to own a car.  You can live in New York and take the subway; you can hire a limousine or cab; you can have your relatives drive you around if you like, and you are perfectly legal while still not buying car insurance.

The individual health care mandate requires each and every American to buy something no matter what, as a condition of living in America.  It may even be worse than that: on some readings, all American citizens must buy insurance even if they are permanent residents of a European country that provides socialized health care for them.  In that case, they'd be required to buy a very expensive private product that they cannot even use.

If government can do this, where does it stop?  Why can't government require us all to buy organic fruits and vegetables - after all, those are good things, aren't they?  How about requiring everyone to throw away their old car and buy a new electric one?  What's the limit?  Is there any at all?

There certainly hasn't been any rational limit expressed: when asked how the bill could possibly be Constitutional, House Speaker Nancy Pelosi couldn't believe the question was asked:

Are you serious? Are you serious?

Yes, we are serious, and very much so: as Patrick Henry pointed out,

The Constitution is not an instrument for the government to restrain the people, it is an instrument for the people to restrain the government - lest it come to dominate our lives and interests.

Government "domination of our lives and interests"?  No better description of the Obama agenda could be found.

An End to Free Markets

Which brings us to another question: what is a free market?  Fundamentally, a market is free when buyers and sellers can mutually exchange goods, services, and money on whatever terms they agree on.

Now, you cannot have a totally free market.  An unhappy husband may be perfectly happy to pay $50,000 to a hit-man to bump off his wife, and the hit-man may be eager to accept it, but that is still an illegal transaction.  The same goes for prostitution, illegal drugs, and various other things that, as a society, we'd like to discourage.

Until recently, though, as long as your product was legal, you had the right to choose whether you'd like to sell it, to whom, and on what terms.  Over the last century, this fundamental principle of the free market has degraded a great deal.

We've seen how during Roosevelt's New Deal, a compliant Supreme Court found that the government had the right to forbid a farmer from growing his own crops on his own land and feeding them to his own cows; instead, he was forced to purchase cattle-feed on the open market.  More recently, we've seen government rules requiring stores to sell their wares to anyone prepared to pay, regardless of their race.  Just a few years ago, in the famous Kelo case, the Supreme Court again found that governments could force people to sell their private property for pretty much anything the government thought was a good idea.

Obamacare once and for all destroys the very idea of a "free" market in health insurance.  You are not free to buy what you like or not to buy at all; you must buy health insurance, and it must be from a government-approved list of qualifying plans.  On the other hand, the insurance companies must sell it to you, and they must do so at a government-approved price.  What's free about that?

Again, where does it end?  Health care is important; so is food and housing.  It's bad enough that many cities have "rent control" which denies property owners the right to control the rent they wish to charge for their own property, but at least there's no Constitutional issue there because it's not the Federal government doing it.

With the precedent set by Obamacare, what's to stop the government from requiring food companies to sell food at a price the government thinks is reasonable, requiring landlords to rent at government-set rates, or pretty much anything else?

Price controls always lead to shortages; we ought to have learned that from the Soviet Union or from the New York City housing market.  In a world where the government sets the prices of whatever it thinks is important, as well as controlling what you must purchase, what room is left for freedom?

Political Monopolies at Your Expense

We now arrive at perhaps the most corrosive, because hardest to identify, aspect of Obamacare's anti-American principles.  We can all understand the injustice of being forced to buy something we don't really want to buy; we can imagine the injustice of being forced to sell something we don't really want to sell.

Buried within the bill is an even worse provision: government bureaucrats get to set the rules for what is acceptable insurance.

What's wrong with that?  Well, traditional free-market salesmanship requires companies to convince individuals that their wares are worth buying.  Coke has to persuade you that their soda is better than Pepsi, milk, or water.  Even in the medical realm, the drug companies try to prove to you that their particular pill is good for what ails you.

With government control over "qualifying" insurance, that no longer matters.  Why bother spending millions of dollars on TV ads when you can spend thousands of dollars to persuade a bureaucrat that your pill ought to be required?  It's already happening, as the San Francisco Examiner reports:

With time running short for Congress to pass a health care bill by Christmas, Christian Scientists are lobbying lawmakers to include a provision that would ban discrimination against "religious and spiritual" health care and encourage private insurers to cover prayer as medical treatment.

