Now Schiff Has a Health Care Law

Representative Adam Schiff (D-CA-30) just introduced his Equal Health Care for All Act, which he claims will assure "equitable health care for all Americans."  This bill belongs in the garbage bin, asap.

Equitable is derived from latin, aequus, meaning equal or same. Rep. Schiff thus intends to legislate the same health care — i.e., same medical care — for all 330 million Americans.  Do we all need identical care? 

A healthy 35-year-old male and a healthy 35-year-old female do not need the same care, viz., the male has no need for pregnancy care.  A healthy 35-year-old and a 35-year-old diabetic most assuredly do not need the same care.  A healthy 80-year-old who rides a bike 25–50 miles a week (this author) does not have the same medical needs as an 80-year-old with chronic lung disease and congestive heart failure.  

Health care cannot be equitable unless all individuals have the same genetic make-up, similar environmental risk factors, identical diet and exercise, and equal luck in the cancer lottery.  Since sickness is inevitable and unavoidable, if equity or sameness were the true goal of healthcare, everyone must be equally sick. 

It is ludicrous to attempt to legislate the same medical care for all people.

Schiff's bill will actually harm patients.  The average maximum wait time to see a primary care physician in Albany is 122 days.  Schiff would require all patients to wait the same 122 days.  If one patient needs the antibiotic chloramphenicol, must this drug be given to all patients?  There isn't enough chloramphenicol on planet earth to do this, never mind the cost.

The bill is based on the erroneous assumption that disparities in medical outcomes are caused by care providers and that Congress must hold doctors', nurses', and therapists' feet to the fire to assure that all patients are treated without regard to race, religion, ethnicity, or sexual orientation.  But the vast majority of providers already do this.  Outcome disparities are not primarily due to biased care providers.  Socio-economic factors, especially poverty and poor education, are the main culprits.  If Schiff truly wants to eliminate medical outcome disparities, he should legislate economic prosperity and educational achievement for all Americans. 

(That is just as impossible as legislating the same medical care for all.)

Schiff's bill intends to make equal access to health care a protected civil right, but that is impossible as well as unconstitutional.  A civil right means political and social freedom: it embodies the U.S. founding principle that all Americans have a right to choose for themselves.

Medical care is the personal service or work product of a professional care provider.  One person — a patient — cannot have a "right" to another's individual's — a provider's — personal service or work product, unless, that is, if you take away the provider's freedom.  Making health care a civil right is unconstitutional.

The Equal Health Care for All Act would create a new federal agency called the Federal Health Equity Commission.  This is just what Americans need and want: a new healthcare agency in Washington — another one that provides no care!  But, like the rest of the healthcare bureaucracy, this commission would steal money from patient care to compensate administrators, agents including insurance and IRS, bureaucrats, compliance officers, consultants, lawyers, managers, oversight officials, regulators, rule-writers, and a host of others who never touch a patient. 

Last year, the U.S. healthcare system consumed 4.3 trillion taxpayer dollars, nearly equal to entire GDP of Japan.  Thirty-one to more than fifty percent of that massive expenditure, roughly two trillion dollars, could have paid for Americans' medical care and instead went to bureaucracy.  Schiff wants to take even more money away from care to create another unnecessary Washington bureaucratic dollar-devourer. 

As more money is diverted from care to bureaucracy, wait times will go from months to years.  American death-by-queue will become the norm: people who die while waiting in line for care they can't get in time to save them. 

Finally, there is Adam Schiff's credibility when saying things like, "all Americans deserve equitable health care."  This is the same man who for two years kept announcing, "I have ample evidence of Trump's collusion with Russia."  He never produced this fictitious evidence.

The Equal Health Care for All Act is worse than a travesty.  It harms all Americans by reducing access to medical care.  It treats people as though they were all the same.  It does nothing to address health outcome disparities, and is unconstitutional.  Schiff's bill should be discarded as quickly as possible, so Congress can stop wasting precious time and discuss real solutions to our very real problems: inflation, crime, our fractured, polarized society, border crisis, loss of trust in great institutions, and international tensions.  

Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award-winning book Curing the Cancer in U.S. HealthcareStatesCare and Market-Based Medicine

Image: Adam Schiff.  Credit: Gage Skidmore via Flickr, CC BY-SA 2.0.

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