Friday, September 4, 2009

Socialism Not in America's DNA

"Look at Obama's behavior as president, beginning with his first address to Congress. Unbidden, unforced and unpushed by the congressional leadership, Obama gave his most deeply felt vision of America, delivering the boldest social democratic manifesto ever issued by a U.S. president. In American politics, you can't get more left than that speech and still be on the playing field."

Charles Krauthammer, “Obama as Mortal,” Washington Post, September 4

President Obama’s biggest problem with health reform is his misunderstanding of American culture.

Socialism isn’t in our DNA. We’re a bottom-up society. We believe in rugged individualism springing from the grassroots, not in bailouts devolving from the eclectic top of the heap.

From our founding 233 years ago, we have distrusted big government as a form of “soft tyranny, ” and as something from which to flee. We believe government that governs best governs least. We believe in equal opportunity, not equal results. We believe in innovation and entrepreneurship, We’re optimistic and see a bright future just over the horizon. Flawed though our health system may be, it fosters an innovative market-driven approach, as opposed to government coverage for all.

These characteristics explain why Americans.

• Prefer a multipayer to a single-payer system.

• Reject federally mandated universal coverage.

• Want to make their own health care decisions.

• Seek immediate access to new medical technologies.

• Trust doctors more than government bureaucrats.

Our culture explains why America continues to be a magnet for immigrants. Our climate of freedom and opportunities are why we attract 80% of the world’s immigrants. It’s why 20% of our 307 million citizens are recent immigrants or close relatives of these immigrants. The chance for freedom and the bottom-up opportunities to become rich is why people originally came to America. That’s why they still come. It’s why the Obama policy of “soaking the rich” will not sell well.

It’s why we lead the world in medical innovation. in Nobel Prize winners in medicine, and in the development of new drugs. It’s why the Bill Gates and Steve Jobs come from American. It’s why, as the Kauffman Entrepreneurial Resource Center in Kansas City puts it. that E=R (Entrepreneurship equals Recovery). It’s why from 1980 to 2005 in America, entrepreneurs accounted for all the net growth rate in jobs. It why 70% of registered voters think of capitalism rather than socialism as the best road to a healthy economy – and a healthy health system.

So raise your half-full glasses high. Shout bottoms up to a bottom-up society, and thumbs down to top-down government.

I’m telling you this now because you’re not likely to hear it in President Obama’s health-care turnaround speech on Wednesdayt, September 8, before a joint session of Congress.


Terence Coughlin said...

What part of any of the current healthcare reform policies under consideration mention or invoke socialism? I have not yet read anything that suggests that doctors and other healthcare providers will be employed by the government.

I agree 100% that the vast majority of Americans would not choose to switch over to socialism in general, but I am not sure what that has to do with health care reform in its current state, other than as a scare tactic without serious merit.

Perhaps I missed the point completely, in which case forgive me.

Richard L. Reece, MD said...

Dear Terence, for starters ,spending $1.6 trillion for health reform; a public option undercutting private plans; paying hospitals and doctors 80% of what it costs to do business; a comparative research institute paying only for "what works" in the eyes of government; cutting Medicare pay for cardiologists and radiologists by 50%; spending $20 billion to put EMRs in every doctors' office or to be paid less; individual mandates to buy insurances and business mandates to force them to provide coverage.
These, I submit, are not "scare tactics witho0ut serious merit."

Medicare, followed quickly by private plans, now sets most physician fees. That is a form of goverment employment. I am sorry you missed the point. I appreciate your interest and understand your point of view.

Terence Coughlin said...

Dr. Reece,

Every single one of the concerns you listed is a serious and troublesome issue, no one can debate that. Working within the health insurance industry myself (albeit on the not-for-profit side), I have plenty of concerns about a government backed insurance option vs. the private sector - Will the federal plan be required to maintain reserves, or will the government simply call on treasury funds to make up any shortfalls, and if so, where will the money come from? What will be the mandated benefits? Will the payment schedule simply further drive up cost shifting to the private sector? Will providers be mandated (directly or indirectly through other reimbursement penalties) to participate? What are the plans to address lack of access to primary care? The list goes on and on.

Not a day goes by where I don't find myself banging my head against the keyboard wishing someone would at least make the distinction between for-profit and not-for-profit health insurers instead of lumping the entire industry in with the big bad evil empire label. But that's admittedly driven by my own sense of self-preservation. I love what I do, am proud of my work, and would like to continue doing it for a good long time.

Your follow up post to this one makes this post more clear, it truly is what "is is". To me, socialism equates to gov't run payments and delivery - but to each their own.

Thanks for the perspective - clearly this is an issue with many many dimensions, making the chances of a neat and clean solution extremely unlikely.

Richard L. Reece, MD said...

Gee, what a civilized discussion. We must be doing something wrong.