G. Keith Smith, M.D.

I’m writing this from Washington D.C., just having experienced the TSA experience many have come to know and love.  The Association of American Physicians and Surgeons invited me to participate in a congressional briefing with Rep. Paul Broun, GA and I feel compelled to make a report. 

Very few in power here have shunned the influence peddling that seems to go along with the job.  Those who are principled seem a bit sad, much of their vigor gone with Justice Robert’s ruling..  Lost with Robert’s ruling was a real opportunity to roll back the commerce clause’s grip on states and on the federal overreach.  The likelihood that a court challenge will occur again in our lifetime presenting this opportunity is remote, according to one legislator speaking to me.  The beast of big government has the upper hand, like never before. 

The beast is bankrupt, however.  One libertarian congressional staffer told me openly that Medicare is going to vaporize whether this is politically palatable or not.  The money coming in doesn’t remotely cover the anticipated expenses by as early as 2017.  The implosion of this Ponzi scheme will be accelerated by the court’s decision to uphold the Unaffordable Care Act (UCA,) bringing fiscal insolvency to this program likely prior to 2017.  Any legislator in office when that happens is probably finished.  I found it interesting that there was more discussion about how to unwind or dissolve Medicare  and Medicaid than how to reform this ill-conceived entitlement program. 

The legislative “kick the can” approach, always leaving tough decisions and issues for the future legislators continues and will bring collapse and chaos to the medical arena and many others.  So many corporatists have bet their future on loot from Uncle Sam to fund their various market-unworthy scams.  These folks will soon be bankrupt and deservedly so.  Hopefully, more bailouts will be politically impossible and these companies will be reorganized and sold off, cleansing the marketplace of this mall-investment. 

What will happen after the government medical juggernaut hits bottom?  We will have to fiercely oppose any “top down” solution that does anything other than remove all federal interference.  I’ve come to some conclusions.  Health care is not a federal issue.  It is not a state issue.  It is not a government issue at all, at any level. Making health care a government problem makes one’s health, another’s liability and begs for control, rationing and euthanasia, ultimately.   

Health care is a service that physicians provide to patients utilizing whatever necessary resources are at their disposal to achieve the best outcome.  That ‘s it, isn’t it?  Anything that interferes with this process is the “issue.”  Robbing one individual for the health benefit of another is an “issue.”  Government created scams like PPO repricing and uncompensated care, two of the primary culprits of the high cost of medical care, are “issues.” 

Government has been the massive “issue,” interfering with the delivery of health care for several decades now and bringing us from a time when no one needed insurance to a time when even with insurance, bankruptcy is a reality for the sick.  Federal “solutions” to health care have focused on insurance coverage, rather than an examination of the true costs, an approach designed to distract attention from those profiting from the finance of health care while having nothing to do with its delivery. 

There are some glimmers of hope, though.   There is general acknowledgement that the high price of care is Washington’s fault.  There is a realization that the politicians must choose their path:  take the money or lose their power.   The collapse of government health care will be a rough political ride for those who are in office when it happens.  If for no other reason than preserving their own political fortunes, we might yet see a roll back, one that will occur in tiny, almost imperceptible bites, though. 

There are some good people in D.C.  Not very many though.   “The reason people think politics is dirty, is because it is dirty,” as Lew Rockwell has said.  I think this is why I always feel like I need a hot shower when I get back.

G.  Keith Smith, M.D.

The idea that a branch of the leviathan federal government (that is in charge of reviewing the power of the very same leviathan government) would issue a ruling that would limit the power of the very same leviathan government is naive.  This corrupt “brother in law” arrangement, as Gary North has called it, precludes any objectivity by SCOTUS.  As Tom Woods has said, it should come as no surprise that a government that is in charge of determining its own powers has expanded its powers.  Today’s ruling was a surprise only in that Roberts sided with the left. 

The court’s decision has insured that the bill will continue to do what it was intended to do all along:  bestow power, money and favors upon those who brought their check books to Washington as this debate unfolded nearly 4 years ago.  Small insurance companies, unable to comply with the Medical Loss Ratio provision will go out of business.  That was the point.  This is the reason that the large insurers supported this bill.  Less competition for the big boys who will now be in complete control.  Small hospitals (particularly rural hospitals) will more likely succumb to hostile takeover bids by the big city corporate hospitals.  That was the point.  That is the reason the American Hospital Association supported this bill.  Physicians will sign on as hospital employees unable to afford the computerized medical record expense or just feeling disgust toward the end of their careers.  That was the point.  Physicians who will as employees do as they are told are much easier to control than the private practitioners focused on the needs of their patients. 

The pharmaceutical industry, whose profits were protected by this bill, will continue to make incredible amounts of money.  That was the point.  Newt Gingrich, lobbyist, and his HIT (health information technology) clients have already walked with billions.  They will continue to do well.  That was the point. 

The whole focus was getting everyone insurance.  The bill doesn’t do that!  It does, however, penalize people for not buying insurance.  Seriously, who benefits from that?

 There never was a discussion about costs.  The reason for this is that if costs are rational, the cronies listed above will not achieve the same profit margins.  Costs will be discussed, whether the elite want them to be or not now, as the court’s decision will cause the cost of health care premiums to increase very shortly.  This will force an examination of the costs of care, the result of which will alarm those who have not paid attention to this aspect of the issue.  More and more facilities and physicians will post their prices to the embarassment of the large hospitals and insurance companies that supported this legislation. 

The curtain on this sham will finally come back as more and more physicians opt out of Medicare and Medicaid, leaving folks with “coverage” but no care.  Make no mistake: the losers of this court’s decision are the poor and the elderly. No one will see them.  This will be the deadly proof that this bill was never about health care at all, but about business as usual in Washington.  The court’s decision will truly reveal that the purpose of this bill like almost all others was to make already rich people much richer.

G. Keith Smith, M.D.