Prohibition and “Medicare for All”
by G. Keith Smith, M.D.
Alvin Lowi, writing in 2008, made a compelling case that Prohibition was never repealed, but rather, that Al Capone and Uncle Sam merely traded places. Without a doubt, brutal consequences await anyone who attempts to skirt the taxes and tribute demanded by the D.C. mob with regard to the sale and distribution of alcohol-containing beverages. This tight control of commerce, from which “juice” is extracted, pervades the medical industry, as well, as the D.C. syndicate currently controls half the sale and distribution of medical commerce in this country. Viewed in this way, it is clear that the “Medicare for All” (Prohibition of Choice) initiative represents a shameless attempt to completely control the funds flowing through this industry, a move that would make even Mr. Capone blush.
Think this is too harsh? That Prohibition made mobsters rich differs in what way from how Obamacare made D.C.’s medical cronies rich? The sad truth is that each and every time a new law is passed and the regulators appear (almost always connected with the industry ostensibly regulated), another chunk of commerce passes through the inefficient and corrupt toll booth of the D.C. “outfit.” In addition, industry consolidation predictably materializes with each new law, so fewer and richer “captains” will remain to kiss Uncle Sam’s ring.
In the same way that many mob-related terms disguise their true meaning (made, juice, family), the titles chosen for many laws serve as decoys for their intended effect. Just as there was nothing Affordable or related to “care” in the Affordable Care Act, the deceit attached to the phrase “Medicare for All” belies the fact that if enacted, the purchase or sale of medical services outside of this system would necessarily be unlawful, or this gangland attempt to coopt the industry would get nowhere.
And while the purchase of medical services outside of this new system would be prohibited for you and me, rest assured that our “representatives” in D.C. would exempt themselves from this restriction, just as they did with Obamacare and just as they did during Prohibition. President Wilson was given a special exemption for his private wine cellar, FDR was known to keep “stocks of gin, rum, and scotch in a closet of his New York home,” and not to be outdone, Congress had its own bootlegger. Remaining true to this tradition and for our own good, the D.C. protection racket managed to remain immune from Social Security taxes until 1984 and continues to have special access to benefits apart from Medicare. Rest assured, “Medicare for All” rationing would not apply to them.
Two of Medicare’s flaws deserve special attention, both highlighting the syndicate-like mentality that pervaded Prohibition days. First, in 1992, Uncle Sam’s “outfit” achieved complete control of those doing business with them, when during a Republican administration, the price-dictating Resource Based Relative Value Scale (RBRVS) was inflicted on the industry. It is important to understand that true prices emerge from competitive activity, fluctuating around a market-clearing price. Prices are, after all, signals that connote the presence of surpluses or shortages and serve the purpose of minimizing resource misallocation. Top-down prices, like RBRVS prices are always wrong. They are either too high or too low with predictable results. If doctors or hospitals are paid a very lucrative amount for one service and a paltry amount for another, surpluses and shortages of care will predictably materialize. This “soft rationing” is a powerful budget-balancing tool for government programs like Medicare, which has recently forecast its own bankruptcy by 2026.
Second, the payroll taxes of those currently working are the primary source of revenue benefiting those receiving Medicare’s benefits, most of whom are no longer working. Charles Ponzi, just like Bernie Madoff, utilized this ploy to lure individuals into their designs, benefitting early investors with funds from newer investors. These schemes, once discovered, disintegrate without the muscle of the government outfit to force future “contributions.”
Finally, for those who believe that the D.C. gang has had our best interests in mind, remember that in an effort to enforce Prohibition, the government deliberately poisoned spirits they knew were destined for consumption, resulting in the deaths of thousands of individuals and the blinding of many more. “The welfare of the masses is always the alibi of tyrants,” Albert Camus’ famous quote, should embolden our skepticism for those who would inflict “Medicare for All” on the rest of us, a scheme that will undoubtedly prove more deadly and tragic than Prohibition at its peak.
Author / Contributor bio:
Dr. G. Keith Smith is a board certified anesthesiologist in private practice since 1990. In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Oklahoma, owned by over 90 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice.
In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention. Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available. His most recent effort is the launch of the Free Market Medical Association which provides a platform where those seeking to obtain high quality and affordable health care can find free market-minded providers, both physicians and facilities.
Operation of this free market medical practice, the standard for all who have embraced this practice approach, has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith’s pricing model resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs and improve quality of care for all.
He has made appearances on the John Stossel Show, CNBC, Huffington Post, The O’Reilly Factor, Capital Account, The Ron Paul Channel, NBC Nightly News and has been featured by Reason Magazine’s TV division. The New York Times, Time Magazine, ABC news, Forbes and many others have written articles featuring Dr. Smith’s revolutionary approach to the pricing of health care and uncompromising free market principles