Thursday, September 23, 2010

Guam: A good laboratory rat cage for the rest of the nation

My friends in the states would do well to keep an eye on Guam in these changing times. Guam is a microcosm of the U.S., a tiny incubator you might say, or perhaps a laboratory rat cage, where U.S. policies, primarily intended for a stateside population of 300 million, are inserted by force of law into a community .0005 times the size.

Whereas in the states, it may take awhile for the implementation of a massive federal policy such as the new healthcare law, otherwise known as "Obamacare", to be felt at the local level, the impact of such a policy on a community our size is nothing less than an immediate shock.

As expected, insurance rates are going up. You can't expect insurance companies to absorb all the new mandates of Obamacare (children up to 26, pre-existing conditions, etc.) and not raise their rates. Rates go up each year anyway, but the increases aren't much different than the cost of other services we pay for such as power and water, etc. But this year they are going up as much as 92%, and co-pays for government workers are going up as much as 300%.

Since salaries and wages are not increasing at a pace anywhere near that rate, and with more and more people are losing income, not gaining, people are incentivized to drop their insurance and go to self-pay. But what that really means is that more people will be showing up at the emergency room of our only public hospital, which translates into greater costs to the government of Guam, not to mention that real emergencies may have to wait in a much longer line.

This isn't a surprise to anyone who has been paying attention which is why at the height of the debate last March, most Americans opposed the health care bill and it's why Obama had to buy some Democrat hold outs in order to squeak it through. This is also when the Tea Party phenomenon exploded onto the scene. The Tea Party is nothing more than the silent majority that was shocked awake by both the reality of what was in the health care bill and the incredible intrigue needed to pass it.

But all of this is by design. Some say Obama doesn't know what he's doing. Obama knows exactly what he's doing. Type the words "single payer" and "Obama" into your search engine and there are endless references to Obama swearing that he is completely committed to a single payer health system and that he realizes that it make 10 or more years to get there.

First, let's define "single payer". It simply means that there are no other players besides the federal government. Bureaucrats will decide what gets treated, who gets treated, and what they get treated with. Insurance companies do that now, but in a free market, one can go elsewhere, however difficult that may be. But in a single payer system, there is no "elsewhere" to go, which is why wealthier people from nations that have this system often come to the U.S. for treatment.

Second, why does Obama say this will take 10 years or more, especially if it's such a great idea? He knows that the average U.S. citizen is not quite yet ready for a complete government take over of matters of health, life, and death. Citizens have to be eased into it. They have to want the government to take over that part of their lives or there will be revolution. It's called soft-despotism and it has been creeping into the American psyche and practice for the better part of a century.

This is why Rahm Emanuel famously said: "Never let a good crisis go to waste". He knew that the American people are more amenable to government intrusion when they feel insecure. The financial crisis created the moment. One would think that the first actions of the administration would have been to address the crisis, but instead Obama headed straight for health care, justifying this strange direction with the claim that no financial recovery was possible with out an overhaul of health care. It was a weak tie in. And America knew it, which is why the legislation was greeted with such upheaval and hostility.

The steps toward a single payer are quite simple:
1. Force insurance companies to provide coverage they can't afford.
2. Insurance companies are forced to raise their rates to cover the new mandates.
3. Force people to either have insurance or pay a fine to the government.
4. Make the fine less than the insurance rates.
5. People drop their insurance and pay the fine.
6. Insurance companies lose their customer base and stop providing health coverage.
7. The government then becomes the "last man standing".
8. All power over health, life, and death now is in the hands of the federal government.

It's a simple design, which is why so many people can see it. But beyond that we have the issue of the health care providers themselves. Under a single payer system, doctors have only one employer, the federal government, and they already know how that's going to turn out given 40 years of dealing with the government under Medicare and Medicaid. Some will still want to practice medicine, but you can be sure that many of the best and the brightest will look elsewhere and we will have an increasing shortage of doctors, especially the very good ones.

On Guam, the crisis will be immediately felt on October 1 which is when the current health care contract with the Government of Guam expires and the new one with the higher rates kick in. It is expected that many will just drop the coverage and opt for self-pay or just not go to the doctor. Since most will avail themselves of the public hospital for services, the cost to the Government of Guam will skyrocket.

As mentioned, this is no surprise, but I'm wondering, where are all the senators and the congresswoman, who were all singing the praises of Obamacare a few month ago? I have an email record of several conversations with Congresswoman Bordallo over the legislation in general and the abortion funding in particular. However, as a good party person, Bordallo swore that this was good for Guam. Anybody with a brain knew that it wasn't.

So now what do we have? As expected, the politicians are scrambling to blame the insurance companies. But by the sound of the public response, more and more people aren't buying it. Too late Guam. No one is even challenging Bordallo in the upcoming election. So she'll have another four years to bring us more such gifts.

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