I was visiting at a friend’s house one day when her three-year old
son asked to look at photos. My friend
told him, “We’ll look at the pictures after [CW] leaves.” He looked at me and I immediately knew what was
going through his young mind. The
solution to his problem was plainly obvious and simple, and without another
second’s hesitation here’s what he said to me: “Leave.”
I can definitely relate to that little boy, because ever since
Obama began lobbying to create the massive entitlement program known as
Obamacare on the basis that hospitals are overwhelmed treating the uninsured for
free the solution was obvious to me: stop
doing that. Problem solved. But like my friend’s child who had to learn a
lesson about the delicacies of polite behavior with company, I’ve had to learn
the hard lesson that mistakes made by those in government can virtually never be
undone (which is the reason, of course, that Obama is so desperate to march
forward with Obamacare in spite of its infamous problems). When I suggest that instead of ruining the
country with Obamacare we simply put an end to the mandate for free-loading it usually
earns me a blank stare, as if I’d suggested doing the impossible.
Let me just say that most people pay their federal income taxes
because the potential consequences
for not paying can be pretty dire. I’m
no fan of our federal tax system but there’s a lesson to be learned here, to
wit: the possibility of bad consequences is usually sufficient to make most
people want to avoid them. Thus if the
consequence of being uninsured means that you could potentially get hit with a
huge medical bill or else face penalties akin to those of not paying your taxes,
trust me when I say that a lot more people would get insurance voluntarily and
much of the purported impetus for
Obamacare would go away. But since common
sense seems to be off the table, let’s at least look at who we have to thank
for helping to sow the seeds of our destruction.
When I brought this subject up in my last post, a commenter (hat
tip to Drpete) pointed me to The Emergency Medical Treatment and Active Labor
Act (EMTALA), described this way in a 2012 article in Forbes:
“EMTALA,
one of the great unfunded mandates in American history, required any hospital
participating in Medicare—that is to say, nearly all of them—to provide emergency
care to anyone who needs it, including illegal immigrants, regardless of
ability to pay. Indeed, EMTALA can be accurately said to have established
universal health care in America—with nary a whimper from conservative
activists. In response, many health
policy types worried about a “free rider” problem, in which people would
intentionally go without health insurance, knowing that federal law required
hospitals to care for them anyway.”1
EMTALA inexplicably included no requirement for free-loaders to
reimburse hospitals at a later time. It was
passed in 1986 by a republican Senate and a democrat House and signed by… Ronald
Reagan.
According to an article from the website for The National
Center for Biotechnology2:
“Although
only 4 pages in length and barely noticed at the time, EMTALA has created a
storm of controversy over the ensuing 15 years, and it is now considered one of
the most comprehensive laws guaranteeing nondiscriminatory access to emergency
medical care and thus to the health care system. Even though its initial
language covered the care of emergency medical conditions, through
interpretations by the Health Care Financing Administration (HCFA) (now known
as the Centers for Medicare and Medicaid Services), the body that oversees
EMTALA enforcement, as well as various court decisions, the statute now
potentially applies to virtually all aspects of patient care in the hospital
setting.”
And…
“Although
the initial intent of EMTALA was to ensure nondiscriminatory access to
emergency medical care, its practical ramifications have broadened
significantly over the years and arise from 3 sources: the statute's original
language (5); the interpretive guidelines that have been issued by HCFA, which
are not merely suggestions but have the force of law; and the various federal
court decisions that have resulted from alleged EMTALA violations.”
Ezra Klein, liberal columnist with the Washington Post, summed up why
EMTALA is a Progressive’s dream: “A
universal health-care insurance program is the logical endpoint of the bill
Ronald Reagan signed into law mandating (pretty much) universal emergency
hospital care.”3
That’s government racketeering explained in a nutshell: create the problem (strain on hospitals due
to mandated free care) and use it as an excuse for wealth transfer, which is what
universal healthcare amounts to in the end.
And look how perfectly it works. The
requirements under EMTALA are ostensibly what led to “Romneycare” and inspired
the Heritage Foundation and Newt Gingrich to propose government- mandated health
insurance coverage, giving liberals and libertarians a fair basis for pointing
to “conservatives” as the ones who first proposed health insurance
mandates.
I suppose it’s fair to say that the federal government’s involvement in
decreeing that hospitals provide free care didn’t exactly begin with Reagan. My brief research on it traced the start back
to 1946 with passage of The Hospital Survey and Construction Act (or the
Hill–Burton Act), a bi-partisan sponsored law passed at the behest of Harry Truman
in 1946 with a democrat senate and house.
It was amended and extended over the years by various administrations
and congresses before culminating in the disaster that is EMTALA, which vastly
expanded the free care decree.
I don’t know what Reagan and other republicans were thinking when they
passed this law. I think it’s fair to
say…they weren’t. Now we’re all paying
the consequences.
~CW
1http://www.forbes.com/sites/theapothecary/2012/02/07the-tortuous-conservative-history-of-the-individual-mandate/
2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/
3http://voices.washingtonpost.com/ezra-klein/2011/01/repeal_emtala.html
