By, Nancy Tengler
“…the Constitution is: a system of restraints against the natural tendency of government to expand in the direction of absolutism.”
Barry Goldwater, 1960
Conscience of a Conservative
If you don’t have a copy of Barry Goldwater’s, Conscience of a Conservative, buy one. If you have one, pull it out and re-read it. Focus, in particular, on the chapter entitled “The Perils of Power.”
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By, Nancy Tengler
“Roosevelt had played around with economics, and economics hadn’t served him very well. He would therefore give up on the discipline and concentrate on an area he knew better, politics.”
The Forgotten Man by, Amity Shlaes (246)
At almost precisely the same point in his first term as Roosevelt was in his, Obama seems to be shifting from playing around with the economy, to hard-boiled, special interest politics. Economics hasn’t served him very well so he is returning to the divisive accusation-driven speeches that hallmarked his campaign.
Back to Shlaes for a moment: “If he (FDR) followed his political instincts, furiously converting ephemeral bits of legislation into solid law for specific groups of voters, then he would win reelection. He would focus on farmers, big labor, pensioners, veterans, perhaps women and blacks” (246).
This was Roosevelt’s strategy for re-election in the face of economic failures and disappointing rulings in the court against his Great Government Centralization Plan. Obama is taking the same bet. He’s just raising the stakes some with angry and accusatory rhetoric. FDR, too, lashed out at the media and Supreme Court when he lost the Schechter Brothers case to a unanimous decision signaling the death knell for the NRA. He tried castigation and abandoned it. Conciliation and clever co-opting became the new calculation. And it worked.
Luckily for us, there is not a conciliatory bone in Obama’s body.
There are more similarities. Social Security legislation was assigned to Frances Perkins of the Labor Department. This was a high priority item. Think ObamaCare in measuring its importance to the Administration. Ms. Perkins worried that she would have difficulty getting her social insurance system past the Court. A little snag called The Constitution. She confided her worry to Justice Harlan Stone. Stone gave her the following advice: “The taxing power of the federal government…is sufficient for everything you want and need” (Shlaes 229). Justice Stone was providing the critical clue to how the Court would view the Constitutional test of Social Security. If it was insurance it wouldn’t hold up. If it were simply another tax, it would meet the threshold.
In response to the various suits against the Constitutionality of ObamaCare, the government is now scrambling to take the same position.
One can hope they are just a little too clever too late. Setting your defense after the offense has already run the play doesn’t usually work out so well.
Fingers crossed, set, hike.
by Dr. Eric Novack
Chairman, U.S. Health Care Freedom Coalition and Arizonans for Health Care Freedom
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We’ve heard frequently from proponents of ObamaCare that the multi-trillion rejiggering of the American health insurance industry should be “given a chance to work.” You can’t blame supporters for changing the subject: A national conversation about the “buy insurance or pay a fine” mandate contained in the 2,400-page bill, or the 47 new bureaucratic entities and 16,000 new IRS agents commissioned by this legislation, would only take the new law’s flagging approval ratings even lower.
Spinning potentially rosy outcomes about America’s tomorrow is far less damaging, unless, of course, we look at how “health care reform” is likely to play out by using one of the most apt examples available – the Medicaid system in Arizona, where I’ve been an orthopedic surgeon since 2001.
Doubtless you’ve heard the horror tales emanating from Massachusetts, where ObamaCare-in-miniature has driven up costs and ER usage while embedding bureaucrats and politicians ever more deeply into the medical decision-making process best left to patients, doctors and families. Arizona’s Medicaid system, known as the Arizona Health Care Cost Containment System, or AHCCCS, has fared little better.
The basics of AHCCCS are simple. State government contracts with private companies to offer managed health care to eligible Arizonans. In Maricopa County, home to Phoenix and about 60 percent of the state’s residents, four companies offer medical services (though certain mental health and long-term care services are carved out from this). When an applicant is accepted into AHCCCS, he or she chooses a plan, or is simply assigned a plan if no choice is made.
With the patients thus divvied up, Arizona’s Medicaid insurers contract separately with all types of providers, from hospitals to doctors, therapists to nursing homes to and medical equipment suppliers. If this sounds familiar, it’s because this arrangement is the very basis of ObamaCare’s “health insurance exchanges.” It’s also huge business for Big Insurance titans like United HealthCare and AETNA, to name just a couple names.
These private companies win multi-million dollar contracts by placing bids with AHCCCS workers, an arrangement that leaves the insurers beholden to the government officials who hand them business – not the Arizonans who are their customers. With money shuttling directly between government and the plans, the plans’ products and services are, by necessity, designed to please government first, and patients second, if at all. And while enrollees can “act with their feet,” in reality they can do little more than shuttle between four similar plans offering virtually the same benefits.
If that doesn’t sound like much of a choice for patients – well, it isn’t.
While AHCCCS-contracted plans do provide important health care services to many Arizonans, this basic fact must be recognized and acknowledged again – the “client” that the plans work to please is first and foremost government, the politicians and bureaucrats who control their contracts. An unhappy AHCCCS patient means not much at all, but an unhappy government employee might well put millions of dollars at risk.
It’s also worth noting that former Arizona Governor Janet Napolitano, now Secretary of Homeland Security, already tried a health insurance exchange for individuals and small businesses, a replica of the ObamaCare exchanges. “Healthcare Group” was to be financially self-sustaining in just a couple of years, the governor assured the legislature and the state. However, the program needed a huge taxpayer funded bailout, benefits were reduced, and eligibility was severely curtailed.
The only party who didn’t seem to suffer inordinately? The Arizona health care giants who in 2008 somehow found enough cash to mount an aggressive effort against a ballot measure written to protect health care rights for Arizonans and their families. Outspending supporters 5 to 1 during its campaign worked, as the measure (back in refined form on this year’s Arizona ballot) failed by less than 9,000 votes out of 2.1 million cast.
ObamaCare supporters and their Big Insurance backers borrowed much from Arizona’s Medicaid system. Sadly, mandating that Americans join a plan, in an AHCCCS-style exchange, takes a fine concept – private management of our critical health care safety net – and perverts it into something else – a fiscally disastrous alliance between unaccountable government bureaucrats and major private corporations.
Arizona’s Medicaid system details for us what happens when health care decisions belong not to patients and doctors, but to bureaucrats and politicians. The result? Nothing good. And health care will surely fare no better nationally as these two powerful entities divvy up 1/6th of the American economy.
A health care provider for more than 20 years, Phoenix orthopedic surgeon Dr. Eric Novack is the author of the Arizona Health Care Freedom Act.
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