As many of us in Doctors for America know, one of the more fevered arguments against the Patient Protection and Affordable Care Act (PPACA), both before and after its passage, was the cri de guerre, "It's a government takeover of health care!"
This argument left me often fumbling for an answer. I know enough about international health care, and enough about our true homegrown versions of government health care (the VA, TriCare, the Indian health Service) to know that PPACA ain't it. Not even close. Trying to explain the difference among single payer systems and true government run systems and private but universal systems, did not cut the mustard (or get through the neural programming, George Lakoff would say). "Obamacare" was a government takeover, and I was just a dupe if I couldn't see it.
Apparently, the answer was in plain sight, and I just was not aware of it. While researching another topic, Google took me to an interesting, but very public place that I had overlooked before. It is on the GOP.gov web site from over a year ago, and billed as "Courtesy of the Senate Republican Policy Committee": 159 Ways the Senate Bill Is a Government Takeover of Health Care
As you scroll through the list, you might get the feeling that every single line in the bill represents a fundamental alteration in health care as we know it, changing our current "system" into some form of crypto-socialist mockery of the free market system we're all so pleased with. I guess a conservative minded person might indeed scroll through all of these initiatives and gasp in horror, but as I read through it, it seems like a very good list for us to trot out and show all of the good stuff actually in the bill!
The idea that various projects and initiatives to promote administrative simplification on insurance claims, to promote quality of care in the Medicaid program, to promote Patient Centered Medical Homes, grants to support physicians and others entering primary care and geriatrics, to develop quality measures, to figure out how to align payment incentives to promote the best patient care, and on and on, that these somehow represent a sinister plot requires epic, delusional almost, paranoia.
One of our kids' favorite books growing up was "A House is a House For Me." It was a delightful exploration of how, when looked at with the appropriate viewpoint, everything was a house: a sock for a foot, a shell for a hermit crab, or a tree for a monkey.
So, in the minds of the GOP Senate Republican Policy Committee, any law or regulation or initiative, can be a "government takeover." This is not new, of course, Ronald Reagan famously opposed Medicare as the clear path to Soviet style communism, and the John Birchers, now resurgent, thought former Supreme Allied Commander and then President of the United States Dwight Eisenhower was a Soviet agent. The difference now is that this is mainstream political rhetoric, even articles of faith, in many circles.
So, in our new book, "A Regulation is a Government Takeover To Me!" we will explore how there are really no legitimate functions of government, Constitution notwithstanding. Protecting air and water safety is a government takeover of drinking and breathing, food safety rules are takeovers of eating, and promoting homework and hard work in school is a takeover of parenting. See how that works? Although, I understand that all limitations of birth control and sex education are intrinsically appropriate uses of government.