Tuesday, August 25, 2009

The Battle for the Moral High Ground

Early in the 2008 presidential campaign, the long shot candidate Barack Obama was often criticized for being vague on the issues. But as I wrote in my critique on Obama’s roundly lauded Reverend Wright speech of 3/18/09:

Senator Obama is a thoughtful, philosophical, and talented orator. He apparently knows that to sell a political package requires a belief by people that it is right.

Statism rests on a collectivist base. But collectivism depends on a certain moral foundation without which it cannot be sustained. That moral foundation is altruism. Altruism holds self-sacrificial service to others as one’s highest moral purpose.

Cashing in on the dominant ideas accepted either explicitly or implicitly in most of American culture, this articulate, smooth-talking “uniter” will lead us down a well-worn path… a path leading to ever-diminishing individual freedom and self-determination.

That “cashing in” is now being brought to bear on the healthcare debate. In a clear political change in strategy, reports the New York Times, President Obama “sought Wednesday to reframe the health care debate as ‘a core ethical and moral obligation’ ”. Speaking to “a multidenominational group of pastors, rabbis and other religious leaders who support his goal to remake the nation’s health care system”, Obama said:

"There's been a lot of misinformation in this debate and there are some folks out there who are frankly bearing false witness. These are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation, and that is that we look out for one another." (Emphasis added.)

“Let us be our brother’s keeper", implored the then Senator Obama in that 3/18/09 speech, “let us be our sister’s keeper…Let us find that common stake we all have in one another…and let our politics reflect that spirit as well.” (Emphasis added.)

The launch of his new strategy “to reframe the health care debate “ before a “group of religious leaders who support his goal to remake the nation’s health care system” is clearly motivated by Obama’s understanding of the common moral bridge between religion and the collectivist Left. More importantly, though, is the historical tie between religion and the state as the enforcer of religious moral law (statism). The Jewish state of Israel, after all, is a socialist-leaning mixed economy. Sharia law is common in Muslim countries. And Christianity’s dominant force, the Catholic Church, has a long-standing tradition of embracing the state to achieve its version of “social justice” and the “common good”. Declared Pope Paul VI in a major 1967 encyclical:

If the world is made to furnish each individual with the means of livelihood and the instruments for his growth and progress, each man has therefore the right to find in the world what is necessary for himself. The recent Council reminded us of this: "God intended the earth and all that it contains for the use of every human being and people. Thus, as all men follow justice and unite in charity, created goods should abound for them on a reasonable basis"[20] All other rights whatsoever, including those of property and of free commerce, are to be subordinated to this principle.

Individual initiative alone and the mere free play of competition could never assure successful development. Hence [government] programs are necessary in order " to encourage, stimulate, coordinate, supplement and integrate"[35] the activity of individuals and of intermediary bodies. It pertains to the public authorities to choose, even to lay down the objectives to be pursued, the ends to be achieved, and the means for attaining these, and it is for them to stimulate all the forces engaged in this common activity.
(Emphasis added.)

Many Christians, of course, disagree strongly that government force should be used to implement their Judeo-Christian altruist creed. But; In any conflict between two men (or two groups) who hold the same basic principles, it is the more consistent one who wins.” The fundamental inconsistency of the Christian Right is a fatal flaw that dooms it to ultimate defeat against the moral righteousness of the statist Christian Left. This is what Obama understands, and is why his statement to the ministers is so logically consistent with his "Christian Strategy”.

And this is where the pro-capitalist forces in general stumble and ultimately fail. Almost across the board, the opponents of Obamacare concede the moral rightness of the President’s position. Said Bill O’Reilly, Fox News’ anti-ideological ideologue of the Right:

"Talking Points" somewhat agrees with the president. Americans should look out for each other, but there are smart ways to do that and not so smart ways."

He then went on to tell us why Obamacare is impractical.

"The bottom line: Wild government spending has many Americans very concerned. The far left doesn't want to hear [about “practical” solutions] because those loons want income redistribution and see government-run health care as a way to do that."

Income redistribution is the political implementation of the “core ethical and moral obligation … to look out for one another”. Yet Mr. O’Reilly fails to challenge that ethical principle. Instead, he “somewhat agrees” with it, leaving Obama on the moral high ground.

