August 13, 2009
Thursday

Maybe you've caught one of those TV commercials that tells you all the terrific stuff about some product that will get rid of sexual dysfunction or pimples or maybe depression, and then, by obligation of law, adds that there are some possible side effects, such as the loss of toes, the growing of a second nose and death.

If you're like me, you find yourself imagining some potential customer thinking to himself, well, it might be a nice thing to get rid of that pimple, but sporting a second nose? Perhaps not. And "perhaps not" is pretty much what lots of Americans are now saying as they look at an Obama health care plan promising a world of good but accompanied by side effects that just might give us a world of hurt.

The chief pitch is that everyone will get a shot at obtaining affordable insurance, through a government-run program if nothing else, but then comes a major, sink-the-ship consequence of that means of achieving a supposedly happy end.

By independent, non-partisan calculation, the cost will be an amount that neither taxes nor deficits can handle without economic mayhem unless something is first done about Medicare's $40 trillion of unfunded liabilities. President Obama says that by letting the present situation continue, you get a crash, which is true and means precisely this: Take care of the system's cost issues before you even dream of adding incredible new costs, and then cut out the dreaming. Figure out a cheap solution.

Supposing the president were under the same legal constraints as the pharmaceutical companies advertising on TV -- forced to discuss side effects -- he would have to admit something else about this government program. By competing unfairly with private programs, it will eventually become the only show in town, giving us the disastrous kind of single-payer systems found in Canada and England and cheered by the left with their rationing, the waits in line and more, much more.

Rationing, of course, is the dirty little secret of this reform. Although in euphemistic terms, the president has discussed it and has made clear he wants to find ways to edge us toward the use of fewer and fewer treatments seen as superfluous or useless. There are models of inexpensive, controlled, good care, but everything we know about the Obama approach is that it would simply increase government control over fundamental medical decisions, not lead us through market mechanisms to something like those models.

Sarah Palin has gone so far as to talk about death panels, and I was initially flabbergasted. With all the sound arguments against these initiatives, why would she parade a gross stupidity that reform supporters would leap on as a supposed example of just how baseless all criticism of reform proposals was? But the reform proposals are complex and obscure and aimed at extending governmental power in hundreds of ways, and it turns out there is material in one bill about advisory panels that could conceivably someday be given authority beyond mere advice.

To say as much is not to defend Palin's far-fetched imaginings so much as to say it's almost impossible to know all we should about the Obama plan. The administration and Congress have been in an utterly irresponsible, politically motivated hurry, the legislative compilations run to 1,000 pages and more, there are several versions of the basic ideas and it's almost impossible to figure out where all of this would take us.

Here resides much of the public angst. Millions of lives will be affected by what Congress does, and we've had the exact opposite of what was needed, a temperate, prudent, step-by-step effort to address one portion of the issue at a time. The groups confronting congressional representatives should aim more for politeness, but a bigger outrage than their shouting is the left-wing propagandists calling them "mobs."

They're not that at all. They are people interested in side effects.

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Ketchikan, Alaska

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