November 25, 2019
He Who Pays The Piper Calls The Tune In Healthcare
By Michael D. Shaw
Readers of a certain age will remember a time when the only health insurance that existed was really hospitalization insurance, and mostly dealt with catastrophic events and long hospital stays. First dollar, or even deductible coverage for routine physician office visits were unknown. To be sure, charitable healthcare programs have existed since at least the Middle Ages, exemplified by St. Elizabeth of Hungary.
In fact, charitable hospitals date back far earlier—to St. Basil and St. Fabiola. The First Council Of Nicaea (325 AD), Decree On Reformation, Chapter VIII mandated that every city having a cathedral should also have a hospital—citing the many pilgrims who develop illnesses on their journey.
The 1881 German Health Insurance Law is widely recognized as the world’s first national healthcare system, ironically instituted to stymie the rising socialist movement. Ultimately, that tactic would fail, as socialism would continue to grow in Europe.
In an article for the Foundation for Economic Education, physician Marc S. Micozzi M.D. traces the intrusion of big government into healthcare. Micozzi laments that the positive reforms that occurred during the Weimar Republic transformed the doctor’s role “from that of advocate, adviser, and partner of the patient to a partner of the state.”
The technocrats were only too willing to replace Christian charity with some fanciful “collective ethic for the benefit of the general population.” Alas, these good intentions would get disrupted with the economic downturn of 1929, whereby healthcare became primarily a question of cost-benefit analysis. It would not be much of leap from this analysis to the sordid notions of Social Darwinism and eugenics.
Following the carnage of World War I, some German observers deplored that many of the strong and qualified had been sacrificed while weak, unqualified, and inferior people had been spared. Scarce resources should concentrate on the “greater good.” A 1920 pamphlet entitled The Sanctioning of the Destruction of Life Unworthy of Living provided the intellectual underpinning for the Nazis’ horrific Aktion T4 program of involuntary euthanasia. From there, it was but a small step to the Holocaust.
Micozzi relates that regrettably, “No profession in Germany became so numerically attached to National Socialism in both its leadership and membership as was the medical profession.” Greed was involved, of course, in that more government funding would be available for research, not to mention that academic positions and medical practices formerly occupied by exiled Jews were there for the taking. Josef Mengele may have been the worst Nazi doctor, but he was not the only one.
In the case of Dr. Herta Oberhauser, she actually returned to private practice after serving her prison term for war crimes. Her medical license was permanently revoked eight years later.
You would think that the ghastly abuses made possible by a government-controlled healthcare system would have given some pause to the architects of America’s Medicare program. But you would be wrong.
In a remarkably detailed 7,000-word 1985 article written by Wilbur J. Cohen, perhaps the main architect of Medicare, he mentions nothing of how similar programs had gone so wrong. Rather, he touts Title XVIII Section 1801 of the original law, which prohibits “any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided.”
That Cohen could have referred to this long-ignored provision in 1985 reveals how much of a true believer he was. He admits in the article that he “had been a strong advocate of a comprehensive and universal nationwide health insurance plan since 1940,” during the heydays of Aktion T4. Just the kind of bureaucrat we need to run healthcare.
Which brings us to the matter of three federal judges ruling against the Department of Health and Human Services’ Conscience Protection Rule. Do you find it puzzling that liberals who whine about every snowflake’s right not be offended can change their tune when it comes to forcing docs to perform abortions, sterilizations, and other procedures?
It’s easy to explain. In the mind of a Leftist, everything not forbidden is compulsory. And Mengele had nothing but good intentions.