Even when the moral issue is raised by someone on the Right, the fundamental principle of altruism is not exposed and explicitly challenged. The implicit egoistic ethics of America’s founding principles of the unalienable individual rights to life, liberty, and the pursuit of happiness has been under relentless ivory-tower assault since the country’s start, because of just such a lack of any comprehensive philosophical defense. That attack descended from the ivory towers to the political arena by the 20th century, igniting a relentless statist trend under the banner of “Liberalism” (or "Progressivism") that continues with the Obama Democrats’ agenda.

This period of rising statism is marked by a steady, stair-step type advance punctuated by conservative -- or “swing to the Right” -- interludes. These conservative interludes have primarily been periods of consolidation for the statists in preparation for the expansion of government under the next electoral “swing to the Left”. A good example of this process is described by Dr. Michael J. Hurd:

"We stand where we are today, on the brink of government dictatorship in medicine, because after the defeat of Hillary Clinton's plan all those years ago, Republicans proposed NOTHING to replace the high level of government regulation and control we have."

Indeed, modern conservatives almost unanimously defend our current system. It has its strengths, of course, especially compared to the rest of the world. But those strengths come from the remaining elements of freedom in the system, which are fast disappearing under the darkening skies of statism. Conservatism is utterly devoid of any record of actually stopping the advance of statism, let alone rolling it back.

What accounts for this failure? Watch the Right’s response to Obama’s moral challenge. They concede all of the Left’s fundamental premises; that it is the government’s job to guarantee some level of healthcare to all through a social safety net (It was a GOP controlled congress that handed President Clinton the original SCHIP bill in 1997); that insurers should be “regulated”; that government is responsible, in some way, for insuring the “46 million uninsured”; that socialists are motivated by “good (i.e., altruistic) intentions”.

The American Right is in full moral retreat, with an unrelenting willingness to compromise on the political front as the logical manifestation. Moral surrender leads to political surrender. You will see that there is only one force from the Right…that is to say, the pro-capitalist…side of the political spectrum that will engage the Left directly on the ethical battleground.

It is only Objectivism …which is in fact a philosophical, not a political, movement … that will state clearly, unequivocally, and with full moral righteousness and certainty that there is no moral obligation to help others, that no man is morally his brother’s keeper, that no man has a moral claim on the life of another, and that President Obama’s healthcare “reform” plans are immoral to the core.

The issue, of course, is not charity (or looking out for one another) as such. That is a personal value decision. The issue is whether charity is a moral obligation. If it is, then those claiming a “need” have a moral claim on the earnings, wealth, property, skills…i.e., the lives…of their “brothers and sisters”. If this is the case, then socialism is moral, and capitalism is, at best, amoral. Once one concedes the moral altruist premise that promoting others’ well-being is a “moral obligation”, and that capitalism must be justified on the basis that it is the “smart way to do that”, the battle is over. This type of “defense” of capitalism is the primary reason for the utter failure of American conservatism. I offer, as proof, the example of American medicine and the ever-rising intrusion of government interference over the past 75 years.

Obama’s appeal to morality and to the religious community is extremely significant. He has now fully exposed, in a clear, concrete form, where the real battle lines are drawn.

"It is not from your own goods that you give to the beggar; it is a portion of his own that you are restoring to him. The earth belongs to all. So you are paying back a debt and think you are making a gift to which you are not bound. You are not making a gift of your possessions to the poor person. You are handing over to him what is his." – St. Ambrose

"Do not hide behind such superficialities as whether you should or should not give a dime to a beggar. That is not the issue. The issue is whether you do or do not have the right to exist without giving him that dime. The issue is whether you must keep buying your life, dime by dime, from any beggar who might choose to approach you. The issue is whether the need of others is the first mortgage on your life and the moral purpose of your existence. The issue is whether man is to be regarded as a sacrificial animal." –Ayn Rand

The moral battle is – altruism vs. egoism. The political battle is – the state vs. the individual. The political battle depends upon the survival of America’s core founding principle…the principle of unalienable individual rights. But the outcome of the second battle depends upon the outcome of the first.

