Saturday, March 20, 2010


The talking heads on television have announced that tomorrow will be an historic day. The stage is set for a show down vote in the United States Congress on the celebrated health care bill.

Not wanting to be left out, I decided to skim a few of the 2,074 pages of the Senate version.

As I ploughed through the incomprehensible obfuscation which passes for federal legislation, I could not help but think of Alexis de Tocqueville, the 19th century French philosopher who visited and wrote insightfully about America.

Tocqueville had many good things to say about our country, but he also expressed some chilling fears about the kind of tyranny that lurks in the bowels of a democracy.

The Frenchman warned of an elected tutelary master.

I love that word, ‘tutelary.’ It means protective oversight. Like a guardianship. Or a guardian angel.

Tocqueville feared that Americans might one day surrender their freedom to an elected government which would dictate every detail of their lives, supposedly for their own good.

He envisioned a race of people living aimless, compliant lives in which every choice has been made for them, every decision preempted, every need and want provided for, every opportunity foreclosed.

In short, the Nanny State.

Nothing could be more nanny-esque than the convoluted concoction known as Obamacare.

And what struck me mightily as I read it was the absolute disregard for even the appearance of constitutionality. It used to be the practice for Congress to preface every piece of economic and social legislation with a recitation linking their purpose to the regulation of interstate commerce.

That was at least a nod to the plan of the Founding Fathers that the federal government was to be one of limited and expressed authority. If the constitution didn’t say they could do it, they couldn’t do it. That was the great scheme concocted in Philadelphia in 1787.

But this time they didn’t bother. The bill dives right into telling insurance companies, states, hospitals, doctors and patients what they can and cannot do.

Nanny says. That’s all the authority they assert.

And I have to chuckle over the last minute reports from the Congressional Budget Office which purport to justify the bill’s economic outlay.

I wasn’t fifty pages into the health care bill, and I saw a number of blank check appropriations giving the Secretary of Health and Human Services the power to spend whatever was needed for this purpose or that.

How the CBO can tally up the economic impact of blank checks is a puzzlement.

Another thing. The bureaucracy being created boggles the mind. Exchanges, Navigators, Co Ops. The list goes on and on.

One particular provision caught my eye. The bill calls for ‘Contract Administrators.’ These will be private business entities hired by the government to oversee the activities of the bureaucrats.


A virtual cornucopia of patronage will spill its goodies into the laps of the political party in power.

And why not?

It works in Chicago, doesn’t it?


  1. Unfortunately, health care (or the lack thereof) effects us all. We all pay for emergency room visits that should be handled with a Dr. visit in our premiums. The system is obviously broken, and there's still a long way to go, but the foundation has at least been set. Don't forget, there were about 180 Republican amendments included in this legislation. Here's a list of some of the things this legislation is going to help with:

    1. Once reform is fully implemented, over 95% of Americans will have health insurance coverage, including 32 million who are currently uninsured.2

    2. Health insurance companies will no longer be allowed to deny people coverage because of preexisting conditions—or to drop coverage when people become sick.3

    3. Just like members of Congress, individuals and small businesses who can't afford to purchase insurance on their own will be able to pool together and choose from a variety of competing plans with lower premiums.4

    4. Reform will cut the federal budget deficit by $138 billion over the next ten years, and a whopping $1.2 trillion in the following ten years.5

    5. Health care will be more affordable for families and small businesses thanks to new tax credits, subsidies, and other assistance—paid for largely by taxing insurance companies, drug companies, and the very wealthiest Americans.6

    6. Seniors on Medicare will pay less for their prescription drugs because the legislation closes the "donut hole" gap in existing coverage.7

    7. By reducing health care costs for employers, reform will create or save more than 2.5 million jobs over the next decade.8

    8. Medicaid will be expanded to offer health insurance coverage to an additional 16 million low-income people.9

    9. Instead of losing coverage after they leave home or graduate from college, young adults will be able to remain on their families' insurance plans until age 26.10

    10. Community health centers would receive an additional $11 billion, doubling the number of patients who can be treated regardless of their insurance or ability to pay.11

    To share this list with your friends using Facebook or Twitter, visit:


    1. Final vote results on motion to concur in Senate amendments to the Patient Protection and Affordable Care Act, Clerk of the U.S. House of Representatives, March 21, 2010

    2, 3, 4, 5, 6, 7, 11. "Affordable Health Care for America: Summary," House Energy and Commerce Committee, March 18, 2010

    4. "Insurance Companies Prosper, Families Suffer: Our Broken Health Insurance System," U.S. Department of Health and Human Services, Accessed March 22, 2010

    5. "Affordable Health Care for America: Health Insurance Reform at a Glance: Revenue Provisions," House Energy and Commerce Committee, March 18, 2010

    8. "New Jobs Through Better Health Care," Center for American Progress, January 8, 2010

    9, 10. "Proposed Changes in the Final Health Care Bill," The New York Times, March 22, 2010

    11. "Affordable Health Care for America: Health Insurance Reform at a Glance: Addressing Health and Health Care Disparities," House Energy and Commerce Committee, March 20, 2010

    Jon M. Fox, Jr.

  2. Reform will fail without a sick leave mandate. Additionally, the mandates are not costly enough to keep people from buying insurance only when sick and dropping it when they get well - a circumstance that will only be aggrevated should mandates be overturned. Either way, insurers will be at the TARP window as soon as the market figures out that failure is inevitable - and TARP will create a single-payer system, probably without additional legislation - although some legislation will be necessary to enact a payment mandate.

    I am surprised that the opponents did not lay their case out in those terms. They simply left how reform led to government control to the imagination of the listener. They should have laid it out just as I have done - although this may have led to stronger mandates rather than the current (doomed) law.

    This makes me think that this is all kabuki theater - with the current crop of insurance executives milking the system and retiring in a few years, golden parachute and all - and the GOP remaining silent so as not to kill the golden goose. I smell a rat.