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HealthCare Redistribution: Rationing By Any Other Name Would Be Rationing!
Finally, a real explanation of the new form of health care rationing coming in the Obamacare Bill that passed in 2010.  If you find your tongue hitting your cheek on this don't worry, it is not a medical emergency.

Before I begin, this essay needs a little set up time.  The editors suggest that this rambles as it goes off topic sometimes.  Though this appears to be the case, there are some prerequisite notions that I try to explain in line, rather than suggest you take a link.  For example, technically, with Medicaid and EMTALA in place for years, there was no pressing need for Obamacare per se back in 2010.  Yes, there needed to be a preexisting condition stipulation as well as policy dollar limits but none of the required changes would have needed the 2700 pages of freedom-stealing regulations.


  • Healthcare Rationing Exists Today
  • Market-Based Healthcare Rationing
  • Medicaid and EMTALA
  • Government Control
  • Government Redistribution of Healthcare
  • Government-Based Healthcare Rationing 
  • Trusting the Government

Don't let all this talk about health care rationing disturb you. It is already happening.  Whenever there is less available than what is needed, there is rationing. So, if 20,000,000 or 50,000,000 new people -- those who reportedly do not have healthcare today, are added to an already overextended system, what will be the result? The result is more rationing, of course.  By the way the number, whatever it is that you hear is wrong. Government has this really clever technique that they have begun to use to keep you well, sorta duped. Perhaps you have heard of the technique.  Many of us used it in grade school.  It is called lying.   
Healthcare Rationing Exists Today

There is a notion that I would like to call "natural rationing." If you do not have healthcare today [And by the way, with EMTALA, and Medicaid, that should be nobody], that would mean that you have been rationed out by the marketplace. (EMTALA is a bill passed in 1986 called the Emergency Medical Treatment Active Labor Act).  If you have no healthcare in the years before Obamacare took effect, you have been thereby excluded by the natural occurrence of people making choices and there is none left for you -- with no government intervention. But, alas, with Obamacare, you are one of the few who may be happy.  
That none left for you part in the current rationing scheme means that you are not helpless. If you were helpless, you would be covered.  It means that you are deemed (at least in Pennsylvania) of making 33% more than the poverty level and so Pennsylvania thinks you should be able to afford your own health insurance.  Sorry about that part but there is good news. You are making more money than the poverty level. The bad news is that Medicaid has decided that because of your "high" income, and the fact that you are not disabled, you do not qualify.  We can call that rationing.
I forgot one other thing about Medicaid at least in PA.  If you are single, and you are not helpless, it is different. No matter how much you scream and yell, Pennsylvania thinks you should go get a job.  You are not covered.  Many of us think that PA law ought to be changed so that while you are on unemployment, you can have some level of healthcare coverage. However, all Americans, in PA or otherwise can go to the ER, and the ER personnel are not permitted to ask for payment until after you are treated.  Then, when they ask, if you have no means of payment, and you choose to leave, they have no power to stop you.  They do put it on your bill and they do expect you to pay it when life is treating you better.  So do I.
The essence is that in a system, which takes care of the helpless, if you are not taken care of you either are deemed to make too much money or you are not helpless or both.  EMTALA, however, is available for all -- legal and illegal.  If you have no insurance card, or you have an insurance card but choose not to use it, you can get health care anywhere in the US because of EMTALA. You cannot be denied treatment by any facility that accepts Medicare. It's the law. 

There is an exception. If a hospital does not take Medicare patients, they may opt not to treat EMTALA patients as the govt. holds Medicare reimbursement over the hospitals. Those that do not take Medicare can send any patient away.   

Mexican mothers who are eight + months pregnant love EMTALA.  Ninety percent of the births in the Southern Border States are from women of Mexican origin who made the run successfully.  These women can tell any American how wonderful the health care prospects in the US are for Americans because they have made themselves available for one or several trips to super hospitals under "ALA" and after the birth process, there is an added bonus:  their children are automatically citizens of the US. 
The derogatory term for this notion is Anchor Babies as they are the anchor that permits a whole otherwise illegal immigrant family to take up residence in the US, regardless of whether they are working or not. The mom first must give birth for free under EMTALA in an American hospital. Jackie Mason would say: "such a deal."  That may have been OK (though I suggest not) when America had money but now, we are flat broke.  Americans are now lining up for charity and as tough as it is for globalists to hear these words, I am for Americans first.

