Posted by
Robert Ditmar on Wednesday, October 28, 2009 3:48:33 PM
Once upon a time, there was a small and prosperous village. The inhabitants of this village were very happy, because they had created a limited town government, whose powers to tax, regulate and legislate were granted by the very inhabitants they had been elected to serve. Every 4 years, the villagers nominated candidates from among themselves to run for mayor of the village. The mayor, as the elected leader of the town, was entrusted with executive powers to manage the village. In turn, the mayor’s powers were balanced by the village council of representatives, who had been elected from among the people. The council was given the power to make the city ordinances and laws by which all villagers were required to live. The council, in turn, was checked by the circuit judges, who were responsible for making sure the laws made and passed by the council and signed into an ordinance by the mayor were enforceable laws. Because the village government was answerable to the citizens, everyone in the village had a say in forming the rules by which they lived.
Over time, the village grew economically and the population continued to grow in size and wealth. Because they continued to elect the mayor, council and judges from among themselves, the elected officials shared the same concerns, problems and issues facing the villagers. As many of these officials owned businesses themselves, they were reluctant to create financial burdens on the population in the form of taxes or by over regulating free trade. These officials understood that their capacity as government officials were not mandates for creating large, unmanageable government bureaucracy. The mayor, council and judges also understood that their tenure was limited in nature. They understood that holding office was not a career nor was it a birth right; rather it was a privilege and honorable period of service to their constituents. Because these officials understood their governmental jurisdictions were only as powerful as delegated by the inhabitants of the village, with a clear understanding that they served only at the pleasure of the voters, the officials worked hard to maintain a fair balance between the common needs of the village and the rights of its inhabitants.
The villagers understood the necessity of taxes for the common good, so long as taxable items were clearly defined and all citizens could have a say in what those items would be. The input from the public could either be in a public referendum or in the village council through their elected representatives. No one argued against the need for a sound infrastructure, meaning access to a good transportation network, schools and emergency services. They understood that continued prosperity and growth required a healthy environment for business, which in turn, created more jobs. Creating jobs required those who had the desire, ambition and drive to succeed in taking entrepreneurial risks to start, locate or expand their businesses in the village, as these places of business were also where the jobs were at. To achieve this objective, it was necessary to create an environment that was friendly to free enterprise and commerce. By agreeing to pay a small portion of their incomes to the public service tax, while offering tax incentives to all businesses in the village, the citizens understood this investment paid off by bringing more opportunities to their town. In turn, the businesses that located or were already in the village understood the efforts made by their hosts, and reciprocated in good faith by creating new jobs and hiring all those who were willing and able to work.
As the businesses continued to thrive, they would voluntarily invest back into their communities through charities, donations to public works, and volunteering time and money to causes. The companies viewed the village as their home and the inhabitants as their family, neighbors and friends. They considered themselves good corporate citizens of the village and continued to actively participate in all activities and projects to make their village a desirable place to live, work, play and raise a family.
Over time, as the village grew, several doctors moved to the village. They established their respective practices in separate locations, specializing in general medical treatments. At first, there was no real difference in the types of treatments offered, and so the villagers did not really care which doctor they went to. As there were no differences, doctors did not worry about improving their methods, because each realized their practices would attract roughly the same number of patients from among the villagers. This made it possible for the doctors to “agree” on a price structure for their treatments with profit margins that were artificially high. Since each doctor practiced the same medicine and were making huge profits, no doctor wanted to undercut the others and ruin a good thing. The villagers did not complain, as they had nothing to compare one doctor against another and therefore believed this was simply how the system worked. And so the villagers continued to see whatever doctor was most convenient and paid the fees without asking. And the doctors began to grow wealthy.
One day, a new doctor moved into the village and set up her practice. When she was invited by the established doctors to join their price-fixing program, the new doctor refused. She had just finished her residency at a medical research facility in a larger city and believed she could provide alternative treatments for her patients at a lower cost. The other doctors scoffed at her boldness, believing she would fail if not part of their group. After all, she was just a new, independent doctor fresh of her residency, without benefit of a long, established practice. The other doctors went back to their old ways.
In a short span of time, the new doctor was attracting most of the villagers to her practice. Word of mouth got around the town that the new doctor was offering newer and better treatments that worked in a way the villagers had not realized existed. The best part, however, was that she charged less than the other doctors, and she soon started taking patients away from their practices. This worried the established doctors greatly, as the loss of their customers endangered their livelihood.
