The U.S. Supreme Court has command of the headlines right now as hearings about the Patient Protection and Affordable Care Act—commonly called ObamaCare—continue. What most Americans don’t know is that the ideas related to healthcare in the PPACA come from a socialist model developed by an iconic figure in global medicine, Milton I. Roemer.
‘Socialist’ is not used here strictly as a political term, it is used in the manner that the de facto father of government healthcare applied it.
Roemer was born in 1916 in New Jersey. The son of a doctor, Roemer also became a doctor after earning a Master’s Degree in sociology. Roemer influenced U.S. medicine in such a profound way that it’s absolutely shocking he doesn’t have his own biographical entry at populist sites like Wikipedia.
ROEMER’S ADMIRATION FOR FORMER SOVIET UNION AS MODEL
Roemer’s ideas about the delivery of healthcare services were directly in opposition to the U.S. concept of free markets. An article published on the National Institutes of Health website, originally run in the American Journal of Public Health, explains Roemer’s political perspective:
“Roemer viewed the Soviet Union as embodying a vision of the future, with a health system more oriented to preventive than curative medicine built on principles of equity. At Roemer’s memorial service in 2001, his son John stunned the audience by saying that his father had believed in the Soviet Union to the end.”
Roemer’s philosophy was also a direct influence on the development of healthcare systems in countries like Canada, the United Kingdom, Cuba and numerous other countries around the globe. There’s even an axiom in hospital circles named for him, ‘Roemer’s Law,’ defined as: the number of available beds creates the demand for their use.
ROEMER’S IMPACT ON US HEALTHCARE
Both Medicare and Medicaid, seeds for the concept of universal coverage sought but not obtained by President Barack Obama in his signature bill, were established under another Democrat, President Lyndon B. Johnson, in 1965.
These government programs are directly related to Roemer’s ideas, and his concepts have for decades been incorporated into influential medical textbooks like Phoebe Lindsey Barton’s Understanding the U.S. Health Services System published in the 1990s when President Bill Clinton (D) chipped away at U.S. healthcare.
As government began to control delivery of services, treatment protcol and payment for major sectors like the poor and the elderly, premiums began to steadily rise for those who held private health insurance policies. Ironically, Barton disclosed in her textbook that in 1996, “Approximately 20 percent of the population accounts for 80 percent of all health expenditures…”
By 2009, as PPACA zigzagged through Congress, politicians on the Left often cited the uninsured in America. Two researchers at Baruch College (N.Y.) undertook a study of the uninsured, discovering information most media didn't publicize.
The uninsured were mostly unmarried males younger than 35. The uninsured were about 4 times as likely to be high school dropouts and about 4 times as likely to be foreign-born non-citizens. Most worked for only part of the year, or had not worked at all in the previous year.
Politicians estimated the range of the uninsured as somewhere between 32 million and 45 million—a range of around 10 percent of the total U.S. population.
Rather than specifically address that sector, however, Democrats chose to accomplish what three or more of their party’s previous presidents had sought but failed to secure—government control of the healthcare market.
RATIONING: THE ‘DARK SIDE’ OF GOVERNMENT-RUN HEALTHCARE
Democrats had allies in media and entertainment, evidenced by a film produced by Michael Moore who praised Cuba’s socialist healthcare system.
However, in 2010, disclosures by WikiLeaks revealed horrors from the system Moore praised—ill treatment of cancer patients and limited access to families who wanted to visit their sick children.
McClatchy reported, based on WikiLeaks’ Cuba documents,“[T]he staff” used a primitive manual vacuum to aspirate'' the womb of a Cuban woman who had a miscarriage "without any anesthesia or pain medicine. She was offered no . . . follow up appointments.''
Those problems are but a few media reported.
As for the United Kingdom, The Telegraph (London) recently reported on the National Health Service financial shortfalls:
“Even the most sentimental champions of the NHS recognise its dark side. Given that its Chief Executive Sir David Nicholson has demanded a £20 billion efficiency saving if the NHS is to survive, and that demographic changes mean millions more elderly people will rely on its services (and space), the NHS can only do one thing: ration.”
In the United States, a primary issue for those who do not support the PPACA, aside from numerous non-medical provisions inserted into the more than 2,000 page bill, is the individual mandate imposing a penalty on anyone who does not purchase insurance.
Proponents claim cost-shifting occurs and the mandate is necessary to prevent it. However, even if all provisions of PPACA are implemented, cost-shifting will occur unless the government takes control of personal decisions such as sexual intercourse without using a method to protect from communicable diseases, abuse of legal or illegal drugs and other substances, and even lifestyle choices that could lead to injury, like rock climbing or surfing.
Politicians also did not address the issue of illegal aliens who will still receive medical care. Employers who hire illegal workers can't be required to provide insurance coverage.
Cost shifting will still occur regardless of the insurance model.
POLITICOS MADE MONEY FROM PPACA
Democrats created controversy because they passed the bill by budget reconciliation when they had absolute control of the U.S. House, the U.S. Senate and the White House. There was a sense of urgency, frequently voiced by the president.
Adding fire to political flames, many Democrats took advantage of the bill’s progress for personal financial gain. Peter Schweizer, in his best-selling book Throw Them All Out, details how Sen. Max Baucus (Mont.) usually didn’t “do a lot of stock trading,” but changed his habits as he negotiated “with pharmaceutical companies…during the legislative process.” Baucus, said Schweizer, was “at the center of forging the healthcare bill.” The senator purchased stock in Gilead Sciences, Abbott Labs and Fluor Corporation in 2009.
“All three,” said Schweizer, “were perceived winners in the healthcare debate.” Baucus made money because “all three [companies] were perceived winners.” All three companies had also lobbied for the bill.
Baucus wasn’t alone. Sen. John Kerry (Mass.) and other Democrats also made money, as did at least one Republican in the House who didn’t want the bill but knew there was money to be made. Reminding yourself that what these politicians did was perfectly legal won’t comfort the taxpayer who didn’t support the bill.
Schweizer also pointed out that companies in the medical tourism sector saw an increase in stock value, expecting Americans with means to travel abroad for medical care once the bill passed.
PPACA—PERSONAL AND FINANCIAL COSTS
In early March, Fox News and many other media outlets reported what bloggers had predicted early on, that the bill would cost more than proponents claimed when it passed. Fox said cost estimates projected over the next decade showed PPACA would “cost twice as much as the original $900 billion price tag.”
Because Democrats focused on healthcare at times when they held control of the U.S. government, no one knows how private sector solutions might be used to address the healthcare challenge that will face the U.S. regardless of the model of care.
Even before the bill was fully implemented, the Obama administration granted waivers to more than 1,500 groups and companies, most of them unions who lobbied for the bill’s passage.
At this point no one can predict the outcome of the SCOTUS review. As one justice noted, the bill would “fundamentally change the relationship between the individual and the state.”
There’s a personal price tag for that relationship change, one that few conservatives or libertarians are willing to pay.
Barton, Phoebe Lindsey. Understanding the U.S. Health Services System. Chicago, Illinois: AUPHA Press, 1998.
Schweizer, Peter. Throw Them All Out. New York: Houghton Mifflin Harcourt, 2011.
[Follow Kay B. Day on Twitter @TheUSReport.]