The bottom line is that Mexican women are some of the biggest users of EMTALA in the southern US states. Close to the border, the Active Labor Act (ALA) part of EMTALA encourages Mexican expectant mothers to do what is best for their future newborn. Who can blame them?  Unwittingly, this act encourages expectant Mexican mothers to jump the border so they can have their babies born in the US. Some observers suggest they are very brave for doing so. Others say they are stealing from the Americans who fund healthcare for Americans. 

EMTALA takes care of all -- legal and illegal. So, I find myself asking, what is it that Obamacare does?  Oh, it does take over healthcare and it does give bureaucrats jobs in positions between the patient and the doctor that most Americans do not want filled.  So, maybe Obamacare is a Jobs! bill of the worst kind.

Obamacare does a few other things. It steals your insurance policy and gives it to somebody who is not helpless but who makes too much money for Medicaid.  So, now, you will know what it is like to have healthcare rationing. Obamacare is merely a different method of rationing that does not take into account that somebody might have been foolish enough to work for a living and that is why they could afford the policy that under Obamacare is now up for grabs in the Obama rationing system.

Under the government plan, there is different rationing that is not based upon who can and who cannot afford health insurance.  So what is it based upon?  It is based upon the good will of the bureaucrat you will get to visit when you are sick. Healthcare in the new system therefore is also rationed but it is redistributed so that those who may never have qualified for free insurance will get it and, as noted previously, those who have always had insurance may have to give it up. 

Obama and the 114th Congress thought you would be OK not having your top level care, which you pay for, as long as you know it has gone to help a new friend who, though not helpless, is in need. And, yes, Virginia, it may very well be you who is excluded from the benefits of your former policy because former policies must be surrendered and they will be forgotten as Obamacare becomes the implemented healthcare law of the land.  
I think you can see that under both systems there is still rationing but in the new plan government bureaucrats will be the ones in charge of choosing what is fair and who gets care.  It may not be you who is excluded, it may be me, the person next door or the guy down the street.  The point is we the working people in the government plan have already lost our ability and our freedom to be included if the government chooses that someone else, legal or illegal is more worthy.  Ask your doctor.  There is only so much care to go around. It's that simple.  If you trust that the government will give you back your healthcare once you give it to Obama then, this is a good plan for you.
Before I move on further with this, I would like you to know that I have written two books that go more deeply into this matter of government controlling healthcare, and who is accountable for medical bills, and a number of other healthcare related topics.  For years, I taught a course in Health Information Technology in the Healthcare Administration program at King's College so I tried to keep up on such issues.  The book references are included at the bottom of this essay.
Government Will Make All Healthcare Decisions
Rather than you having a say in how the care gets rationed, the government will take that burden from you. Even if you once had insurance, when most of your friends had insurance, your insurance will only get you a policy in the "exchange" and this may not and probably will not be good enough anymore.  That's what happens when rationing is artificially enforced by a third party agent, such as the government, rather than by market forces.  You once had control of your own healthcare. Under Obamacare, Obama is in charge.  Be nice to the government bureaucrats that Obama places in charge of your healthcare. Exercising freedom or liberty or freedom of speech regarding healthcare may very well cost you your next several appointments. 
Why do some think this is implausible?  If you are not in control and somebody else is in control, how is it that you might think you will have the same advantages as when you were in control?  As of March 21, 2010, Obama got control.  Nobody refutes that. Even now as a lay person Obama has control of Joe Biden so things are back as they once were.  

