Will Obamacare resuscitate freedom?

Audrey Pietrucha

It already does

Providing health care to a population doesn’t have to be complicated, but we have made it so. We added third parties in the form of either private of government-provided insurance payment. We added exchanges and multi-level plan choices. We added tax credits and subsidies, navigators and multiple government and quasi-governmental agencies to the picture. What could have been a simple line drawing has turned into a Where’s Waldo book.  

Perhaps I should use the pronoun “they” rather than “we” because we, the people, did not really have much say in this. The Affordable Care Act was forced on us at the federal level just as Green Mountain Care is being forced on Vermonters. We, the people, have been taken out of this equation entirely. Those of us who were happy with our health care plans, the vast majority of Americans, are losing them. The State has decided it is better able to determine our needs and has taken away our choices. Our governments, which were originally instituted to protect our liberties, now take them from us.

The chaos that has resulted from the roll-out of the ACA, or Obamacare, as it is popularly known, would be comical if it weren’t so frightening. Billions of dollars – 600,000,000 and counting – have been spent on the exchange website alone and the result has been disastrous. No need to go into the stories here – they are many, widespread and well-known. And this is just the beginning, the individual plans. When employer-based plans join the mix next year the confusion and chaos will likely grow exponentially. Suffice it to say a private company would never allow such a shoddy product on the market. If they did you can bet Congress would be hauling their executives in for investigative hearings faster than you could say “Big insurance.”

We haven’t even gotten to the substance of how this legislation will work (or not). Once we do, more nasty surprises assuredly await. Patient records and payment forms will create a labyrinth of unmanageable paperwork. Privacy will become a thing of the past as government bureaucrats from multiple agencies, not excepting the IRS, will have access to our personal health and financial information. As for choosing or keeping our healthcare professionals – that remains to be seen but, based on what has happened so far, is by no means guaranteed.

There was a time when medical care was regarded as the consumer good it is. A doctor, a midwife or a well-trained nurse provided care and in return was given reasonable payment, something mutually agreed on by provider and recipient. Sometimes that payment was in the form of eggs or firewood but usually it was in the form of cash, an affordable one-time payment or an amount that could be paid over time. The system worked well until outside parties began intervening a hundred years ago, beginning with the regulation of medical schools (hint: the main beneficiaries of these regulations were not patients but doctors seeking to stifle competition). The proliferation of health insurance benefits during World War II as an end-run around government-imposed wage controls greatly expanded the third-party payment system. Today third-parties pay the vast majority of our doctor bills and having someone else pay for one’s medical services has somehow evolved into a right.

The practice of medicine has undergone incredible changes over the past century and modern practices must be accommodated. That being acknowledged, there is every reason to believe that, with a few updates, a market-based system could work again. One of the first might be re-introducing actual risk-based insurance. What we have now is actually a payment service. A free-market system would eliminate insurance for all but catastrophic care. Patients would pay for routine visits and would have access to price information. Providers would compete for patients by offering either lower fees or superior service. Insurance would be detached from employment and all plans would be individual or family plans. Under such a system new ideas such as subscription services might become popular or former arrangements such as mutual aid groups formed by churches, community organizations, etc. might be revisited. Civil society’s ability to creatively solve problems knows no bounds.

Except when it is inhibited by the bureaucratic power structure that has become our government. The health care schemes we are faced with actually move away from individual freedom of choice and toward government’s unimaginative and immoral fallback position, the use of force.  Neither President Obama nor Governor Shumlin gravitated toward free-market solutions; rather they are engaged in behavior more befitting dictators than public servants. Mandates should not be part of the conversation but they are, in fact, the bulk of it. Free people should not be compelled to purchase something they do not want and will not use, yet that is exactly what it happening. If nothing else, Obamacare and its evil twin, Green Mountain care, have lay to rest any notion that Americans in general and Vermonters in particular are free.

Yet the ACA may prove useful. It has provided the best American illustration to date of the folly of central planning. A successful system of exchange requires the input of the millions of people of which it is composed. A few people at the top, no matter how educated or experienced they are, can never anticipate every need and every action that spontaneously work together to create an effective arrangement. Maybe this debacle is the wake-up call we need. The horrific implementation of this latest one-size-fits-all government scheme might be a blessing in disguise if Americans once again discover freedom, with all its warts, still provides the fairest and most satisfying framework to society.