The doctors realized the only way to survive was to start attracting new patients. This meant that the doctors, who had earlier collaborated to fix their prices, had to start competing against each other as well as the new doctor to attract the villagers back into their offices. They now had to offer better health care at a lower cost to their customers in order to attract new patients. So the other doctors abandoned their former arrangement and began trying to outdo each other to gain patients at the others’ expense.
Over time, the doctors realized it was necessary to keep up with the latest medical trends, technologies and procedures in order to offer the best care to their patients. There was a high cost, both in time and money, for the doctors to keep abreast of these advancements. However, the training and investments allowed the competing doctors to differentiate from their competition by offering more specialized and advanced treatments in various fields. For the first time, the villagers now had a variety of doctors and treatments from which to choose. The open competition had created a means for patients to shop for the best doctors and treatments at the lowest competitive costs. These factors determined which doctor the patient would see. The doctors had to work very hard to compete for these patients in order to cover their cost of advanced medicine, yet many were pleasantly surprised when they realized their operating costs could be offset by expanding their customer base. In turn, this allowed many doctors to still keep their prices to the patient down while offering even more advanced, and better treatments.
As time went by, some doctors who refused to keep up with the latest trends lost their patients to those who invested in research and development, and their practices failed. Those that remained had carved specialty areas in which they practiced, which gave the village a health care system higher than any other town in the land.
Eventually, the doctors started to work with the village businesses to create plans that would help employees with medical insurance options. This meant that all villagers who were employed were now able to pay even less for their better level of medical care. The companies shopped the doctors and their insurers for the best rates and options, in which the employers paid a large percentage of each employee’s medical premiums. The benefit was to all parties, because the employee now only had to pay a very small percentage of their fees while the employer covered the remaining costs to the insurers. The benefit to the employers and the village was a work force of healthy individuals. It was also a fair system, because it rewarded those villagers for their hard work by offering them a benefit while still maintaining a top-tier health care system. Since ninety percent of those in the village were employed, most villagers were extremely happy with their benefits and their doctors.
In the meantime, the village government had grown in size and started to lose its course. Even though the village government was still run by elected citizens, various offices had somehow become corrupted by career politicians. Certain council members now seemed to get reelected for infinite terms. In order to first get elected, and then to continually win reelection, several of the council members had to offer special favors to their own constituents. As each member of the council represented a subset of the overall village population, several of the “favors” promised were usually to special interest groups within their own constituency, at the expense of the all the village citizens. Often, these career council members would find ways to funnel tax dollars, originally set up for the limited public services as permitted by the citizens, into personal favors or projects to those of his “own” constituency. This meant that citizens in one constituency were paying for unauthorized projects in another council member’s constituency, indirectly “buying” votes for the career council member.
This is not to say that there were still several government officials who served for the public good. There were still several council members who tried to do the right thing and not cave to special interest groups. However, their viewpoints were often overshadowed by those government members who had become corrupt from the perks of their seat.
Several bills were offered to the council by the decent members to be passed into an ordinance to protect the public, only to be dismissed by the vocal career politicians. It was during this time that a good member of the council proposed an ordinance to create a fund to insure those citizens who could not work for reasons that were beyond their fault. However, this councilman made clear that the program would have restrictions. It would not cover those who simply did not want to work due to laziness. It would not provide coverage to any villager who was in the village illegally or participating in an illegal act. And it could not be funded unless both the citizens, businesses and doctors of the village participated in the fund’s creation. Finally, such an ordinance would not be passed until put to a general referendum in a special election. The good councilman was almost shocked when the other council members passed his bill on his restrictive terms. And when the plan was presented to the citizens of the village, they elected to provide some benefit for their fellow citizens who found themselves in a slump.
The village government, which by now had grown exponentially, had created committees to regulate commerce within the village. These committees answered to special designates appointed by the mayor and answerable to no one else. They were responsible for setting the rules by which commerce must operate and had the power to put anyone out of business if deemed as not complying with the designate and his committee.
The new mayor, freshly elected to office on a wave of hoping for an even better future with some minor adjustments, had campaigned as a proponent of strong commerce and keeping the village government free of corruption. However, when he was sworn into village hall, he quickly began a radical shift in the village government’s direction, from a limited, representative pro-free market government to a bureaucratic, non-transparent, anti-business and anti-doctor big government. With the aid of his career politician allies in the council, Spokeperson of the Council Nana Pessimist and Council Pro-tem Henry Greed, the majority in the village government set about to completely overhaul all areas of the village economy and the lives of its citizens. From this point on, they made clear that all decisions, private and public, would be made by government bureaucrats and carry the weight of the law.
