Sunday, 07 May 2017

Meddling in Medicine: 100 Years of Federal Healthcare Control

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Should the U.S. Senate follow their colleagues in the House in passing TrumpCare, the federal government will take yet another step toward government-managed healthcare, something it has tried (and failed) to do for over a century. 

The Republican betrayal of their promise to repeal ObamaCare was reported by The New American’s Alex Newman on May 4:

The vote in the House was extremely close, with 213 against and 217 in favor. All Democrats, along with some Republicans, voted against the legislation, dubbed the “American Health Care Act” (AHCA). Indeed, media outlets reported that Democrats in the House taunted Republicans, singing “na na, na na na na, hey hey hey, goodbye,” apparently a reference to their belief that GOP lawmakers will be defeated in the 2018 mid-term elections due to their vote. House Democrat leader Nancy Pelosi called the bill “a zombie, even more scary than before.” A coalition of Big Government Republicans also opposed it. Some liberty-minded Republicans, meanwhile, opposed it for not getting rid of ObamaCare.

The bill does cut back some of the taxes imposed under ObamaCare. But despite deceptive coverage of the bill by much of the establishment media, which went along with the ruse that the AHCA repeals ObamaCare, the legislation actually keeps huge swaths of the unconstitutional statute in place. For instance, under the GOP version of ObamaCare, most of ObamaCare's regulations, mandates, decrees, and meddling are kept firmly in place. It keeps subsidies for insurance, and penalties for not having it, but changes a few relatively minor elements. While the bill purports to “allow” states to “apply” for waivers from some mandates, the legislation simply requires that states create what critics slammed as “mini-ObamaCare” schemes at the state level to obtain the exemptions.

But TrumpCare and ObamaCare are hardly the first federal foray into the management of the country’s healthcare systems. In fact, for over a century, social justice warriors have meddled in medicine.

In the first quarter of the 20th century, Abraham Flexner began building the case for government administration of healthcare services.

In 2015, cardiologist and medical school professor Michel Accad rehearsed the story of Flexner and his “reforms.”

Abraham Flexner was an important figure in educational activism who was hired by the Carnegie Foundation to study the state of medical education in the United States.  He had previously issued a report critical of higher education in colleges and universities.

Flexner and leaders at the Carnegie Foundation were impressed with recent scientific and technological advances and wished to promote a philosophy of “scientific management” of human and social affairs, a philosophy that characterizes the progressive era.  At the behest of the AMA’s Council on Education, the Carnegie Foundation decided to fund a survey of medical education and hired Flexner for the task.

What did Flexner propose as a result of his “research?”

Again, from Accad’s survey of the story:

Except for a few academic schools which he praised, Flexner condemned the state of medical education in no uncertain terms.

The report called for the closure of all medical schools which did not demonstrate a commitment to scientific standards and did not incorporate a laboratory practice.  It also called for licensing laws to require higher educational standards. The report was consonant with the goals of the AMA, established in 1847 ostensibly to strengthen medical education and to reduce the number of physicians.  In fact, Flexner collaborated closely with members of the AMA, and the organization provided him with findings of a survey it had previously conducted and on which he relied to write his own, allegedly independent, report.

The Flexner report is frequently credited for setting into motion medical education reform, but this is erroneous.  Great improvements in education had already occurred in many academic institutions in the previous two decades, and the innovations and higher standards were spreading across the country prior to the report.

The main effect of the report was to change public and political opinion about medical education and to influence the implementation of strict licensing laws.  The change in sentiment was facilitated by the political and financial influence of organizations such as the Carnegie Corporation and the Rockefeller Foundation.

In the wake of the report, and under the lobbying efforts of the AMA, states rapidly established medical acts to regulate the issuance of medical licenses.  Henceforth, licenses would only be given to graduates of schools that met criteria set forth by the Flexner report.  Those medical schools would have to be accredited by the Liaison Committee on Medical Education, a joint venture of the AMA and its close ally, the American Association of Medical Colleges.

Here again we witness foundations spending money on moving the needle of public opinion toward approval of federal accumulation of power.

In 1950, Ludwig von Mises warned that this interventionism was antithetical to capitalism and the free market and would eventually lead to overt socialism:

Control is indivisible. Either the consumers' demand as manifested on the market decides for what purposes and how the factors of production should be employed, or the government takes care of these matters. There is nothing that could mitigate the opposition between these two contradictory principles. They preclude each other. Interventionism is not a golden mean between capitalism and socialism. It is the design of a third system of society's economic organization and must be appreciated as such.

As for how the policy proceeds on to socialism, Mises explains, “The measure proves abortive from the very point of view of the government and the groups it was eager to favor. It brings about a state of affairs, which — again from the point of view of the government — is even less desirable than the previous state of affairs which it was designed to improve.”

Individual rights then give way to “social justice” or “the good of society” and the government demands that such ends are moral imperatives and that their power must increase in order to achieve that noble goal.

Social justice, of course, does not exist, but nearly everyone believes that it does, so government need only perpetuate that popular belief and then claim to be pursuing it and government then grows unchecked, as it would be heartless to hamper its progress toward perfect social equality.

Collectivism is at the core of the federal government’s zeal to force Americans to purchase commodities (healthcare is, after all, a bundle of commodities and services). With the passage of the American Health Care Act, Republicans in the House of Representatives sided with socialism, no matter how watered-down or “step in the right direction” that bill be.

Constitutionalists recognize their representatives’ action for what it is: a betrayal of campaign promises, a breaking of their oath to “preserve, protect, and defend the Constitution,” and a rejection of the principles of individual liberty upon which this country was founded.

Not a single one of our Founding Fathers, not even the most ardent advocate of a powerful central government, would have remained a single day at the Philadelphia Convention if they believed that the government they were creating would become the instrument of despotism that it has become.

In their dissent to the 2012 Obamacare decision, four Supreme Court justices pointed to the constitutional contradiction in government-managed healthcare:

The case is easy and straightforward, however, in another respect. What is absolutely clear, affirmed by the text of the 1789 Constitution, by the Tenth Amendment ratified in 1791, and by innumerable cases of ours in the 220 years since, is that there are structural limits upon federal power — upon what it can prescribe with respect to private conduct, and upon what it can impose upon the sovereign States. Whatever may be the conceptual limits upon the Commerce Clause and upon the power to tax and spend, they cannot be such as will enable the Federal Government to regulate all private conduct and to compel the States to function as administrators of federal programs.

Americans must insist that their state legislators step up now and nullify each and every unconstitutional act of the federal government. This is their duty and they must be held accountable for performing it and protecting the people from tyranny.

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