The reason is simple. You cannot separate the political right to life from the moral right to life, because the principle of individual rights is itself a moral concept. Individual rights are a guarantee of your freedom to act in accordance with your own moral values and independent rational judgement. The only political-economic social system consonant with the principle of individual rights is capitalism.

Capitalism has won the economic argument. It is, thus, the answer to the problems plaguing our semi-socialist, semi-fascist, semi-free healthcare system. But, as history makes clear, capitalism cannot win on economic grounds alone. Capitalism must now win the moral battle.

Of all of the disparate elements of the Right now united against Obamacare, Objectivism stands alone as the only movement with the consistent intellectual firepower to win the moral battle now unfolding. Objectivism alone holds that:

"Man—every man—is an end in himself, not a means to the ends of others; he must live for his own sake, neither sacrificing himself to others nor sacrificing others to himself; he must work for his rational self-interest, with the achievement of his own happiness as the highest moral purpose of his life. Thus Objectivism rejects any form of altruism—the claim that morality consists in living for others or for society."

To defeat Obamacare, as the first step toward the systematic roll-back of the statist-collectivist establishment in America, the Right must be ready to embrace Ayn Rand’s revolutionary new non-predatory, rights-respecting morality of rational self-interest. Without it, the best that can be hoped for is just another in a long line of consolidation periods of the statist trend. As long as the Left is allowed to hold the Right hostage to the altruist trump card, the full adoption of their socialist agenda will be only a matter of time. They will not stop at government-run healthcare. The key to winning the healthcare battle and the war for freedom and capitalism in America is to “take the moral high ground—which is ours by logical right”.

Thursday, August 20, 2009

The Dems' Unintended Warning Against the "Public Option"

AP reported on 8/19/09 that:

A spokesman for Rep. Bart Stupak, D-Mich., said Tuesday night that 52 letters had been sent to health insurers with $2 billion or more in annual premiums.

The request to insurance companies included records relating to compensation of highly paid employees, documents relating to companies' premium income and claims payments, and information on expenses stemming from any event held outside company facilities in the past 2½ years.

The requests were made in letters signed by Rep. Henry Waxman, D-Calif., who guided a portion of health care legislation through the House Energy and Commerce Committee last month as chairman, and Stupak, who heads a subcommittee on the panel.

To believe that letters of this kind coming from powerful politicians can seriously be considered “requests” is naïve, to put it mildly. In our mixed economy, where the tentacles of government control and coercion extend into virtually every nook and cranny of private business, the letters “asking” for this kind of information can only be viewed as threatening. There is no telling what kind of retribution may be brought down on any company that fails to comply with the wishes of Waxman and Stupak.

And this brings me to a point I have been making about the attempt to create a government-run health insurance “public option” to “compete” with private insurers. In response to a Star-Ledger letter writer, I wrote:

The government is a unique institution, distinguished by its legal monopoly on the use of physical force. America's great achievement was to limit that compulsive power to the protection of our inalienable individual rights. That is government's proper role. Stepping outside of those constraints invalidates government, as America's Founders understood.

The proposed "public option" is intended to destroy private health insurance, and clear the way for single-payer medical tyranny. Everyone knows it. The politicians will do whatever it takes to support their "competitor". They will use government's tax and monetary powers to keep premiums "affordable"; regulatory powers to hamper private insurers; force below-market prices on providers; harass private executives with explicit or implied "back-room" threats using the arbitrary and capricious powers of the regulatory apparatus, the IRS, or antitrust division of the Justice Department. The employment of government's unique powers of legalized physical force to destroy private businesses, industries, and livelihoods is legalized criminality. (Emphasis added)

The House committee request is a concrete example of “explicit or implied threats” by representatives of the unique institution that holds the legal monopoly on the use of physical force. Reports AP:

Robert Zirkelbach, spokesman for the American Health Insurance Plans, said Democrats on the panel hoped to "silence the health insurance industry” [by] mounting a "fishing expedition" [to] “distract attention away from the fact that the American people are rejecting a government-run plan" as part of President Barack Obama's planned overhaul.

