Obamacare: All Unfunded Mandates are not Created Equal

A followup to this post here:
Again, Republican ≠ Conservative


Back in my days as a resource manager in the defense industry, I got to hear some of the worst excuses ever contrived by people who just did not want to do what they were supposed to do.  One of them was the unfunded mandate objection, as if it were some sort of automatic absolution of responsibility.

This is not to say that unfunded mandates are always proper or fair, not in the slightest.  However, the way that federal bureaucrats use the term stands the concept on its head.

One incident was in the Information Technology field where the Congress had proscribed that the whole government would begin keeping better track of all systems that it had, all of the systems that the Congress funded needed to be tracked.  With that came system certifications and compliance measures, along with the requirement that some human being actually check off the blocks on electronic forms certifying that indeed the systems under their domain were in compliance.  To those of us paying the bills, this sounds perfectly reasonable, yes?

Not to one of the bureaucrats.  The powers that be in her directorate had her designated as the "block checker" for certification of a substantial number of systems. I was the next person in the line to certify her work, which she never did, claiming that it was an "unfunded mandate."  This situation went on for at least two years while I was dealing with that stuff and I heard it continued long after I moved onto another project.

Changing duties and responsibilities within a job one is already being paid for can be called many things, but an unfunded mandate it ain't.  If the load becomes too great you can always move on to better conditions or just quit.

This brings me to the latest federal debacle that had potential to be correctly labeled an unfunded mandate (by those who stretch the term), but somehow has escaped that label: Free-riders in the healthcare system.

The Leftist script has gone in generally the same direction for 100 years, beginning with Progressive Teddy Roosevelt in 1912 proposing a national healthcare system based on the German national model and the proposal was continually rejected until Obamacare came along.  This is not to say that bits and pieces were not adopted, and each of them were accompanied with a new list of demands.

In the years leading to the passage of Obamacare, the Left's complaint was that everybody did not have access to healthcare.  The list of victims were the usual: poor, minorities, women hardest hit.  That complaint did not last long when it was revealed that poor minorities were filling up emergency rooms across the country and quite a few of them were uninsured.

As Leftists are want to do, they morphed that complaint into a different lie: Emergency rooms are forced to treat people without insurance, so we need a law to make everybody buy insurance.  As reasonable as that complaint sounds, and the evidence is not a complete lie, it is only a partial truth, rarely does anybody stop to ask who is forcing hospitals to take uninsured patients?

That answer is, of course, the federal government.  Under the Emergency Medical Treatment & Labor Act (EMTALA) of 1986, all hospitals that participate in Medicare must take all emergency patients regardless of means to pay.  The case for this being an unfunded mandate would revolve around the issue of how Congress moved the goalposts on what hospitals are required to do to get Medicare funds, decades after the program began.  The case against: No federal requirement to take Medicare patients or Medicare money.

Many States, like Tennessee, have State hospitals that are open to anybody who shows up and everybody receives the same care, regardless of means.  From personal experience I can tell you that if you show up in their emergency room, they will indeed care for you.  If you give them insurance information, the bill goes to the insurance company.  If you do not have insurance, the bill goes to your house.  I do not know how they handle a failure to pay, but feel free to research that one on your own.

So, where is the problem?  According to the Leftists there was a crisis caused by people who could not afford healthcare getting free healthcare and the hospitals were unfairly burdened with the costs, or passed those losses onto other patients.  (Whenever you see that last bit in a story, it is a rare acknowledgement that business do pass on costs that fails to get factored into any other business.)

There solution to this 'problem' created by government was more government, more regulation (2,700 pages worth), and of course another tax.  In the name of paying for people who cannot afford to pay, who need free healthcare (you know, the people who already get free healthcare), a national socialist solution was struck whereby all Americans would be required to buy healthcare insurance.  And by all Americans, they mean only those who can afford to pay for it, those who cannot afford to pay are exempt.

