Will Mob Rule Fix—or Wreck—Healthcare?

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Jane M. Orient, M.D.

The Washington Post of October 18 says that the biggest issues in the midterm elections are the threat that Republicans will slash Medicare and Social Security, and maybe get around to repealing ObamaCare after all. It quotes a tweet from Sen. Tammy Baldwin (D-Wis.) that Republican statements about “adjusting” entitlements are “Washington-speak for cutting the Medicare and Social Security benefits you have worked hard to earn and making you pay for tax breaks to millionaires and billionaires.”

So, will rescinding the tax cuts and taxing the “rich” even more fix the problems?

Think about it for just a minute. Didn’t seniors already earn their benefits? If so, why the need to tax the rich to pay them?

The ugly truth is that the payroll taxes paid by today’s retirees were taxes, not contributions to a protected pension program. That money was spent immediately on yesteryear’s retirees—and any excess on reducing the deficit. The money in the “trust funds” is only a claim on future tax revenues.

There is no longer any excess. Payroll taxes from fewer than three working Americans are supposed to support one retiree, and the trust funds are being drained. Retirees’ and Medicare providers’ checks are coming from the wages of burger flippers, teachers, construction workers, or anybody else who is employed. Even if you think this is fair, it is a precarious and unsustainable situation. As the Baby Boomers retire, workforce participation by men of prime working age is shrinking, and wages have been stagnant.

The rich are not sitting in their counting houses counting out their money. The money is mostly invested in enterprises that create jobs (and payroll tax revenue) and produce the goods and services we all need. Even if a draconian increase in taxes produced an increase in revenue—and it usually doesn’t—it would likely crash the economy.

The situation for all of us, not just seniors, is deadly serious, and it requires economic realism, not name-calling, bickering, platitudes, and magical thinking. The Association of American Physicians and Surgeons is compiling questions to ask candidates of both parties, on issues such as pre-existing conditions, women’s health, the opioid crisis, the role of the federal government, Medicare for All, and bipartisan solutions.

Voters should also look at the big picture: the impact of the broad Democrat agenda on their own access to medical care:

  1. How would open borders affect already overburdened emergency rooms, or the rate of infectious diseases?
  2. How would amnesty affect employment opportunities, wages, and the resources of welfare and entitlement programs?
  3. Does the country benefit from chaos produced by blocking presidential appointments, threatening impeachment, and inciting incivility, harassment, or even violence against people with dissenting (or conservative) views?
  4. How would care of seniors and disabled people be affected by expanding the programs designed for them to younger, able-bodied people, as in “Medicare for All”?
  5. How would our people and medical facilities be affected by hampering law enforcement efforts to protect us against criminals of any type, including illegal aliens?
  6. How would draconian regulations or taxes on the fuels that power our economy (coal, natural gas, oil) affect the costs of transporting goods or generating electricity, and how would that affect our ability to afford medical care, food, shelter, and other necessities? (Consider, for example, California’s “renewable energy” mandate.)
  7. How do increases in taxation, regulation, and litigation (as for allegedly offending a member of a protected group) affect our ability to support our families, afford medical care, and receive care from physicians who can live by their conscience and communicate with us freely?
  8. Should Congress and the executive branch insist on honesty, transparency, and full and open discussion on economic and scientific issues—or heed calls to gag, marginalize, and pillory dissidents?
  9. Do calls for “equality” of outcomes (e.g. in college admissions, employment opportunities, tax policy, medical treatment, or prosecutions) override considerations of individual justice or achieving excellence?

It is not possible to save entitlements or medical care if the economic and social fabric of the country is destroyed by identity politics, class warfare, mob rule, and the shredding of constitutional protections for life, liberty, and property.

Both parties and all candidates have deep flaws, and problems have no sound-bite solutions. But at this point in history, there is a civil war over foundational principles. The agenda of a candidate’s party counts.


Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. Since 1988, she has been chairman of the Public Health Committee of the Pima County (Arizona) Medical Society. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fourth editions of Sapira’s Art and Science of Bedside Diagnosis published by Lippincott, Williams & Wilkins. She authored books for schoolchildren, Professor Klugimkopf’s Old-Fashioned English Grammar and Professor Klugimkopf’s Spelling Methodpublished by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine.More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.

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