In the months leading up to the passage of the Affordable Care Act, conservatives and Republicans railed against Democrats’ plan to increase government’s role in health care, with many arguing an expansion could eventually lead to the creation of “death panels” — government committees that determine which health care services will be covered and for whom.
Conservatives’ theory went something like this: If government is responsible for health care and thus dependent on tax revenue to provide health care services, then government has an incentive to cut services. Further, if government is in charge of health care, then it could theoretically use its power to force people to behave in a certain way if those people want to continue receiving government services.
Conservatives called these bureaucrats making health care decisions “death panels” because, they reasoned, they could eventually be used to deny certain life-saving treatments to people in the name of the “public good.”
The left roundly attacked conservatives for daring to make such a bold statement and the left, since Obamacare’s passage, has often used death panels as an example of how conservatives allegedly lied about the dangers of expanding government’s power over health care. Politifact even went so far as to call it 2009’s “lie of the year.”
Fast-forward to 2017. Obamacare is collapsing, insurance premiums and deductibles have skyrocketed compared to the pre-Obamacare era and people have fewer health insurance options in the individual market than ever before. And now a new story out of the United Kingdom seems to justify the many fears limited-government Americans have had for the past decade about the potential development of government-controlled health care decision-making panels.
A dangerous new policy
According to a report published Tuesday in The Telegraph (U.K.), “The NHS [United Kingdom’s National Health Service] will ban patients from surgery indefinitely unless they lose weight or quit smoking,” a policy change Royal College of Surgeons Senior Vice President Ian Eardley said could be just the “tip of the iceberg.”
The Telegraph reports in some parts of the country, those who refuse to give up smoking “could wait indefinitely” for access to surgical care, and “those with a Body Mass Index of 30 or more will be set targets to reduce their weight by 10 percent over nine months, with those with a BMI over 40 will be told to cut their weight by 15 percent.”
Once a patient is identified by the government as being, quite literally, too fat to be worthy of medical attention, a “clinical panel” will be summoned to determine whether an exception should be made for an overweight or still-smoking patient.
Why is this happening?
If you’re angry, you shouldn’t be — at least according to the British health officials who made the rule. Apparently, this is all for the good of the patients and society. According to the agency making the new rule, “This policy is designed to improve patient safety and outcomes, both during and immediately after non-urgent surgery. No financial savings are expected as a result of these measures. We do however hope to improve the long-term health of our residents through the targeted stop-smoking and weight-loss support on offer to patients.”
The reason the agency goes out of its way to say it won’t save any money from this new policy — which, by the way, doesn’t seem to make any sense — is because many have argued the policy is direct result of NHS being significantly underfunded and facing numerous staff shortages.
As The Telegraph notes, “While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP [general practitioner] practices close, displacing patients on to A&E [accident and emergency] departments as they seek medical advice.”
Why this matters
Whatever the reasons are behind the NHS decision, the result is the same: People considered to be too fat to matter and smokers will be treated as second-class Brits under the new rule. Why? Because they aren’t healthy enough to deserve the same resources as “more responsible” citizens. Who decides? Of course, the government, who in socialist-leaning nations like the United Kingdom is the final arbiter of what’s right and wrong and who has rights and who doesn’t.
Needless to say, this is truly horrifying, and when coupled with the tragic story of United Kingdom baby Charlie Gard, it should serve as a very clear warning to all those Americans crying for more government power in health care. When the government is in charge, systems are cold-hearted, inefficient, and designed to enhance the power of the ruling administrative state — or, as President Donald Trump likes to call it, “the Swamp.”
A better way forward
There is hope elsewhere, however. Rather than put your faith in government to manage health care — a government that can’t even manage to run the Post Office, Amtrak or DMVs without chaos ensuing — Americans should put their trust in each other.
Yes, the health care system that existed prior to Obamacare was a disaster and in desperate need of reform. It had become a crony-capitalist market full of unfair rules, regulations, and greed. But replacing the failures of the previous system with the current, much-worse model was the wrong way to go.
We need more freedom in health care, not less, and there are several ways this can be accomplished. Perhaps the most important is to move away from a model that makes everyone dependent on insurance companies for every health care service they get.
When you get an oil change, you don’t pay using your car insurance, so why would you use insurance when getting a check-up with your primary care doctor? This is a huge part of the problem, because insurance companies act as a costly middle man in almost every health care transaction, even those where they clearly aren’t needed.
Further, because consumers don’t ever think about prices when they go to the doctor, even for routine services, there are no market forces working in most of the health care system. Most of us don’t even know how much health care services cost!
This system needs to change so that patients work directly with their primary care doctors when getting routine services, negotiating prices as they would in any other situation. People would only use health insurance in extreme emergencies, which would make insurance much, much cheaper.
There are plenty of other solutions, too, but for any of them to happen, we need stop thinking about ways to make it easier for government to be involved in our lives and start thinking about how we can thrive without government.