Whatever the reason, the fact is that the heavily controlled and regulated private health insurance industry is directly threatened by any public “option”. The request for the private company records without warrants, court orders, probable cause of any legal wrongdoing, etc., during this contentious period leading up to a vote on the future of American healthcare cannot be seen as a coincidence. If a public option is ever established, whether it comes in the form of a government-run plan, government controlled “co-ops”, or any other guise, it will mean the end of most private insurance and a huge step toward socialized medicine.

The Democrats have unintentionally flashed a clear warning signal, and a lesson on the workings of a mixed economy government.

Saturday, August 15, 2009

Rights vs. Privileges

The drumbeat of pro-Obamacare letters continues in New Jersey's largest newspaper. The following LTE appeared in the 7/30/09 addition. From the Star-Ledger Reader Forum:

Health care a right

After reading the article, "Twenty-somethings contemplate Obama's health care plan," (July 27) it became even more evident to me the national crisis we face with our health care system. As a college graduate, I have seen so many of my friends struggle to find jobs and have an even harder time getting insured after they were kicked off their parent's insurance plan.

America is one of the leading industrialized countries, and yet has one of the worst health care systems in the western world. The health care system we have now will never sustain itself, and it is time for reform.

If we reform our health care system we will also be strengthening our economy. So many Americans are left uninsured and have no other option but to go to the emergency room for even minor health problems. Because of this, taxpayers pay more.

Having private companies compete with a public health care option will bring the cost of the health care down for even the people who are already insured.

With health care reform our economy will recover and job opportunities will increase. Most importantly, the health of our nation will improve. It is not a privilege, but a human right to have health insurance.

Victoria Maione, Hamilton

Victoria Maione’s letter reads like a collection of unsubstantiated leftist talking points, but it ends on the fundamental issue underlying the entire healthcare debate. She states;

“It is not a privilege, but a human right to have health insurance.”

We can probably infer from her statement that she also believes that health care itself is a “right”. What’s interesting here is that she declares that health insurance/healthcare is not a “privilege”. She complains that;

“As a college graduate, I have seen so many of my friends struggle to find jobs and have an even harder time getting insured after they were kicked off their parent's insurance plan.”

Leaving aside the question of the high cost of healthcare and insurance in America (which, as I have been exhaustively explaining, is primarily the result of massive government intervention), Ms. Maione apparently equates earning the means to cover your own healthcare expenditures with a privilege. So what, exactly, is a privilege? According to Webster’s, it is:

An exceptional law made in favor of or against any individual… a right, immunity, benefit, or advantage granted to some person, group of persons, or class, not enjoyed by others and sometimes detrimental to them. (Emphasis added.)

So, according to Ms. Maione’s terminology, if you earned your healthcare, you have been granted a privilege…rather than having exercised your right to spend your own money as you see fit. Granted…by whom?

What, then, constitutes a right? As laid out in America’s founding documents, a right is not a grant from any politician, state, or collective such as society or a democratic majority. A right is an unalienable sanction of the freedom to take action, such as freedom of speech, association, religious practice, etc. As Ayn Rand explains:

[F]or every individual, a right is the moral sanction of a positive—of his freedom to act on his own judgment, for his own goals, by his own voluntary, uncoerced choice. As to his neighbors, his rights impose no obligations on them except of a negative kind: to abstain from violating his rights.

A right is not an automatic claim on the products, services, earnings, skills, or property produced by others. Rights are political, not economic…a crucial distinction all but forgotten today.

Now, keeping in mind the definitions cited above, consider the claim that a manmade product such as healthcare (or health insurance) is a right, and what it actually means in practice. If someone requires medical care, then the doctors, nurses, pharmaceutical and device makers, etc., must be legally obligated (i.e., compelled) to provide their services to that person. Likewise, that person’s neighbor, or the person 3000 miles away, must be legally obligated to pay for his treatment. In other words, the providers whose skills make medical care possible, as well as those whose taxes pay for it, are serfs.

Every person in a free society has a right to take the actions required to satisfy his own healthcare needs, so long as those actions don’t entail the violation of anyone else’s rights. Thus, he has no right to rob his neighbor to pay for them, nor force any provider to “serve” him, nor elect politicians to impose those obligations. There is no such thing as a “right” to healthcare or any other man-made product, beyond what one can pay for himself through a voluntary transaction with those who produce it.