Simpler version: some people could not afford to pay their emergency room and other healthcare bills in the past, so everybody else (even those who did not have medical bills, through their Medicare tax) covered those losses.  To solve this problem, a massive bureaucracy was created to make the people who can afford to pay for healthcare cover the bills of those who cannot pay.  Added bonus: All those people who paid for routine medical services in cash are now required to pay an insurance company.

Another added bonus: A mountain of actual unfunded mandates for the States.

The next time someone brings up the issue of "free-riders" in the healthcare market, ask them who created the free-rider system in the first place.  If they respond with anything besides EMTALA, direct them to the nearest internet connection for some self education.

The House or the Cancer?

Your Winnebago or your life?

In today's National Review column by Jonah Goldberg, Tyranny of the Typical, he covers a recent Wolf Blitzer/Ron Paul face-off during a Republican debate.

Goldberg makes his point by recalling Murray Rothbard's Fable of the Shoes (Libertarian Manifesto, Chapter 10) as he introduces his defense of Ron Paul's answer to the pathetic question: what should happen if a man refuses to get health insurance and then has a medical crisis.  Paul's answer needs no defense, at least it is a perfectly fine answer for anybody who has seen the world beyond the classroom or playground:

“We’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves,” he observed. “Our neighbors, our friends, our churches would do it.”

 I find myself surprised that the long running, frequently posed, false dichotomy has not been tossed out against Doctor Paul in the wake of the debate:  Someone lost their house because they had to pay for their own healthcare!  Perhaps that nonsense is still going on at Slate, The New Republic, and other bastions of socialism thinly hidden behind their latest Progressive banner?  At any rate, that was the topic I wanted to cover here and I shall hijack this debate question for my own sinister ends.

So, there was this old woman who lived in a house and she got cancer.  She had several well-to-do children and grandchildren and they did not know what to do.  The old woman had some insurance, but the did not have the foresight to purchase insurance with an infinite benefit, but her house was worth a fortune. So, the grandma was faced with a dilemma: sell the house to pay medical bills, or die and leave the house free and clear to her well-to-do relatives.

Of course, if the government were not ruled by 'Corporate Nazis' she would have universal healthcare and be cured.  That is why we need Hillary/Gore/Kerry/Obama Care, or those fascist Republicans will kill her!

I made up the version above, so the details are different, but the story is the same from one year to another.  My favorite version was from candidate Al Gore about one Winifred Skinner, who was reduced to collecting aluminum cans to pay for her prescription medications.  The truth was, her son has always offered to pay for anything she needed and she had other sources of income.  To make it look even worse, and I am surprised that Karl Rove was not given credit for the Winnebago portion of the story.  This 'poor' woman, who could not make ends meet, drove from Iowa to Boston for the event in a Winnebago.  Turns out, the vehicle and gas were furnished by the Gore campaign.

Now, to what sort of Leftist, Socialist mind is this a sympathetic character at all?  Only the loftiest of limousine liberals could possibly believe that adding a comfy recreational vehicle to this story makes it a bigger tearjerker!

So, imagine the woman really had a Winnebago.  What is more important, the drugs or the vehicle?  Yes, that is a serious question.  I have known people in my almost half-a-century on this earth who really would rather spend the last of their wealth on comfort over care that may prolong their lives for a few more years.  These are known as practical people.

The practical folk do not rely on others when they can do for themselves, well frequently anyway.  There is a range, I am sure, where they may grudgingly ask a friend or relative for assistance.  They are the opposite of the socialist, who will demand from all of society that they are provided for with the lifestyle of their choosing.  Many a college professor and politician come to mind.

The real question is: What is more important, your health or your stuff?  The socialists turn it into a punchline from a Jack Benny routine.

So, in the mind of the urban and suburban Leftoid, it is perfectly fine for the McMansion to remain the property of the ailing grandmother whilst the rest of us pay for her hospital visits and drugs so that a new generation can have an inheritance, at a value below the "rich kid" death tax rate, of course.

So, how did America survive before the government rushed in to save us from certain death and poverty?  Scroll back up and read Ron Paul's quoted answer.