The new mayor’s top priority was to destroy the current village health care and insurance system. Instead, a village government-run single-payer health plan would replace the old private plans. Led by Pessimist and Greed in the council, the government started to tell the villagers that they were in a massive health-care crisis, and that over fifty percent of the villagers were without health care. The mayor said the village doctors were out of control, because they were vastly overcharging the villagers while performing unnecessary advanced treatments. These doctors, according to the village mayor, were only lining their own pockets with money that they did not deserve. What’s more, the mayor insisted the businesses that had created a voluntary insurance benefit for their employees were also lining their pockets by not covering even more of the cost for their employees. The mayor and his council allies stated that the fifty percent of the uninsured in the village had a right to health care benefits, regardless of whether they were unemployed by choice or beyond their abilities. Finally, the mayor told the people the village that a government health plan must also cover those who are in the village illegally or involved in illegal activities.
The mayor and his allies were convinced they had sold their plan to the citizens. However, the citizens rose against this plan. The mayor had cited several inconsistent and false statistics. The village did not have fifty percent uninsured, they had about ten percent. The villagers also questioned the mayor about his unproven attacks on doctors and employers, and they demanded that he prove which treatments were unnecessary, and by whom. They gathered in front of the village hall in huge numbers to get answers from the mayor and council about how the village government intended to fund this plan. Almost all of the villagers made clear that they did not want to lose their doctor or the plan they were in, and told the mayor and council to please back off. Finally, they made clear to the mayor that there was already a village collective fund to provide medical care for those who were in an unfortunate economic situation. The villagers made clear they had no issue to help the poor or disadvantaged, but were not interested in funding slackers or illegal residents.
The protests fell on deaf ears in the mayor’s office. Spokesperson of the Council, Pessimist, accused the villagers who gathered in front of the village hall as an unruly mob that were criminally immoral. However, she threw the citizens a bone by offering to create a village-run program with a “public option.” She explained that this public option meant that the current plan could stay in place, but if you left your employer, you would automatically be placed on the village government plan, which constituted the public option. Pessimist changed the term to “competitive option” as a means of selling the citizens on how the program will still offer competition. The only difference is now the village government would be the competitor in the game and will create an option for all those who do not have employer insurance to be covered on the government program. In other words, the employer-insurers would compete against the village government itself.
Unconvinced, the citizens explained to the bewildered Spokesperson that it is not “competition” when one of the so-called “competing” entities is also the regulating entity. They tried to reason with the mayor and the radical career council members that it would be impossible for the employers insurance to compete with the village insurance, because the village is also able to simply regulate the competitors out of existence. They expressed their concerns that this would force doctors out of practice, because the doctors would no longer invest time and resources into an education to become doctors and then have to carry the costs of advanced medical treatments. The Pessimist-Greed plan is for the village government to regulate compensation for doctors, which will destroy competition. No doctors will work harder than the next if all are being structured at the same rate. Finally, if all the doctors are all doing the same treatments, what is the point of so many doctors?
Again, the Spokesperson and Council Pro-tem responded with a look of bewilderment. They then informed the villagers that it was the mayor and council who knew what is best for them, and that they would ram this ordinance through even if all of the citizens were against the plan. She then insulted the group once more, likening them to a peasant mob. Then she turned abruptly into the village hall and proceeded with the ramming vote.
One year later, the village had sixty percent of its citizens unemployed. After months of paying a new business and property tax, levied on them by Pessimist and Greed, most of the businesses could no longer afford to do business in the village and had either closed their doors or simply relocated to a more business-friendly town. The jobs they had created disappeared with the employers who left or shut down. The village government had forced them to pay a double-tax to fund the government health plan they enacted. This meant they had to pay for the program they voluntarily set up years before and had to pay the same amount to the village to support the public plan. They were also required to pay a two-thirds tax on the total of their profit margins to fund other government programs. It was simply too much, and so the end result was lost businesses and high unemployment.
As for the medical situation, there are still two government doctors practicing medicine in the village. Each one is paid a fixed salary from the village, and all procedures are covered by the publicly funded village government health plan. Because every citizen is now in this village plan, the village government oversight committee and its medical designate have the right to decide who will get what treatment, if any. The advanced medical treatments are no longer optional, as the committee is unwilling and unable to pay for it. Because of the extremely depressed economy, brought about by the vast number of businesses fleeing the village, there is simply not enough tax dollars to cover everyone’s medical care. So the village government allows anyone to apply for care, but if you are over a certain age, you are instructed by a government life panel to let your ailments deteriorate and hasten your end, so as not to be a burden on the population.
Once upon a time, there was a happy, prosperous small village that grew into a wealthy town. That village is now a desolate shell of what it once was.
The End.