Health Care Reform: Our Past is Your Future

This past Sunday’s passage of the “health care reform” has brought something I heard a long time ago back to mind, and it seems appropriate to repeat it in the wake of this monumental legislation.

In the wake of the collapse of the old Soviet Union, many American churches attempted to establish a viable presence there.  The Church of God was no exception.  One individual that helped make that a reality was Sergei Ryakovsky, a very sage pastor who gave the church’s leadership a Russian presence, crucial for long-term success (the church still has a legal presence there, in spite of the restrictions that have grown of late.)  One time Sergei visited my own church in the US, and in the course of his sermon he predicted that what had been in the USSR was coming our way, because, as he put it, “our past is your future.”

The “it can’t happen here” crowd might have dismissed this pessimistic outlook, but it seems now that Sergei was on target (as I suspected when he said it.)  Our current administration has as its desire the alteration of the relationship between the government and its people, and health care reform is the centrepiece of that alteration (which is why they worked so hard to get it.)   All of the Republicans bawling about repeal is rubbish; they may chip around the edges, but they won’t alter the core.

Beyond that, the reform in its current guise is an expensive kludge, unworkable in practice (especially for the less educated, who can’t navigate the maze of public assistance we have now) and too expensive by any standard.  In time the motley collection of insurance companies and health care providers will find complying with its provisions unprofitable, and so facilitate the outright nationalisation of the health care industry, much like the NHS in the UK.  (And all the Brits I’ve talked to roll their eyes at the thought of the NHS replicated on these shores.)  But then again that’s part of the long-term objective of such a programme.

The key thing that our overachieving elitist snobs have overlooked is that ordinary people, faced with free services at low income level, will not have the incentive to put the effort into their working careers that they had before, especially considering that many of the “better” jobs include health care that expires when the job does.  That process will start in the health care industry itself: faced with rising paperwork, unrelieved liability and declining reimbursements, we’ll see one or two of them trampled in the rush for the exits, a process which will only accelerate true nationalisation.  Beyond that, it’s possible to make health care a free (or subsidised) benefit at lower income, so why work so hard only to pay taxes?  This calculation applies to rising taxes of any kind, of course.

It’s certainly true that our counterparts across the Atlantic don’t have to put the effort into their careers as we do in the US to get the same level of benefits (on paper, at least.)  But then again they don’t have the outsized results to show for it.  As one friend from there pointed out to me, the UK is struggling with a similar relative debt level as the US, and the former doesn’t have anywhere near the defence budget of the latter.  That disparity is true for the entire EU, and has been the case since World War II.  Given our current level of indebtedness, it will take a vibrant economy and a hard-working people to service the debt, and in a disincentivised society, that isn’t going to happen.

And this illustrates the core problem with “welfare societies.”  Over time, none of them can really make their people work to support the lavish welfare state.  Hillare Belloc, in The Servile State, predicted a society that would do just that, and the closest we’ve seen is the high debt level world we live in in the US that makes people slaves of the financial institutions.  But even the Soviet Union, with its gulags and labour camps, couldn’t avoid the running down that comes with not giving people an incentive to work.  That was especially true in the Brezhnev years that ultimately lead up to the collapse of the country.

But that’s something that the Obama Adminstration–and the country at large–are going to find out the hard way.  And their timing isn’t the best either.  With the Baby Boomers attempting to retire and our debt mounting from all of this “stimulus” and new social welfare spending, a society that “lays out” is only a prelude to national backruputcy, which is ultimately what happened to the Soviet Union.

And with that event, everyone will have to go back to work again.

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