What is Healthcare Redistribution?
I think that about explains Obamacare. All Obamacare wants to do is redistribute the rationing to make it more fair.  For your part, just trust the government and all will be as well as things always are when you trust the government. I personally do not trust the government as far as I could throw it. Millions of government employees make it pretty tough to throw.  
I call this Healthcare Redistribution and it is destined to be far more intrusive in your life than simple wealth redistribution. In this plan, it may be your friendly government bureaucrat who actually decides whether you live or die.  [Maybe I am not permitted to say that?]
With the Country so far in debt, which way do you think the bureaucrats will go -- life and more costs, or death, and the costs are not only lower, the costs are over.  You may recall that some time in 2010, the "free" press slipped and told the story of the limit on Mammograms to those women over 50.  This had to be a leak.  The essence is that one of the first regulations that we will see that purposely permits people to die to save costs is this mammogram notion. There have been many more such regulations from the government as healthcare costs are substantially reduced when the patient is dead.  

Forget about death panels and yes, they exist too. That, ladies and gentlemen, as described above, is healthcare rationing.  Let me say it differently, that ladies and gentlemen is Obamacare.  It is a clever method to permit somebody else to get your healthcare insurance, while Obama and the Congress keep theirs, no matter what their press releases say.  So, when you are explaining what this is all about to your kids, you can laugh and recall those days when you had control over your own health, your family's health, and the family's health insurance and it did not matter what Obama thought.  Now, with Obama-directed healthcare redistribution, which Matt Cartwright fully supports, you know who is in control of your life -- Uncle Sam. But, on the weekends, you may call him Uncle Obama.
But, the government says it will be fair.  Who can argue with fair?--fair for society and fair for the country as a whole--fair for those who never had insurance because they had other things to do with their time other than work--fair for those who one day would like to be citizens and take your job.  The country, after all, according to Obamathought is far more important than the individual.  
Trust the Government and All Will Be Well!
To do your part in this new people friendly government you must trust your elected representatives that they will surely do the right thing. Just let it happen. Stop complaining! Vote for the incumbent if you like what you see. You will keep liking it.  
First the stimulus and other actions handled some income redistribution but because there still are rich people who are not hard left or radical activists or members of Acorn, important elements of society are still not happy.
Secondly, The Government controlled healthcare insurance system will be pleased to handle the healthcare redistribution and this is necessary for its success.
The reason why there was a 2700+ page bill that passed with much chicanery by adult children in the House and a similar one in the Senate is because our lawmakers believe we are worth the paper.  They love us so much they knocked off a few forests to write the bill.  Well, sorta. Actually it is so that nobody can read the gotchas in the bill, with all but a few pages written by lobbyists who are known to be prolific writers. but it would not be PC to discuss that. 

The intent of Obamacare is to give Obama full control of healthcare. Today it may seem like Biden is in control but no, it is still Obama behind the scenes. You may get something but it will be like income tax.  You give all of your income tax to Washington and then your state gets 3% back.  This will be different.  You can feel it. It is Obama who is in charge.  In 2010, he picked up one sixth of the economy and all the wonderful patronage jobs that came from that.  Obama has surely been a fair impresario in giving out the jobs.
Don't ever expect to get the real reason if you get a real job.  It just would not be popular if Matt Cartwright, Nancy Pelosi, Bob Casey Jr., and / or Barack Hussein Obama gave the real reason for all of this distress.  They were hoping for eustress.  Why is it so bad if the intent is to make all of these important figures in history more powerful? Why should you care if making them more powerful makes you more dependent?  Nobody can argue that important people are not important.
But, for a moment, let's pretend that it is not as I have described. Let's say Obamacare is necessary because the disadvantaged (as shown in letters F to H in chart below) need the healthcare insurance that you already have.  Unfortunately, it is a zero sum game, and if you have your insurance, they cannot get your insurance.  So, if you read it carefully, or you read any of the synopses that are available, or you pay attention to the right news outlets, you'll see that the new bills provide for you to first give up your healthcare insurance.  This is step 1.  This permits you to be a candidate for the more perfect government health insurance version or the modified, more expensive version of your own insurance, which the insurance companies would rebuild to carry all the new regulations... if you can get your policy back at all. 
The simple fact is that the disadvantaged need your healthcare insurance. Clearly, they need your insurance more than you need it. If you needed it and did not have it, you would be disadvantaged.  The only problem is that you still have it.  They want your insurance and your lawmakers want you to give it to them. They cannot get your healthcare without either (1) a full government takeover or (2)  enough regulations that it is a defacto takeover. In either scenario, you  giving up your care to the government for redistribution.  So, at a defacto level, Obamacare works in either scenario. 
Will 25% More Doctors Appear Overnight?
Fear not, if 25% more skilled doctors and nurses than exist today, out of nowhere, show up to practice in the U.S. immediately, and the number of hospital beds goes up by 25% overnight, and all costs go down substantially,  and China forgives our debt,  and the moon is in the seventh house, and Jupiter is aligned with Mars, your healthcare insurance may not have to be redistributed to a more deserving person. But...
Right now, however, all systems are go, and your current Congresspersons and Senators knew it and they voted for it. They gave your healthcare away to somebody you do not know. But, perhaps peace will guide the planets and love will steer the stars. And, then again, perhaps your own healthcare, along with Alice Cramdon, will arrive on the moon some time in 2013, right after Obama gets reelected. In other words, unless you are an Astronaut, kiss your Health Insurance good-bye.
As you can see, I have tried to use some humor to paint the direness of the times in which we live.  So, that we understand the notion of rationing regarding healthcare and health insurance, let's discuss how healthcare is already rationed today, in more succinct terms than above, though many of us may not at first see it that way.  In the chart below, we introduce the current rationing system. Following this, with a little hyperbole, I will show you how this will change when the already passed rationing is redistributed. 
Market Based Rationing Formula for Patients with "Health Insurance." 