What Ms. Maione has actually accomplished is to invert the meanings of the words privilege and right. Or, put another way, she has substituted economic “rights” for political rights. In so doing, she has, in essence, called for the replacement of freedom with slavery. This is the nature of the inversion that today threatens the survival of America as a nation based upon the unalienable rights of the individual and the government as protector of those rights.

Re-read the definition of “privilege”, and you can easily see that it applies to any alleged “right” to any man-made object, service, or what have you. Once again quoting Rand:

It was the concept of individual rights that had given birth to a free society. It was with the destruction of individual rights that the destruction of freedom had to begin.

The “gimmick” was the switch of the concept of rights from the political to the economic realm.

Jobs, food, clothing, recreation(!), homes, medical care, education, etc., do not grow in nature. These are man-made values—goods and services produced by men. Who is to provide them?

If some men are entitled by right to the products of the work of others, it means that those others are deprived of rights and condemned to slave labor.

Any alleged “right” of one man, which necessitates the violation of the rights of another, is not and cannot be a right.

No man can have a right to impose an unchosen obligation, an unrewarded duty or an involuntary servitude on another man. There can be no such thing as “the right to enslave.”

The concept of economic rights establishes a perverse new version of the master/slave relationship…the provider as slave by virtue of his ability to produce the needed value, with the consumer of the provider’s product as the master by virtue only of his need for those services. This new privileged class of healthcare consumer is, thus, granted “rights” that are “detrimental to” and “against” the very people needed most…doctors and other providers. The alleged “right” to health insurance is actually a privilege granted to some by force of government, at the expense of the freedom and property of others.

There are essentially two types of persons – those willing and able to support themselves by their own effort, and those who aren’t. In a moral…that is to say, in a free and capitalistic…society, those who do are free to use their surplus wealth and time to help the others by voluntary choice. Those who fail to provide for themselves must rely on whatever goodwill charity is available, motivate themselves to improve their lot in life, or make due as best they can on whatever their own efforts yield.

The medical socialists propose to establish a new class of privilege composed solely of the non- or sub-productive, since the amply productive (the vast majority in a free country) have nothing to gain by this new entitlement called “the right to healthcare”.

Victoria Maione should learn that words have meanings because what she and her ilk advocate, whether they are honest enough or even conscious enough to acknowledge…is“the right to enslave.”

Tuesday, August 11, 2009

GOP to the Rescue - Take 2

The growing revolt against the Obama administration's health care reform proposal has been mainly a grass roots movement, contrary to the claims (or, perhaps, hopes) of top democrats. And it looks like it will have to remain that way.

In yet another display of the intellectual bankruptcy, and growing irrelevance, of the Washington GOP establishment, three top Senate Finance Committee republicans are working with committee democrats to "save" health care reform. According to the CATO's Michael Tanner (SENATE DEAL: CHANGE A FEW NAMES):

THE "compromise" health-care reform being negotiated by six members of the Senate Finance Committee is shaping up as a classic warning of the dangers of bipartisanship without principles: It looks like they'll keep the worst features of other ObamaCare bills -- but simply change the names.

Finance Committee Chairman Max Baucus (D-Mont.) and Sens. Kent Conrad (D-ND), Jeff Bingham (D-NM) Charles Grassley (R-Iowa), Olympia Snowe (R-Me.) and Mike Enzi (R-Wyo.) are reportedly putting the final touches on a bill that may save President Obama's chances for passing health-care reform this year.

The proposed bill is forthright on still containing many of the worst aspects of ObamaCare. It would mandate that all Americans buy insurance -- and not just any insurance, but a specific government-designed set of benefits, even if that package was more expensive or contained benefits that you didn't want.

It would set the stage for government interference in how doctors practice medicine. It would extend subsidies for health care well into the middle-class, making millions more Americans dependent on government. And it would pay for all this with huge tax increases on American workers and businesses.

In exchange for this pu-pu platter of bad ideas, it offers two supposed compromises.

First, instead of a government-run "public option," it would set up a nationwide health-insurance co-op.

But these aren't true co-ops. The members wouldn't choose its officers -- the president would. Plus, the secretary of Health and Human Services would have to approve its business plan, and thus could force it to offer whatever benefits, premiums and reimbursement schedules Washington wants. Finally, the federal government would provide start up, and possibly ongoing, subsidies.