Audrey Pietrucha is on the executive board of Vermonters for Liberty. She can be reached at vermontliberty@gmail.com.

Surviving the Shutdown

by Audrey Pietrucha

If you had told a 19^th century American that the federal government had been forced into a partial shutdown, he or she would have probably stared at you blankly for a moment, then shrugged and said “So what?”

Today, of course, the reaction is a bit different. Washington D.C. and its dealings, or lack thereof, are the favorite topic of conversation among the chattering class. Those of us who are constantly exposed to their diatribes through the spoken, printed and digitized word can’t help but believe that if Washington is not working, America itself is on the verge of collapse. Though all around us we see evidence that life, indeed, does go on without the blessing of the federal government, we can’t help but be uneasy. Disaster is right around the corner, right?

Not necessarily. Though modern Americans have been trained to look to Washington first whenever there is a problem, in truth there are many ways to meet challenges, most of which do not involve government at all. In civil society we have families, neighbors, friends, church communities, civic organizations and charitable groups among which to help and be helped. With such a cornucopia of options, it’s a shame that government even comes to mind when solutions are sought.

Some would argue government is the most efficient way to centralize and solve problems. I would vehemently disagree with that (the health insurance exchange debacle comes to mind) but even if we cede that point, is efficiency always the most desirable outcome? Perhaps when the focus is primarily material, but if the long-term well-being of individuals and society are considered it seems the personal and societal growth that comes through organic, creative community-based actions benefits everyone now and later.

Too many of today’s centralized, top-down solutions involve taking money from one group and giving it to another, with a big chunk skimmed off the top for bureaucrats and politicians. There is no personal interaction, no sense of gratitude, appreciation or obligation and everyone is left dissatisfied. What’s worse, the problems are never truly solved – more money is always needed. Eventually the money runs out and we have places like Detroit, a city that is currently bankrupt.

Detroit’s bankruptcy has resulted in few city services. Despite this lack, people continue to live and work in Detroit. Since they know they can’t rely on government to solve problems, many residents are taking matters into their own hands. People such as Tom Nardone, who hated to see the parks and playgrounds in his neighborhood fall into disrepair when the city stopped maintaining them.  He was pleasantly surprised when dozens of volunteers answered his invitation to take this task on. Now “The Mower Gang” regularly “kicks grass” around Detroit’s abandoned parks with semi-monthly mowing parties and other improvement projects. Sure, it helps the kids but it is arguably the adults who really benefit as they build friendships and leave a legacy of community service. The Mower Gang is a timely example of achieving cooperation without coercion.

This used to be the American way. Alexis de Tocqueville remarked upon it in Democracy in America, his 1831 treatise on life in our then-young republic. Americans of all ages, conditions and dispositions formed numerous and diverse association, Tocqueville observed, accomplishing everything from building inns and churches to circulating books, founding hospitals and hosting entertainments.

“I met with several kinds of associations in America of which I confess I had no previous notion,” Tocqueville wrote. “And I have often admired the extreme skill with which the inhabitants of the United States succeed in proposing a common object for the exertions of a great many men and in inducing them to voluntarily pursue it.”

We have been robbed of our cultural heritage by a large, centralized government which insists on trying to do everything and then holds us hostage when the political process fails. The wheels of this most recent failure were set in motion several years ago when an unpopular law with the Orwellian name of the Affordable Care Act was muscled through without bipartisan support. Legislation that initiates sweeping social change requires unity and Obamacare has never achieved that. It doesn’t help that many are being exempted from the law such as certain corporations, some unions and even government workers. The divide between the ruling elite and the rest of us continues to widen and such events as the current government shutdown are merely symptoms of how far we have strayed from our foundational moorings.

This is one crisis, though, which truly shouldn’t go to waste. The Chinese symbol for crisis is composed of two characters, one representing opportunity and the other meaning danger. The opportunity before Americans is to take back our place as proponents of a robust civil society in which families, churches, neighborhoods and community organizations once again provide the bulk of assistance and service. The danger is that the more we take care of ourselves and each other the more we’ll discover we don’t need Washington nearly as much as they want us to believe.

Audrey Pietrucha is a member of the executive board of Vermonters for Liberty. She can be reached at vermontliberty@gmail.com.