Use the word, "Patient" as the subject of the sentences below: 

A. Has lotsa money, no insurance, and use your wealth to pay your own healthcare bills.
B. Has lotsa money and buy health insurance.
C. Has an employer who provides some or all of health insurance.
D. Is a retiree and former employer provides some or all of health insurance
E. Is on Medicare --- most often with affordable supplementals
F. Is on Welfare or Disability and get your health insurance from Medicaid.

Market Based Rationing Formula for Patients without "Health Insurance." 

G. Figures he or she won't get sick and stick the $$ in pockets for vacations
H. Cannot afford insurance -- goes to ERs;  emergencies and routine healthcare (EMTALA) -- pays never or sometimes
I. Illegal Alien  -- go to ERs; emergencies and routine healthcare (EMTALA).
(EMTALA -- In 1986, Congress enacted the Emergency Medical Treatment & Labor Act to ensure public access to emergency services regardless of ability to pay. Thus, nobody is without the ability to get health treatment, regardless of citizen status or ability to pay the bill. )
Right now, the scenario above depicts how natural rationing works. It occurs because there just isn't enough to go around.   It is based on the haves / have not scenario.  If you can afford a higher bracket, it is your choice as to whether you engage that bracket.  

If there were enough healthcare / Obamacare to go around then both parts of the above list would be served equally.  There is not enough, however,  and therefore, in the above scenarios somebody does not get the insurance per se, or the healthcare from the doctor's office, or preventive medicine.  When there is not unlimited supply some rationing scheme is always used. Most often in the US, the scheme suggests that those that can afford get, and those that cannot afford do not get. It is the same scheme used for who gets ice cream. 

When Obamacare comes in, there still won't be enough to go around so there still will be rationing but it will be a CHANGE as President O once said -- a "change that you can believe in."  The government, instead of the marketplace will re-distribute your old insurance policy to a more deserving fellow or gal.  

Those who have worked in the current system above (A to F) are still reaping their just rewards, at least for the time being.  If all of your life you worked and are still working, more than likely, you have health insurance. I you retired, the same, etc. etc. ad nauseam.  It will be from the people who have worked and have vested interests in their health insurance policies, that the government will claim the dollars to fund items G through I above.  Ironically, the people losing the most were more than likely the ones who wanted Obamacare the most. 

Can't There Be Something for the Non-Workers? 

Some who have worked but have not achieved much in life may not have received their rewards. In some cases this is because they did not prepare for employment or they chose not to work or they could not find work.  These of which we speak are not the helpless. 

As we look at the scenarios above, in the marketplace system, there is always the possibility that even without government intervention, somebody who cannot afford health insurance today, one day may get a job and be able to afford it. That is how most of US, pre-Obama have looked upon healthcare, and in fact having a job. 