A "co-op" run by the federal government, under rules imposed by the federal government and with federal funding is simply government-run health insurance by another name.

Or, as Senate Majority Leader Harry Reid put it, "We're going to have some type of public option, call it 'co-op,' call it what you want."

If this is what bipartisanship looks like, give me some old fashioned partisanship any day.

The key words in the above are, "the dangers of bipartisanship without principles". To be more precise, the republicans do embrace principles...those of the Left. They simply are content to quibble over the details of how to achieve their supposed opponents' socialist goals.

Friday, August 7, 2009

GOP to the Rescue

Just when Obamacare is increasingly threatened with mounting grassroots opposition, along come the “bipartisan” Republicans to rescue it. In an article in the Washington Post, six democrats, five republicans, and one independent declared: “We refuse to let partisanship kill health reform”.

The result is the Healthy Americans Act. The 12 co-sponsors of the bill said:

As 12 U.S. senators from both sides of the aisle who have widely varying philosophies, we offer a concrete demonstration that it is possible to find common ground and pass real health reform this year. The process has been rocky, and slower than many had hoped. But the reports of the death of bipartisan health reform have been greatly exaggerated. Now is the time to resuscitate it, before the best opportunity in years is wasted.

In comments posted to the article, I said:

Zemack wrote:

This "compromise" may be bipartisan, but it is not a deal between "U.S. senators...who have widely varying philosophies". The basic premise underlying the Healthy Americans Act is that it is the government's responsibility to guarantee health insurance and health care to every American. That is the essential collectivist principle of all forms of socialism. Once that principle is accepted, all talk of "empowering individuals and bringing market forces to the health-care system" is just so much deceptive hot air.

For a government to guarantee any man-made product or service, it must assume totalitarian control over that industry, sooner or later, as well as enact wealth redistributionist policies. There is no other way.

This article is riddled with statist concepts. While ending the tax code-engineered third-party-payer system is a must, this bill does no such thing. It just shifts responsibility for health insurance from the employer to the federal government, a gigantic step toward a total government takeover of health care. It taxes some for the unearned benefit of others, forces "employers to contribute to the system", and forces "all individuals to have coverage". There is nothing "free market" about that.

The real tip-off is embodied in the phrases "we allow all Americans to have the same kind of choices" and "giving Americans choices". This statist mindset signals the inversion of a key American principle...that the people, as individuals, act by unalienable right, and the government acts by permission. In a free market, choices aren't a gift of government. A free market by permission is a contradiction in terms.

Of course, there is no one here advocating a free market, which is based upon individual rights...only some vague notion of "market forces". There is no talk of liberating the insurance industry of government mandates, or of ending state-imposed restraint of trade practices, or of phasing out and abolishing compulsory government "insurance" schemes like Medicare, Medicaid, or S-CHIP, or of reigning in the FDA's power to dictate which medicines we can take. A true free market is one in which force and compulsion is banished, and government acts as protector of individual rights (which includes vigorous enforcement of laws against fraud and breech of contract). All individuals are free to think and act on their own judgement, in voluntary association and mutually beneficial trade. That is what the "free" in free market means.

The Republican "activists" are acting without principles, in the name of "bipartisanship"...demonstrating once again the intellectual and moral bankruptcy of their party. The Democratic activists have won. They will just have to wait a little longer for their socialized medicine. There may be some good nuggets in this bill, but the heavy hand of coercive government will doom it to failure. The normal market incentives toward lower prices, higher quality, and wider and wider availability...inherent features of individual freedom...will not be able to operate. Then it will be declared that the free market was given one last chance and had failed...where no free market was ever established.

8/5/2009 7:31:19 PM

Monday, August 3, 2009

A Medical "1984"

Marc K. Siegel, a practicing internist and associate professor of medicine at NYU Langone Medical Center, has painted a scarey picture of what American medicine will be like under Obamacare. In an August 3, 2009 New York Post Op-Ed entitled DESTROYING THE DOCTOR-PATIENT BOND, professor Siegel writes:

"The most frightening thing about Washington's idea of 'health- care reform' is how it will interfere with the doctor-patient relationship."

