Death panels? We don't need no stinkin' death panels!

Lets face it. The Brainless One, Sarah Palin, has in two words transformed the debate about ObamaCare in a way that the Brilliant One, Barack Obama, could not do in ten thousand.

Palin's detractors--meaning everyone in the Democrat- media-academia complex--would like you to believe that Palin—via her August 7th "death panels" entry on her Facebook page-- claimed that the Democrat’s health "reform" bill authorizes government bureacrats to deny care to the terminally ill or elderly. Of course, Palin claimed no such thing. Palin’s remarks were not meant as an indictment of any particular section, paragraph or clause of any proposed legislation. Rather, they were meant to describe the inevitable process that would be set in motion by whatever it is the Dems pass. Said Palin:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Now, we can debate some other time whether or not the Democrats' proposed health care system is "evil." Personally, I'd prefer to reserve that term for something really horrendous, like waterboarding the likes of Khalid Sheik Mohammed. But there is little debating the consequences of what has come to be known as ObamaCare.

Look, it’s really not that complicated. Obama has repeatedly said that the stated goal of health care “reform” is to reduce the costs of health care. Indeed, cost cutting was the core public justification for his plans. So taking Obama at his word, let’s consider the various ways that cost reductions can be accomplished:

(1) Reduce the fees docs and other providers receive for service.

(2) Reduce the amount of services delivered.

(3) Increase competition among providers and insurers to drive costs down.

(4) Reduce the number of people receiving health care.

(5) Create savings by focusing on "preventative" care.

Let’s look at these in descending numerical order.

(5) Savings from focusing on preventative care. As Charles Krauthammer pointed out recently, studies show that every ten dollars spent on prevention of illness yields about a dollar in savings. That is because preventative medicine is by definition practiced on the un-sick, most of whom will not get sick. Even the Democrat-run Congressional Budget Office states that preventative care will only increase, not decrease health costs. So prevention, while a laudable goal, is not going to reduce health care costs.

(4) Reduce the number of people receiving care. The other big goal of "reform" is to cover the 47 million poor souls without insurance. Sticking for a moment with the fictitious "47 million" number, that means adding more people to the system than are currently receiving Medicare. And half of all health care dollars are now spent on Medicare patients. By the Dems own math we are going to double the amount of people eligible for government-sponsored health care. No cost reductions here.

(3) Increase competition among providers and insurers to drive costs down. Even with increased competition, it is hard to see how health care costs would drop dramatically, especially with so many millions more in the system. But the point is moot because there is nothing being proposed by Democrats that would promote price competition either among docs or insurance companies.

(The last person who believed that the purpose of the so-called "public option" is to foster competition among insurance companies left the building weeks ago.)

And despite the cries of the Democratic-media complex to the contrary, Republicans are offering "reform" alternatives that would be pro-competitive, like making insurance available across state lines; tort reform; allowing patients to contract directly with providers, etc. But no one is listening, because competition has never been the goal of liberal health care "reform." Scratch number (3).

(2) Reduce the amount of services delivered. Now we're getting somewhere. The draft Waxman-Dingell-Miller “Tri-Committee” House bill establishes a vast federal bureaucracy with unprecedented (and unchecked) powers, among others, to audit medical records, analyze treatment outcomes, establish treatment protocols, mandate coverage caps and establish provider fee schedules on a one-size-fits-all basis. This byzantine structure will effectively exist for the sole purpose of deciding how much money is spent on health care and worse (if that,s possible) how those limited dollars are spent.

Ironically and bizarrely, politics and political correctness will compel the health bureaucrats to mandate heretofore un-covered treatments for the un-sick (think gender-change operations and abortion services). Meanwhile, economics and budgetary pressures will compel them to deny treatment to the sickest among us. So count on number (2).

(1) Reduce Fees to Providers. This goes hand in hand with number (2). The same bureaucracy that will determine how to spend the budgeted health care dollars will also reduce the rates that docs can bill for service. They will certainly have the legislative mandate to do so and will be subject to political pressure to reduce costs at any price. Reduce reimbursements or fees to the docs and they will take their talent and work ethic to a different endeavor. The iron law of economics cannot be broken even by bureaucrats.

And it is that iron law (and logic) that leads to the inevitable conclusion that the goal of health cost reduction so often expressed by Barack Obama and his minions can only be achieved on the backs of either the sickest (i.e., the oldest) patients, the doctors, or both. With fewer providers, fewer choices and less care, waiting lists and rationing are the inevitable result.

So who needs death panels or “public” options? The vast, unaccountable bureaucracy and its unforgiving mandates envisioned by the Democrats will be quite enough to completely re-make the health care industry, wreck the private health care market, and make life miserable or intolerable for millions for Americans.

So we can be afraid. Or we can do everything in our power to strangle this misbegotten monster in its crib