When somebody won the interview and got a job twenty years ago, they would immediately move to the upper area of the marketplace rationing system described above. They had earned it. The Obama system may label those people, perhaps as capitalist pigs.  Those who could afford insurance but choose not to buy it, still may not get insurance by choice-- until they become older and then, they can move to a number of different categories in the upper area or perhaps they may fall into a lower area.

Illegal's of course can become legitimate citizens by working through the process and then get better jobs with healthcare insurance or of course go back to their home countries and pick up the health insurance they left behind.

The point is the rationing scenario is very dynamic. People are not in these categories all their lives. The jobless get jobs and those with jobs lose them every now and then. Sure a system should preserve health insurance and help Americans but the current system did not have to be disassembled to do that.  So, the above rationing is natural and it is dynamic and no bureaucrat gets to decide who goes to the head of the line or who has to die. 

People's life choices and in some poor circumstances, fate, make the decisions today -- much better than a government bureaucrat would.  Some might suggest that individual determination and tenacity and hard work along with luck and help from God have some say in how well one does in life. Would it be better to give up this method and turn your fate over to government bureaucrats?  Maybe for a few, it would be better -- but for many, especially the elderly it would not. 
Please remember there are losers today and there are winners today and this fact will not change with Obamacare. The faces will change.  Many of today's winning faces, who worked hard all their lives -- by government decree will become losers,  and many whose fate or poor choices were made losers -- by government  decree will become winners and take the insurance once held by a "winning" face -- perhaps your face.  That's how the government rationed system will play out.  The underserved will have won the healthcare distribution lottery and someone who has a job must pay for their winnings.
It really is like a healthcare lottery except the government rules say that all players must participate in the lottery.  As much as Congress and the President deny it, the fact is that those with healthcare insurance will have to give it up to get their healthcare lottery ticket.  They will no longer be in control of their health. All citizens must play and your ticket is your insurance policy or a note that you have none.   For those with insurance the stakes are high. For those without insurance it is a winning scenario. 

Even in full communism, it always helps if you "know somebody."  So, perhaps the schmoozer's have another option. Perhaps not.
Government Based Healthcare Redistribution 

Now, let's talk about the pattern of the government rationing since the monster bill passed the House and the Senate in 2010 and President O has signed it into law. At this point, the government is still fully in control of all health insurance from infants to seniors whether there is the full banana government controlled health care insurance option or not. The hoopla is muted because those in office, such as Matt Cartwright, who inherited the bad deal, think if they say nothing for months, we will forget. 

Obama and company did not have to press for the public option, because they engineered it into the bill that passed March 21.    It was the natural happening and then government would be the only permitted payer. Insurance companies will eventually be gone -- phased out.  While capitalism is paid lip service, Insurance Companies will be the servants of the government, and they will be paid well. Then, one day, poof, they may be gone. 

For the hard working American, life in America will no longer be something that is easily understood.  It doesn't matter if you worked all your life to earn your health insurance. It doesn't matter if you went to graduate school and invested a lot of time and money and debt into your education.  All insurance will be the same -- unless you run for Congress and make it -- just once. Then, like me, you can change it and hopefully there will be a lot of guys like me who will change it. That, of course is up to you. 

Cartwright's predecessor Kanjorski voted for Obamacare.  O'Brien, a fine man otherwise, said it was better than nothing.  I say Obamacare is anti-American and must be replaced.  Like a bad penny, however, it is still around and so is Obama with Biden supposedly calling the shots.  agree.
Government Based Rationing Formula for Patients Regardless of Insurance 