Comparing the legislation to George Orwell's world of 1984, he describes the "new committees and commissioners with undefined but far-reaching powers -- a Health Choices Commissioner, a Health Benefits Advisory Committee, a Comparative Effectiveness Committee . . . ."

He writes:

A prime example comes in the section starting on page 425 of the House bill. This dictates that an Advanced Care Planning Consultation must take place every five years from the age of 65 -- with the intervention of so-called counselors, trained and appointed by the government.

The clear goal of the consultation is to decrease unnecessary care to the elderly. But, while a lot of resources are too often wasted in the last days of life, there are many vigorous and engaged senior citizens who shouldn't be shortchanged or pushed prematurely to euthanasia.

Whose decision should it be to phase out such people? The government's?

Another worry is created by Section 123 (page 30) of the House bill. This establishes a Health Benefits Advisory Committee, chaired by the Surgeon General, which makes recommendations to the HHS Secretary on what should be covered and what shouldn't.

These rulings from on high are problematic, since useful treatments or tests for one patient are not appropriate for another. Appeals are bound to be time-consuming and largely ineffective. This is the government interfering directly with the practice of medicine.

Then there is the Task Force on Clinical Preventative Services (page 937), whose stated purpose is to "review the scientific evidence related to the benefits, effectiveness, appropriateness and costs of clinical preventive services . . . for the purpose of . . . disseminating evidence-based recommendations on the use of such services."

The most disturbing word, of course, is "appropriateness." Where is the government and its board of political appointees going to get the insight needed to advise me on what's appropriate to prevent disease in a given patient?

While we should all worry about the government's intrusion into our rightful medical decisions, perhaps the scariest statement is this:

"Many of my patients use me as a guide to direct them to the best possible care. I'm not alone in this -- it's part of what makes medicine worthwhile to practice.

"But if the president has his way -- cutting costs through regulatory rationing and decreased reimbursements -- doctors will soon be so busy filling out government forms and seeing more and more patients for less and less pay that none of us will have the time to do a preventive curbside."
(Emphasis added.)

What will happen to the quality of medical care under this type of heavy-handed government control? It's not hard to fathom. The best, most independent, most innovative doctors and medical professionals will begin leaving the field in frustration. They will be replaced by what philosopher Leonard Peikoff calls "the new bureaucratic doctors...who want to escape the responsibility of thought and judgement... These doctors don't mind the forfeit of their professional autonomy to the HMO [or government] administrator...or object to practicing cut-rate medicine with faceless patients on an assembly-line basis, so long as they themselves can escape blame for any bad results and cover their own tracks." (From "The Death of a Profession" in The Voice of Reason, page 299. Dr. Peikoff comes from a medical family. His father was a surgeon.)

There are already signs of a coming abandonment of the field of medicine by the most competent, independent doctors to the "new bureaucratic doctors" who don't mind working under government orders. This veteran psychiatrist declares that if Obamacare passes, "I'm done". In an LTE, New Jersey doctor Leo Battenhausen writes:

"As a psychotherapist, I do not accept Medicare or Medicaid. Why? Because they pay a pittance compared to private health insurance...

"If President Obama's health care reform passes, any provider worth his weight will not take insurance at all and take only cash, freeing themselves from the organized crime of insurance all together. This will leave only the worst providers as 'In network.' Quality care will be left only to the rich, while those trying to save a buck will save little."

And Los Angeles Dr. Shira Miller already "doesn’t accept Medicare or health insurance so there can be no third-party interference with her individual rights or those of her patients", according to an article in the New York Times.

What will happen to independent doctors like Miller and Battenhausen once government gains a stranglehold on all of health care? Perhaps we get a hint of what is to come from a minor charactor in Atlas Shrugged, Dr. Hendricks, who retires in protest of socialized medicine:

“I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind… Let them discover the kind of doctors their system will now produce. Let them discover…that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it- and even less safe, if he is the sort who doesn’t.”

Mr. Siegel offers a warning, and concludes with a plea:

"If the president has his way . . . the art of medicine will be lost.

"If only the feds were bound by the same Hippocratic vow that I follow: 'First, do no harm.' "