Now, if you want to pray about your sickness or somebody else's, that's your business.  If you want to pay somebody else to pray for you, that's also your business.  If some insurance company wants to offer coverage where they'll pay somebody to pray for you... OK, that seems a bit strange, but fine.

Why on God's green earth should the government require insurance companies, or even to encourage them, to provide this sort of coverage?  I surely don't want it.  Do you?  Do you want the government to be able to require that sort of thing?

We've seen this problem for years at the state level.  One of the reasons why health insurance is so expensive in certain states is because those states require the insurance companies to cover everything from acupuncture to chiropractic to sex-change surgery.  Again, if you want those things or the insurance company wants to offer them, that's fine; but how dare the government force them to be provided, and force you to pay for them if you don't want to?

We recently saw a perfect foreshadowing of what is to come with the uproar over the United States Preventive Services Task Force's new recommendation that women wait until 50 to get mammograms instead of 40.  Women demanded that this advice be revoked.

Why did it matter what this panel thought?  Because it influences what insurance companies cover: based on their advice, it was thought that insurance companies would stop covering mammograms for 40-year-old women.

Now, if private individuals paid for their own medical care, none of this would matter: they could have a mammogram whenever they and their doctor felt like they wanted to, and pay the bill accordingly.  If private individuals could buy health insurance like they buy car insurance, again there would be no problem: each woman could choose a plan that covers mammograms at 40, or a cheaper one that doesn't cover them until 50, however they prefer.

Unfortunately, government "advice" takes on the force of law and leads to one-size-fits-all medicine - which leads to political pressure, increased friction and anger, and megabucks in the pockets of lobbyists and politicians.  Don't we have enough problems with lobbying as it is, without having to lobby the government for each and every pill?  Do you really want to depend on the tender mercies of Senator Foghorn Leghorn to make his bureaucrats require that your particular pill be covered... while not also forcing you to pay for the services of politically well-connected snake-oil salesmen and charlatans?

Where Is A Man?

The problems with Obamacare are so many, so vast, and so fundamental that it is truly frightening - it must have been to induce the poor benighted residents of Massachusetts to rise from their slumber and elect a Republican senator for the first time in half a century!

In what claims to be a democracy, it's even more hair-raising to find two-thirds of the people opposed to a given bill, and nearly two-thirds of politicians (in the Senate anyway) voting for it.  It's enough to make you wonder whether the conspiracy theorists saying the world was run by shadowy powers answerable to nobody might have had a point all these years.

It doesn't have to be this way, if we could find even a handful of Senators and Congressmen willing to scream the plain truth from the rooftops for as long as it takes.  Persistence pays off: after many years of conflict, Cato's position won the day.

Carthage was destroyed and, legend has it, its land sown with salt so it could never be rebuilt.  The Carthaginian Empire was destroyed so thoroughly that what we know about it today comes mostly from Roman records, as whatever records the Carthaginians had were burned.

In 1989, we thought socialism had met a similar fate; alas, it has risen from the ashes again.

Where is the Republican who will close every speech, echoing Cato, with "Obamacare must be destroyed" - until once and for all, it is?

The German imperialist Otto van Bismark once said in frustration:

God protects fools, drunks, and the United States of America.

Perhaps He still does.  Welcome, Senator Scott Brown (R-MA)!

Petrarch is a contributing editor for Scragged.  Read other Scragged.com articles by Petrarch or other articles on Politics.
Reader Comments
Great article.

Just wanted to make one point, your insurance premiums don't include any 'profit.' At least not in car insurance. I can't imagine in any other type of insurance either as the DOI will fine any company that is deemed to be charging too much in premiums.

The goal of the insurance companies to make money by investing the money for the one week that they have before they have to spend it again. So any time you hear about greedy insurance companies you really should just laugh... if we make money on premiums one year we lower them the next.
January 20, 2010 4:33 PM
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