Democrats tell us they’ve been trying to nationalize health care for 65 years, but the first anyone heard of the “opt out” provision was about a week ago. They keep changing the language so people can’t figure out what’s going on.

The most important fact about the “opt out” scheme allegedly allowing states to decline government health insurance is that a state can’t “opt out” of paying for it. All 50 states will pay for it. A state legislature can only opt out of allowing its own citizens to receive the benefits of a federal program they’re paying for.

It’s like a movie theater offering a “money back guarantee” and then explaining, you don’t get your money back, but you don’t have to stay and watch the movie if you don’t like it. That’s not what most people are thinking when they hear the words “opt out.” The term more likely to come to mind is “scam.”

While congressional Democrats act indignant that Republicans would intransigently oppose a national health care plan that now magnanimously allows states to “opt out,” other liberals are being cockily honest about the “opt out” scheme.

On The Huffington Post, the first sentence of the article on the opt-out plan is: “The public option lives.”

Andrew Sullivan gloats on his blog, “Imagine Republicans in state legislatures having to argue and posture against an affordable health insurance plan for the folks, as O’Reilly calls them, while evil liberals provide it elsewhere.”

But the only reason government health insurance will be more “affordable” than private health insurance is that taxpayers will be footing the bill. That’s something that can’t be opted out of under the “opt out” plan.

Which brings us right back to the question of whether the government or the free market provides better services at better prices. There are roughly 1 million examples of the free market doing a better job and the government doing a worse job. In fact, there is only one essential service the government does better: Keeping Dennis Kucinich off the streets.

So, naturally, liberals aren’t sure. In Democratic circles, the jury’s still out on free market economics. It’s not settled science like global warming or Darwinian evolution. But in the meantime, they’d like to spend trillions of dollars to remake our entire health care system on a European socialist model.

Sometimes the evidence for the superiority of the free market is hidden in liberals’ own obtuse reporting.

In the past few years, The New York Times has indignantly reported that doctors’ appointments for Botox can be obtained much faster than appointments to check on possibly cancerous moles. The paper’s entire editorial staff was enraged by this preferential treatment for Botox patients, with the exception of a strangely silent Maureen Dowd.

As the Times reported: “In some dermatologists’ offices, freer-spending cosmetic patients are given appointments more quickly than medical patients for whom health insurance pays fixed reimbursement fees.”

As the kids say: Duh.

This is the problem with all third-party payor systems — which is already the main problem with health care in America and will become inescapable under universal health care.

Not only do the free-market segments of medicine produce faster appointments and shorter waiting lines, but they also produce more innovation and price drops. Blindly pursuing profits, other companies are working overtime to produce cheaper, better alternatives to Botox. The war on wrinkles is proceeding faster than the war on cancer, declared by President Nixon in 1971.

In 1960, 50 percent of all health care spending was paid out of pocket directly by the consumer. By 1999, only 15 percent of health care spending was paid for by the consumer. The government’s share had gone from 24 percent to 46 percent. At the same time, IRS regulations made it a nightmare to obtain private health insurance.

The reason you can’t buy health insurance as easily and cheaply as you can buy car insurance — or a million other products and services available on the free market — is that during World War II, FDR imposed wage and price controls. Employers couldn’t bid for employees with higher wages, so they bid for them by adding health insurance to the overall compensation package.

Although employees were paying for their own health insurance in lower wages and salaries, their health insurance premiums never passed through their bank accounts, so it seemed like employer-provided health insurance was free.

Employers were writing off their employee insurance plans as a business expense, but when the IRS caught on to what employers were doing, they tried to tax employer-provided health insurance as wages. But, by then, workers liked their “free” health insurance, voters rebelled, and the IRS backed down.

So now, employer-provided health insurance is subsidized not only by the employees themselves through lower wages and salaries, but also by all taxpayers who have to make up the difference for this massive tax deduction.

How many people are stuck in jobs they hate and aren’t good at, rather than going out and doing something useful, because they need the health insurance from their employers? I’m not just talking about MSNBC anchors — I mean throughout the entire economy.

Almost everything wrong with our health care system comes from government interference with the free market. If the health care system is broken, then fix it. Don’t try to invent a new one premised on all the bad ideas that are causing problems in the first place.

Teresita died on my birthday almost five years ago. I didn’t grow up with my older cousin — she stayed behind in Havana after the revolution and my father, her uncle, was wise enough to leave.

But when I met Teresita and her son and daughter during a monthlong reporting trip to Cuba in 2002 it was an instant connection. The grainy black-and-white photos of a beautiful teenage Teresita at my baptism, with her long black locks and beaming smile, came to life in the color of five decades of regrets.

What if she had left when my parents started making arrangements to bring her to Miami, instead of falling in love, at 18, and deciding to marry and stay? Why did she wait too long to leave during the Mariel boatlift? Why didn’t we keep in touch all those decades?

