Freeborn Americans may not gaze upon their presidents without the permission of the bureaucracy
There's a certain amount of lingo that
comes with the provision of health care. In most developed countries, these
words are "doctor," "nurse," "scalpel,"
"appendix," that sort of thing. But American health care has its own
unique vocabulary: "co-pay," "HMO," "COBRA,"
"doughnut hole" . . . And we're always adding to it. The latest word
is "exchanges." A mere twelve months ago "exchanges" were
something to do with stocks or trying to get a larger size when you're given a
too-tight thong for Christmas. Now, suddenly, it's the new health-care buzzword.
You go to the federal website for the "exchanges," if you can get
through, and they redirect you to the state websites for the
"exchanges," if they're working. In Oregon, there are some 1,700
different rules that determine eligibility for the new "exchange." In
Maryland, you're advised that "we may share information provided in your
application with the appropriate authorities for law enforcement and audit
activities." But we're used to all that by now, aren't we? The point is
it's going to be complicated, time-consuming, and in breach of almost any
elementary understanding of privacy. That's what makes it quintessentially
American.
Most developed
nations have a public health-care system and a private health-care system — of
variable quality, to be sure, but all of them far simpler to navigate than
America's endlessly mutating fusion of the worst of both worlds. Obamacare
stitches together the rear ends of two pantomime horses and attempts to ride it
to the sunlit uplands. Good luck with that. But we should remember that this
disaster has been a long time incubating. The Democrats' objection to the
pre-Obama "private" health system is that Americans wound up spending
more than any other country for what they argued were inferior health outcomes.
But the more telling number is revealed by Avik Roy elsewhere in this issue: In
2010 (in other words, before Obamacare), U.S. government expenditures on health
care were higher than those in all but three other countries in the world.
Quick, name a European social democracy full of state-suckled wimpy welfare
queens: France? $3,061 per capita in public-health expenditures. Sweden? $3,046
per capita. Belgium? $3,000. In 2010 the United States spent $3,967 in
public-health expenditures per person — more than anywhere on the planet except
Norway, the Netherlands, and Luxembourg. I am confident that, under Obamacare,
we'll be outspending even the Norwegians. But in reality our so-called private
system was a public system in all but name.
Why did we
think otherwise? That gets back to the fundamental disconnect between America's
national mythology and who Americans are as a people, or at least as a voting
majority, in the 21st century. To reprise the Frenchman I quoted in this space
a while back, "Americans love Big Government as much as Europeans. The
only difference is that Americans refuse to admit it." And, because they
refuse to admit it, they've wound up with a uniquely disastrous form of statism
— a kind of statism on the sly, in which the zombie husks of private industry
are conscripted as the front men for de facto nationalization. As part of the
sky-is-falling rhetoric over the soi-disant shutdown, the media warned that,
with federal employees furloughed, many American homebuyers would be delayed in
moving into their new homes.
Tragic. But how
did it come about that government bureaucrats are mixed up in your home
closing? It's bad enough that the feds have a piece of so many mortgages, but
it's far worse that, even if you walk into the realtor's office and plunk down
a certified check for the entire cost of the house, you're still obligated to
comply with all the federal HUD paperwork. In many key areas of life — your
home, your health, your bank — Americans now enjoy considerably less freedom of
maneuver than Europeans. They don't think of it like that because it's statism
at one remove. But third-party statism is inevitably more cumbersome,
bureaucratic, and expensive — summed up in those commercials for "Medicare
supplement plans," patiently explaining why an already hideously unaffordable
taxpayer-funded entitlement nevertheless apparently requires huge additional
private expenditures in order to function.
If you blur the
lines between public and private as artfully as American statism does,
eventually everything becomes the government, and your private sphere is no
more genuinely private than those private museums, boat launches, restaurants,
and campgrounds ordered closed at no notice by the shock troops of the National
Park Service. In South Dakota, the NPS attempted to shut down an unmanned,
open-air parking area on the shoulder of the highway to prevent Americans from
looking at Mount Rushmore. Apparently, the view belongs to the government and
you can enjoy it only with their approval. In the days of absolute monarchy, a
medieval proverb nevertheless assured us that a cat may look at a king. But in
South Dakota freeborn Americans may not gaze upon their presidents without the
permission of the bureaucracy.
It was a rare,
direct, explicit revelation of how, underneath the "exchanges" and
other sock puppets, American statism's conception of itself is as expansive and
unbounded as the most doctrinaire Eurosocialist's. They should demolish those
guys on Rushmore and chisel in a giant federal official-scenic-view application
form, with sky-high small print explaining that your confidential information
will be shared only for the purpose of "audit activities," and with
pyramid-sized boxes to check rising into the clouds and up to the heavens.
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