Last week, I had mentioned that President John Adams authorized a state-run hospital for retired American naval officers. The stark coincidence of a Massachusetts’ born President enacting the first medical insurance mandate was too good to pass up, since Massachusetts would later pass the first state-wide insurance mandate. In 2010, President Obama, with strong Democratic majorities in the House and the Senate, passed a nationwide insurance mandate, both for individuals and employers, allowing with fines for those who failed to comply, based on the Massachusetts model.
In light of President Obama’s recent decision to delay the employer mandate in his Patient Protection and Affordable Care Act (Obamacare), a more expansive look at the consequences of state-run health care is in order.
Let’s first look at the history behind “An Act for the relief of sick and disabled seamen” or “AdamsCare”:
In 1798, the Congress drew up legislation which would permit the government to draw twenty cents per month from every naval officer’s pay. The monies would provide for their health care in existing hospitals, and surplus funds would build new hospitals. The Marine-Hospital Service created centers for naval personnel to rest, recover, and recuperate throughout the Eastern Seaboard of the United States.
Congress centralized control of the program, then raised taxes on naval officers. Reports of financial mismanagement and poor quality health-care plagued these institutions in the 1860s. The Office of Surgeon General was created to supervise the healthcare and well-being of our veterans. Today, veterans wait months, if not years, to receive their benefits. The poor oversight of Veterans Administrations throughout the country attests to the failure of state intervention in the care of our wounded. Their modern-day successor, Walter Reed Medical Center, closed down following revelations of poor care and broken men and women made worse under government-funded health care. To this day, the Brentwood VA in Los Angeles, California, remains farmed out to private interests, while the land itself, dotted with dilapidated buildings, remains empty and useless while tens of thousands of homeless veterans struggle or die on the streets. To this day, the Congressman who is supposed to oversea the Brentwood VA, Henry Waxman (D-Los Angeles/South Bay) has done nothing aside from writing letters and appropriating funds to “fix the problem”.
Then there’s Romneycare .
In 2006, Governor Willard “Mitt” Romney required that 95% of Massachusetts residents purchase health insurance or pay a fine. This legislation was enacted in response to growing concern for indigent health care recipients entering emergency rooms and not paying. The Federal Emergency Medical Treatment and Active Labor Act (EMTALA) complicated this situation, by requiring that all emergency rooms provide care, whether the patient could afford it or not.
As any state-sponsored mandate would claim, RomneyCare would expand access and control costs. The law did neither. As sure as any other law of human nature, the moment that anyone provides something for free, people will sign up for it. Government subsidies would allow the uninsured and unable to pay to get something for nothing. The program has faced massive cost overruns since then. A larger number of residents pay nothing , and healthcare costs have increased. Following a year and a half of debate, Massachusetts Governor Deval Patrick had no choice but to enact price controls. Now health care practitioners will have to register with another public agency and report costs, too. More paperwork, more wasted money, and diminished access altogether has made bad health care worse in Massachusetts.
And now ObamaCare .
President Obama’s signature legislation, officially (though not truthfully) referred to as “The Patient Protection and Affordable Care Act”, received nation-wide vetting from the President in 2009 and 2010. Voters hated the law then, and they hate it now. Today, Obamacare is facing numerous complications, as would any 2,500 page law, plus the tens of thousands of pages of regulations which have emerged in furtherance to the legislation since then.
Just as Obamacare relied on the Massachusetts model for design and implementation, so too the law has generated the same challenges, mishaps, cost –overruns, and financial malfeasance. The liberal Los Angeles Times has already reported the law’s numerous setbacks. Insurance carriers are leaving entire states, or at least leaving off insurance recipients. The President has rescinded key provisions of the law, including the 1099 mandate for small businesses, the requirement to provide contraception as part of employer health insurance. Now the White House has decided to delay the employer mandate by one year, and only twenty-six states have opted into the Medicare exchanges, which are still not ready, and likely never will be.
Democrats as well as Republicans have decried the law as a big mess. US Senator Max Baucus called the law “a train wreck.” US Senators Ed Markey and Elizabeth Warren claimed that they would repeal the law’s medical device tax. If liberals have complaints, there is no telling what other terrible surprises will unfold. Even Democratic activist Donna Brazile acknowledged that her health care premiums are going up.
From AdamsCare to RomneyCare to ObamaCare, there is no worse kind of health care than the state-run kind.