MAKING UP FOR LOST TIME

After our bittersweet encounter we tried to make up for lost time. I would send her antacids every month, and money when I could. She complained about digestive pains a lot, and after I visited her home in the historic and crumbling section of Havana and saw the filthy cistern where trucks delivered the water I had a queasy feeling about the possibilities.

Except I never realized that Teresita’s yellowish-brown color might not be from biking to her accountant’s job every day in the hot tropical sun. She had a liver disease, undiagnosed for years. When she became severely ill, I was alerted and told to send all kinds of special prescriptions. I was hunting for the medicine when the call came.

Maria Teresa Marcos had died, as so many Cubans do, because the communist island’s much-lauded healthcare system is an evil hoax.

For years she had been complaining to doctors about her digestive problems. For years they told her to try to get antacids from family or friends abroad. No scans were done. No blood tests were taken — until her liver was so dysfunctional it became her death sentence.

A transplant? For Fidel, sure. Maybe for a hard-core member of the Communist Party. But for my cousin, a typical Cuban who lived in a ramshackle building, where the top floor had crumbled and the water likely had amoebas, nada. At least she was able to bring new bed sheets to the hospital — the ones I had bought her and my cousins.

Teresita became another statistic, collateral damage in a revolution that promised elections and prosperity and delivered dictatorship and desperation.

`SICKO’ MISSES MARK

That’s the real Cuba that lefty propagandist Michael Moore doesn’t want to see. The “documentary” filmmaker of Sicko gloated about the lack of healthcare insurance for millions of Americans by taking American rescue workers with respiratory problems from the 9/11 terrorist attacks to get “free” treatment in Cuba at one of its swank hospitals that serve tourists.

The film, which was shown at Doral Middle School last week to a social studies class looking into the healthcare systems of Canada, France and Cuba, is hardly an educational tool. But perhaps the teacher had that in mind.

The school system went by the book. Students had to have signed forms from parents if they did not want to see Sicko, and two decided not to watch. What irks me is that they are still required to know what’s in the movie. How can they without watching it?

The discussion the class should have is what Sicko didn’t show. In Teresita’s memory, please do.

by Gary Varvel

View all recent cartoons

Of the countless reasons for our health care crisis, one, a lack of personal responsibility, has been getting short shrift. It certainly failed to get a single mention in President Obama’s health care speech last week.

Likely it is because the whole concept of personal responsibility and its cousin self-reliance get short shrift. Once as American as pumpkin pie, personal responsibility has slowly been whittled away to the nub of an idea. When New England farmers — the original and definitive self-reliantists — began accepting farm aid and relying on government handouts, you knew it was over.

The problem was “briefly” addressed in the Republican response to Obama’s speech. Louisiana Congressman Charles Boustany angered those few newspaper columnists left when he said: “I operated on too many people who could have avoided surgery if they’d simply made healthier choices earlier in life.”

Sadly, what Boustany did not say was something to the effect that my health is my responsibility, not my government’s. He also failed to mention that 75 percent of the $2.1 trillion dollars spent in this country last year on health care costs were for chronic diseases such as heart disease that are largely preventable and even reversible by changing diet and lifestyle. No, that was mentioned by Dr. Dean Ornish, founder and president of the Preventive Medicine Research Institute.

By the time the morning edition landed on the lawn, apologists had fired back at Boustany with a litany of pretexts for being fat and lazy as long as my arm. Mary Schmich — who certainly looks healthy judging from her mugshot — had more excuses than a pregnant nun: “A lot of people don’t have a wide set of… healthy lifestyle choices,” wrote Schmich in the Chicago Tribune. Schmich interviewed an “expert” who observed that “not everyone can afford to buy organic, join the gym, live in a walkable neighborhood.”

Schmich and her expert are being disingenuous. She is erecting a whiny, politically correct straw man in the hopes of drawing attention away from the issue. Rep. Boustany was certainly not referring to those with genetic predispositions, or the poorest of the poor who live in drug and crime-infested areas where supermarkets and organic farmer’s markets are few and far between, and cannot afford gym memberships. (By the way, I know of a gym everyone can afford. It’s called the outdoors. I use it every evening.) Nor was he talking about the few folks who live in the bayous and Appalachian hollers and in Death Valley trailers.

No, he was talking about average Americans who weigh way above average.

…

SCHMICH ALLEGES that we are too busy to eat well, and — allow me to paraphrase here — that you can’t expect us to turn off Gossip Girland go for a brisk walk ’round the block; that you can’t expect us to stop smoking or stop at two drinks; that you can’t expect us to bring a healthy lunch to work when you could order in a pizza with extra toppings. Besides somebody has to bring in Krispy Kreme donuts every morning or how are we going to get motivated to sit our big butts down in front of the computer? Rep. Boustany is not being fair. He’s for punishing the poor. And the lazy. And the obese. In other words, punishing the victims.

Of course, who is really being punished are those Americans who maintain a healthy lifestyle and then have to pay the medical bills of those who won’t.

