The New Third Rail... by Robert Tracinski

TIA Daily • July 21, 2009

The New Third Rail

Save Individual Private Health Insurance

by Robert Tracinski

President Obama is pushing hard to get his health care bill up for a vote in the next few weeks. The trademark tactic of this administration is speed. They try to achieve their agenda by ramming legislation through Congress as fast as possible—too fast for opponents to subject the bills to scrutiny, search for objectionable provisions, or develop effective counter-arguments in a public debate. Heck, Obama and his allies in Congress push through the bills so fast that congressmen and administration officials themselves don't even have time to read the damned things.

If we're able to block his health care bill, it will be because we actually got a little bit of time to read it. The folks at Investor's Business Daily did just that, and what they found right away is that Obama's bill would outlaw individual private health insurance. It was already known that the so-called "public option" for health insurance was an attempt to "crowd out" private health insurance by luring people into government-subsidized insurance, but the plan to kill private health insurance is actually much more direct: the bill bans insurance companies from writing new individual policies. Government-provided health insurance turns out not to be an "option": it's mandatory.

Killing private health insurance is the only way the left can achieve its dream of a government-run health-care system. They have to do it, because government-provided health coverage, even if it is subsidized, cannot actually compete with private insurance. Government-provided care always leads to cost-cutting—isn't that the whole stated purpose of health-care reform, to cut costs?—which always means rationing the amount and kind of care we will be provided. Given that risk, many people would refuse to go onto the government program and cling to their individual private plans instead. And this makes it harder for the bureaucrats to impose rationing on government-funded care, because they know patients in the government program will compare the quality of their care to what is available from private plans.

Private health insurance sets a kind of gold standard for the quality of care people expect—and that's a standard government-run health care has never met and can never meet.

All of the relentless propaganda about how "our health care system is broken" is an attempt to blind us to this fact. It is supposed to make us think that we are not getting the best care in the world, when we are.

I know, because my family has been a pretty significant user of medical care in the past few years. Two years ago, our first child was born, and we now have a second child on the way. In between, my wife was in a semi-serious car accident. So we've spent our share of time in hospitals and examination rooms recently, and I cannot adequately express my gratitude for the quality of care we have received.

Three experiences stand out. When my first son, Walter, was born, one of the pediatricians noticed that his heart was making a slight noise, so he sent us up for a consultation with a pediatric cardiologist. I have a decent knowledge of science, and I have a few friends who are doctors and engineers, so I consider myself a decent judge of experts. It's not too difficult to tell when you're dealing with a physician who really knows what he's talking about and is able to answer your questions clearly and thoroughly. I was very impressed with this cardiologist, who performed an echocardiogram (a high-precision ultrasound imaging of the heart) and explained that what the pediatrician heard was actually a normal sound—what he called the singing of the "heart strings" that connect opposite walls of the ventricles. It was a thorough cardiac workup that relieved all of our anxieties—with no need to get on a waiting list or ask anyone's permission or go through some arcane cost-benefit analysis.

After Sherri's car accident, she experienced some vision problems. Since she is very near-sighted, she is at heightened risk for retinal detachment, and she was afraid that the impact of the collision—she was rear-ended by a truck going about 60 miles per hour—could have broken her retina loose. So again we searched around for the best expert we could find, a very impressive retina specialist, who did a very thorough check.

More recently, we went in for an ultrasound on the new baby. If you think an ultrasound is just about getting a grainy image of the fetus, you haven't seen one lately. In this ultrasound, our physician looked at the development of the baby's internal organs and the brain (I could clearly see the cerebellum). Using Doppler ultrasound, which is able to track the direction and rate of motion, he looked at the blood flow through the baby's heart. And he performed a whole other series of measurements (the length of the femur, the circumference of the skull, etc.) which are markers for potential birth defects. It was a thorough physical check-up—way more thorough than anything I've ever had—performed long before the baby is born.

All of this offered us the reassurance that we have another healthy child on the way. This is not something we take for granted. My wife and I waited a long time to have children, and with age, the risk of complications increases. So it is an enormous benefit for us to be able to check thoroughly and be sure.

Now notice that all of these examples are, fortunately, about medical problems that did not exist. Which makes them precisely the kind of tests that would be very easy for bean-counting bureaucrats to deny on the grounds that they are not cost-effective. Not cost-effective, that is, for the government. But I didn't have to worry about what was cost-effective for the government. I only had to think about what was cost-effective for me. I was able to make the choice based on what my insurance would cover and—since I have a Health Savings Account, one of the few pro-free-market health-care reforms Congress has managed to pass—what I could afford to pay in deductibles and premiums.

My experience with the "health care system"—i.e., with my own doctors and nurses—has been a dream. I am not wealthy by any means (I am a self-employed writer, which should say just about everything right there), and I have no special connections or "pull." Yet I have had no difficulty making sure that my family receives top-quality care.

The key is that we are in control. We are able to shop around for the best doctors and the best insurance coverage, and we are able to decide if we want to spend, say, $1500 on an ultrasound or amniocentesis in order to avoid greater costs (or more tragic consequences) later on.

