About this time last year we were all watching the activities of our Congress with a great deal of anxiety. The healthcare reform process exposed the rather seedy side of the political gaming that goes on in Washington everyday, to one degree or another. But in this instance the eyes of the American public were a bit more focused than usual, and no matter which side you favored, the backroom deals and strong arm tactics had to make you more than a little uncomfortable with the way power was being wielded. What we saw was anything but representative of the will of the people.

In the end, both the House and Senate passed the President’s healthcare reform strictly along party lines, with votes being cast by elected representatives who freely admitted they had not even read the bill. The Speaker of the House declared that they had to pass the bill in order to find out exactly what was in it. So now, in the wake of all that, the question we should be asking ourselves is why. Why is controlling or overseeing your personal healthcare such a big deal to this current administration and their minions in the Congress? The answer is actually very simple and it has absolutely nothing to do with ensuring your health or wellbeing; its all about Power and Money.

For elitists who aspire to power, often based on their perceived superior intellect, the easiest way to achieve it is to first convince the masses that they need the government’s help providing for a specific need. The success of this philosophy relies heavily on a combination of fear and protection. We’ve all heard the statement, “never let a crisis go to waste” and the reason is that public fear is a natural product of any crisis. But, if fear doesn’t actually exist, then create it. Once fear is well established the power-seekers can step in and offer protection and security in the form of a magnanimous government solution.

So, why healthcare? Simple, it is far easier to create a sense of fear over an emotionally charged issue like healthcare than it is for any of the “necessities of life” like housing, food, clothing or virtually anything else we use or depend on everyday. No one would tolerate the government telling us where we can live or what we can eat, or even what kind of car we can drive, but since we don’t actually use healthcare everyday it represents only a potential need rather than an immediate one. Even so, it’s natural to be concerned and even a bit anxious over the possible impact of an unexpected illness or injury. All it takes to turn that anxiety into a full-blown crisis-level fear, which demands a government solution, is the injection of the final element – money.

Obviously, the cost of obtaining healthcare has escalated over the years, and the prospect of a major expense arising from an unexpected injury or illness is the reason why most people feel they must have health insurance. However, it must be pointed out that among the major reasons for the rising cost are the significant improvements that have been made in recent years in the diagnosis and treatment of virtually every malady known to man. New and typically expensive technologies have helped us become healthier and live longer than any previous generation. And, since people are living longer, there has been a corresponding increase in demand for medical care across the board.

Perhaps the most significant part of the healthcare cost equation has been all but ignored. Since one or more third parties pay the majority of the cost of healthcare, demand has continued to rise unchecked. Given the reality of these runaway costs, the eventual result has been declining payments for most services and ultimately the rise of a thinly veiled restricted access to care. This is precisely what has happened to healthcare in America over the last two decades under what the insurance industry refers to as “Managed Care.”

Clearly, government control of healthcare has been a goal of “progressives” in this country for more than a hundred years. When the liberal factions of the Democrat party gained control of both houses of Congress and the Presidency in 2008 their long awaited opportunity finally presented itself. They were quick to point to private insurance companies as being guilty of raising premiums and reducing coverage at the expense of the consumer, and on that score they were correct. “Reform” became their rallying cry without specific mention as to what exactly needed reform. Change for the sake of change alone was considered by many to be reason enough to overturn what has been the best healthcare system in the world.

Social progressives truly believe the government should run the entire healthcare system, similar to how it is done in Canada, Great Britain and other openly socialist countries. After all, under those systems healthcare is available to everyone without cost to the individual. What they don’t say is that those who have the resources, and even those who don’t, must pay higher taxes to cover the government’s obligations, and that access to care must be restricted to avoid runaway costs. The American public would surely never accept this if it were stated policy, so enter the government bureaucrats with their “smoke and mirrors.” They recognize that it is possible to achieve their desired result by simply lowering payments to providers until there is no incentive to offer a particular service. They also impose highly restrictive access criteria under the guise of quality controls. In fact, under the President’s healthcare reform law there are more than one hundred fifty new government agencies and committees designed specifically to control every physician’s ability to order tests and prescribe treatments. They use safe sounding aphorisms like “best practice guidelines” instead of access control, and reduced payment schemes are disguised as “Pay for Performance” initiatives.

While all this is very upsetting to those of us in medicine who have dedicated our lives to providing that care, it should be truly frightening to every American based on where it will most certainly lead. Using the time-tested approach of “fear and protection” our increasingly dependent society appears to be ripe for the progressive destruction of personal freedom and individual liberty by our leaders drunk on Power and Money.

Thomas Jefferson has been widely quoted in recent years on a number of issues, but in one of his somewhat less famous writings he said to Edward Carrington in Paris, May 27, 1788, “The natural progress of things is for liberty to yield, and government to gain ground.”   I pray God it isn’t so.

First posted 3/21/2011 on robertsewellmd.com