In a piece in the August 12 Wall Street Journal, Whole Foods CEO Jim Mackey offered a modest proposal that upset more than a few liberals: “Rather than increase government spending and control, we need to address the root causes of poor health,” he wrote. “This begins with the realization that every American adult is responsible for his or her own health.”

Mackey’s op-ed resulted in a call for a nationwide boycott from its liberal base of shoppers. The Boycott Whole Foods’ Facebook page now has nearly 34,000 members, all of whom seem offended by Mackey’s suggestion that government-run health care is not a human right.

I have always chafed at the government telling motorcyclists or bicyclists that we have to wear helmets for our own safety. Such laws, however, have always been embraced by liberals who note that the taxpayer might have to pay for your hospitalization, surgery, and rehab should you suffer a head injury. This liberal logic, however, doesn’t seem to apply to other types of reckless behavior, like shoveling two Big Macs down your gullet every day for lunch. Suddenly it is not an issue of taxpayers being made to pay for others’ reckless and stupid behavior. It’s an issue of punishing society’s victims.

I realize it is not easy to be healthy in this country. It takes a genuine effort. With the exception of produce sections, supermarkets stock mostly unhealthy foods, full of sodium and fats, because that’s what most of us continue to demand. Some towns — my own hometown, for instance — have chosen to ban farmer’s markets in an attempt to lessen the competition on brick and mortar grocers. Here in the Midwest we’ve chosen to design our cities and towns with few if any sidewalks and with wide, fast streets in what seems an effort to discourage walking. With both parents choosing to work, no one has the energy to cook slow, healthier food. And forget about trying to eat healthy in a restaurant. Brown rice? Whole wheat pasta? What are you, a comedian?

We libertarians would never dream of telling people how to live their lives. You want to smoke a carton of cigarettes a day, let me get out of your way. But when the day comes — and come it will — don’t expect me to pony up for your open-heart surgery with a public option.

Those who claim that President Barack Obama’s speech on health care this past week wasn’t a glorious success are fooling themselves. A Washington takeover of health care never sounded so enticing or fun.

Just ignore the specifics. Because when the president says he welcomes substantive new ideas, he means that if you have the nerve to offer any ideas — like Whole Foods CEO John Mackey did in the Wall Street Journal last month — his allies will attempt to destroy your business and reputation.

And when the president says he welcomes bipartisanship, what he means is that he hasn’t met with a single Republican on the issue since April — despite numerous requests and two separate House bills chock full of ideas.

When this president says he is a deal-making centrist and will stand up to his own party, he means he will rebuff progressives on a complete strawman like a “single-payer” plan (a plan he supported at one time), which has been a non-starter in any iteration of health care reform this year. I only wish there was a stronger word for “courage.”

When the president says everyone must chip in and sacrifice, he means more than 95 percent of small businesses won’t have to chip in and sacrifice. That’s good. But consider his plan a small-business generator, since larger businesses are sure to be small in no time (and many small businesses have a new incentive to stay that way).

President Obama says government will mandate that every American purchase insurance (despite his campaign promise not to do so) rather than allow us to indulge in “irresponsible behavior” — or, in other words, “choice.”

Insurance companies, on the other hand, will be mandated to provide coverage, with no extra charge, to everyone, no matter how irresponsibly they behave. Also, feel free to ask for check-ups and “preventive” care like mammograms and colonoscopies on demand, no matter how needless your visit may be, no questions asked, no extra cost.

That should bend the cost curve in the right direction.

When the president says there is no possibility that a government-run public option could crowd out private markets like they have in nearly every other arena they operate in, he, as the tactful South Carolina Rep. Joe Wilson might say, is trading in hogwash.

The president says that the public option is small potatoes because it would only cover 5 percent of Americans, pay for itself and run like a private not-for-profit. If such an option can change the dynamics of competition in health insurance, why not open a new private not-for-profit organization that pays for itself?

Silly question. As we all know, if any organization has demonstrated an uncanny ability to control costs, drive innovation and foster competition, it’s been government.

The best part? Like that exotic mortgage taxpayers are paying for you, according to the president, all this wonderment can be yours for absolutely nothing! Better yet, it will not add a single dime to the deficit in the next 10 years. Ignore the Congressional Budget Office’s $900 billion estimate (and the Lewin Group’s $1 trillion estimate).

Nope, we can pay for this by extracting $1 trillion in savings from insurance companies and Medicare (start cutting down on gratuitous use of paper clips, pronto). And if you even allude to the prospect of cuts (meaning government rationing for seniors) you are trafficking in a ghastly fabrication that might hasten your being “called out” by the president. No one wants that.

You may wonder how President Obama can logically sell a public option while at the same time claim that reform will be paid for by waste found in another “public” option. You may also be wondering how mandates, price controls, regulations and added costs will save us any money and preserve level of care. Don’t. Just bask in the radiance of barren rhetoric.

Because when the president tells us that this is “the season for action” and we can no longer waste time debating, he means that legislation won’t be initiated until 2013, that this is all about politics and his very own entrenched ideology — not yours.

by Gary Varvel

View all recent cartoons