 

Audrey Pietrucha

Guns and spoons

 

If I go to the freezer every night and scoop up a large bowl of chocolate marshmallow ice cream, after a while I will start to gain weight. Whose fault is that – mine or the spoon’s?

Clearly the fault is my own since a spoon is an inanimate object with no will of its own. It is merely a tool used by humans in their quest to feed themselves. If I took all the spoons out my drawer but really wanted some ice cream I could contrive to use something else with which to scoop it. A fork might not be as efficient but could still get the job done. To paraphrase a trite but true phrase, spoons don’t fatten people, people fatten people.

Yet after last month’s tragic shooting in Newtown, Connecticut most of the national discussion has centered on tools. Realistically, we cannot remove all the tools that are used to murder people. A look at the history of mass murder (defined as four or more people killed) shows people who want to kill others will find the way to do so.

Grant Duwe, author of Mass Murder in the United States: A History, says mass murders are neither unique to America nor the modern era. Two terms that mean to go on a killing spree, amok and berserk, have been around for centuries, he said. Throughout this time mass murders have been accomplished with a variety of weapons: guns, of course, but also swords, axes, knives, arson and explosives.

The first school shooting in America occurred in the summer of 1764 when four Lenape American Indians shot a teacher and 10 students dead in Greencastle, Pennsylvania. More than a century passed until another school shooting occurred. Since then, the United States has experienced two waves of mass shootings. The first occurred in the 1920s and 30s with 1929 having the highest recorded mass murder rate in history. This wave was characterized by family killings and felony-related massacres (think Al Capone, gangsters and prohibition).

The 40s and 50s were a tranquil period with regards to mass public shootings in America. Ironically, this was also a period when rifle clubs and guns themselves were in almost every high school. It was common for students to hunt in the morning and leave their guns hanging in cars and trucks parked in school lots all day long. Competitive shooters brought rifles into school and left them in their lockers or with a homeroom teacher. My research did not uncover one mass shooting at the hands of a rifle club member.

The second wave of mass shootings stretched from the mid-sixties to the early 1990s and began with the infamous University of Texas incident in which a student climbed a 27-story tower and shot and killed 14 people and wounded 31. It wasn’t until the 1990s, though, that mass public shootings really started to tick upward. There were more than 40 mass public shootings in that that decade but the years 2000 to 2009 saw a drop as the number fell below 30. This past year, however, we witnessed seven mass public shootings. Suddenly it is starting to seem like these awful events are far too common.

Yet what gun laws have changed over those years that have made weapons more accessible? If anything, gun laws have become stricter over the past few decades yet those with murder on their minds and in their hearts find access to weapons, either by legal or illegal means.

This brings us to the one constant in these horrific crimes – people. Mentally unstable and disturbed individuals have always existed and their illness sometimes (though actually very seldom) reveals itself in murderous behavior. The tools they use vary from crime to crime and all the laws in the world seem unable to prevent someone who really wants to kill from doing so. Think about it – is someone intent on  breaking God’s or nature’s law against taking life really going to be concerned about breaking man-made laws about which tools he cannot use?

It is especially frustrating to watch lawmakers in Vermont, many of whom don’t seem to know a magazine from a clip or an automatic from a semi-automatic weapon, jump on the anti-gun bandwagon. Vermont does not have a gun problem and many would say this is precisely because our gun laws are so liberal; there is respect for firearms here. According to FBI statistics Vermont has one of the lowest rates of criminal firearms usage in the nation and our murder rate involving guns is an extremely low 0.75, making us 44^th out of 50 states. Robberies and assaults involving guns also rank very low here. So why do lawmakers and city councils feel it necessary to fix what obviously isn’t broken?

Worse, emotionally-driven laws punish responsible citizens and gun owners but do little to inhibit those who disregard laws. They also make it more difficult for law-abiding citizens to protect themselves. Incidents of lives being saved by gun are many but receive little attention from the media or the politicians. Just like spoons, guns can be used for good or evil.

As with any situation involving human beings, circumstances surrounding shooting incidents are complex. We can never predict and prevent the many factors that lead to someone taking murderous actions. We might feel better as a society when we put a bandage on the collective emotional wound these incidents open but we rarely put in place measures that actually prevent more. People have been finding ways to kill each other for centuries. Unfortunately, laws won’t change that.

 

Audrey Pietrucha is a member of the executive board of Vermonters for Liberty. She can be reached at vermontliberty@gmail.com.