This system works at allowing me to protect myself and my loved ones. And that's why I am terrified that Barack Obama wants to smash it all to pieces.

A few days ago, I got an e-mail from Vern Hodgins, a long-time subscriber in Canada, who recounted a very opposite experience with Canada's health-care system. Read this carefully, because if Obama gets his way, the happy story I told above is not the future. This is:

"My wife and I relocated to a new community. For my wife, that meant finding a new doctor, which became a six-year wait. During that time, she had to do with a local outpatient clinic, which rotates its medical staff. It is rare to see the same doctor twice, which renders continuity feeble at best. As well, the rules do not allow rotation doctors to provide full physical examinations; only a family physician may do that.

"While waiting in line for a family doctor, my wife became ill. Typically, a patient gets about ten minutes with a community clinic doctor, which for my wife meant cursory examinations and referrals to physiotherapists and chiropractors.

"My wife's condition worsened and we could not do anything about it. Finally, the government granted her a family doctor. That doctor also gave her a cursory exam, diagnosed her ailment as a sports injury, and referred her to more physio and chiropractic treatment. Her condition worsened still, and still her doctor insisted it was a sports injury.

"Fed up with my dear wife whimpering her nights away in pain, I visited her doctor. The doctor's receptionist rudely rebuffed me, saying my wife had to wait in line just like everyone else because despite what I thought, she was no more or less special than anyone else.

"The next morning I described my wife's condition to a work colleague who is a doctor. Having never met my wife, and with only my description, that doctor told me to get my wife into a hospital immediately because she was certain it was a metastasized cancer.

"Sure enough, as soon as the hospital emergency staff saw my wife, they knew; it was advanced non-Hodgkin lymphoma, which had dissolved some of her collarbone. My wife had to be told her prognosis was not good, that she had to prepare for the worst. Fortunately for me, my doctor colleague, a high profile media individual, used her influence to get my wife the best specialists in the country—which, yes, meant that my wife is somewhat more special after all. She survived. She endured the most aggressive treatment regimen there is, and though she's left with considerable damage from the radiation, she's alive.

"The incompetent family doctor, who misdiagnosed, suffered no consequence. As well, my wife must keep the same family doctor unless she wishes to wait another six years or so.

"That's socialized medicine. Worse still, one may not openly criticize our system without being told to move to America if we don't like the world's finest socialized medical system. Criticizing our system is tantamount to being a global warming 'denier.' The propaganda is that effective."

Anyone can have a family doctor who makes a wrong diagnosis—but in America, you're not stuck with him. I'm a fan of the TV show "Mystery Diagnosis," which tells the real stories of people with very rare medical conditions who spend years trying to get a proper diagnosis and treatment. One of the things these patients talk about is how you have to "be your own advocate," and most of the cases are solved when the patient himself searches for information on the Internet, finds a specialist who is an expert in the disease, and seeks out that physician's advice.

But how can you be your own advocate under socialized medicine? It is outlawed, because you are no longer in control of your own health care. You have no freedom to choose a physician, or to seek out a specialist on your own, or to decide what medical tests you will pay for.

Mr. Hodgins concludes his story by saying, "In Canada, the patient is not a client; deference goes to the doctor." I don't think that's quite accurate, because I've known a few doctors who had to work under the Canadian system, and it's no treat for them, either—not for the decent ones. In Canada's system, deference doesn't go to the doctor. It goes to the state. Care is denied in order to cut costs and save trouble for the government.

The Democrats' attempt to eliminate individual private health insurance, combined with the enormous, multi-trillion-dollar price tag of their health-care bill, tells us that this is what they want for America, too. The purpose of this bill is not to save money or provide better care or—try not to laugh—provide "health choices." Its purpose is to make us dependent on the government for the most important needs of our lives.

For the political leaders on the left, the purpose of socialized medicine is control: they want us to turn to them as the saviors we have to supplicate for every need in life. For the political supporters on the left, the motive for socialized medicine is envy: the want everyone held to the same equal standard, even if it is an equally low standard, so that no one will be allowed to think that he is "special" and has a right to seek out better care.

What we need, and we need it urgently, is a political rebellion in favor of independence, which is the only real guarantee of our security and happiness. And to preserve our independence from government, we need to send the message that any legislation that even remotely threatens individual private health insurance is a red line that politicians dare not cross.

President Obama is already frightened of this issue. Late last week he tried to defuse it by responding that "If we don't get health care reform done now, then no one's health insurance is going to be secure." In effect, he's telling us that he has to destroy our health insurance in order to save it. I don't think anyone's going to find that very convincing.

For years, Social Security has been the "third rail of American politics"—an analogy to the electrified extra rail on commuter train lines. The rule has been "touch it and you die": any reform that even threatens to scale back Social Security has (supposedly) caused the political demise of the person who attempts it.

I think we should create a new third rail in American politics: individual private health insurance. If we can block Obama's health-care bill—causing Barack Obama to fail on one of the central goals of his presidency—then we will send the message: leave our health insurance alone. Touch it and you die.

That's a harsh rule for politicians, but it reflects the harsh fact that if they touch it, we die.