Government healthcare rationing is about to materialize this way.  If you need a procedure, depending on where you are in the selection table below, you may or may not receive government permission for the procedure.  First, of course before you see your doctor, your friendly bureaucrat will make the determination. Let's look at the probable pecking order for Obamacare
A. Filthy Rich who pay their own -- see the doctor immediately
B. Senators and Congressman and ex senators and ex congressman -- all of their wives, friends, campaign donors, concubines,  etc.  see the doctor almost immediately
C. The filthy rich not included in A or B.   See the doctor as quickly as those included in item B above.
D. Young illegal aliens between ages 15 and 45. See Doctor definitely next in line
E. Older illegal aliens and young illegal aliens 2 to 14 who were never on Medicare  See Doctor next in line
F. Medicaid patients who are ages 15 to 45,  See Doctor next in line. These are followed by
G. New Underprivileged Healthcare Insurance Recipients ages of 15 and 45, See Doctor next in line
H. Formerly Covered by Insurance -- Ages 15 to 45. See Doctor next in line
I.  Formerly chose not to be  covered -- had used the $$ for fun -- ages 15 and 45 See Doctor next in line
J.  All other groups, including illegal aliens ages 2 to 14 non illegal's 46 to 64, See Doctor next in line
K. Medicare  and other patients not in a prior grouping from ages 65 to 79,  See Doctor next in line-- followed by
L. Medicare and other patients not in a prior grouping from ages 80 to 99,  See Doctor next in line, followed by
M. All patients 100 or older -- See Doctor next in line. These folks get to view the Sarah Palin Death Panel Video and a Dr. Kevorkian video before being scheduled.
Under the new system, reading the writings of the Obamacare Doctors (CZARS), the following will have no health care insurance: 

N. One to two year olds -- not yet productive according to govt. -- small societal loss. 
The charts and the text  probably need some work but this is a continual work in progress.  Yes, though incomplete, it  is scary enough to take some action. Though government may build the cafeterias, those with the highest survival rates will be those that believe there is no free lunch. 
As you can see, as long as you know your place in line and you are patient, you will eventually be served. Additionally, the new czars in the administration have made it known that they find little redeeming value in senior citizens.  This is good to know if you are a senior. Seniors take away care that others might get, and if they would only see Dr. Kevorkian, and his clones, the costs to society would be substantially lower. 

For example, the Czars like using number of years left to live for the good of society as an important gauge. Thus, it would be far better to prioritize for rationing a 15 year old with 30 more years until they reach 45 than five or ten sixty-five year olds.  Considering that the old coots consume lots of healthcare, his eminence, Barack Obama, supreme commander of the allied health services, might be called upon to request a quick death to save society the expense of caring for somebody who only has five or ten years left anyway.    

The moral of the story is no health expenses, no death panel.  Health expenses,  no medicine. No medicine, no life. No life, no health expenses.  There you go-- finally a final solution. Was that term ever used before?

Healthcare Will Be Restricted 

Rationing is just rationing. The definition of rationing is "To restrict to limited allotments."
So, what's the big deal?
Some simple equations follow:
2 split two ways == 1 + 1 = 2
2 split three ways ==  2/3 + 2/3 + 2/3 = 2
2 split four ways == 1/2 + 1/2 + 1/2 + 1/2 = 2

If 2 is all ya got then 2 is all ya can give.

You can get to 3 only if you can first find another 1.  The point is since there are no more doctors, and many doctors plan to retire if Obamacare is passed, all we are doing is splitting up how much we can get and that is the definition of rationing. The more to whom we give, the smaller is everybody's allotment.  
Rationing Is Rationing Is Rationing

Do you like the natural system to determine who gets health care or should the government bureaucrats make that determination?

Hint: the government bureaucrats may be fine people in your neighborhood.

Either way there is only so much to go around.
In the natural system, remember that you are not powerless unless you do not work and cannot come up with -- money.  If you can find a few dollars, you would not be at the whim of a government bureaucrat standing between you and your doctor.
If you would like to read more about my perspective on Obamacare, I have written two books that have lots of information on the subject.
Obama's Seven Deadly Sins
Healthcare Accountability

Both are available at www.bookhawkers.com 

I am 100% against the Obamacare plan as it is not a reform of healthcare but a means of giving everybody less care than was formerly available and making everybody dependent on the good will of a bureaucrat rather than rugged individualism and survival of the fittest. 

If you like being the best that you can be, rest assured that in the world of Obamacare, somebody who has no concern for what you want or do not want, like or do not like, will make the decisions for you.  It is a major loss of freedom for all, forever.  I promise to work for its repeal if I am elected. 

It is simply a government takeover of healthcare