The Godfather of Medicare and Obamacare Is Not Really Dead
Rashi Fein, a husband, father and beloved friend, died last Monday at the age of 88. While this is sad news for those who will personally miss him, I'm torn.
Because Mr. Fein, an economist, devoted much of his life -- with some success -- to the pursuit of universal, government-run, taxpayer-funded health care, I rejoice that his work on this mortal coil has drawn to a close.
And yet, this man is not dead...not really.
There are some Darwinian evolutionists who believe that individual members of a species exist merely as the vessels of DNA -- the famous "selfish gene." So long as the genetic material survives and replicates, the physical manifestation of any individual DNA-vessel matters little.
In that sense, the life force that impelled Rashi Fein will not go gently into that good night. It continues to rage and reproduce.
The New York Times credits Fein with helping to lay "the intellectual groundwork" for Medicare in the 1960s.
Dr. Fein, a proud liberal, regretted that Medicare did not apply to everyone, just as he was disappointed that Mr. Obama’s Affordable Care Act did not consolidate insurance payments under the federal government. A federal single-payer system, he maintained, would be more cost effective and inclusive.
You see, Rashi Fein, with all of his "ethical and humanitarian perspectives," was, at best, a dupe of the tyrants (whether idiotic or despotic) who want to limit both your access to health care and the length of your life. At worst, he was one of them.
His obituary in the Times, however, is positively magical.
When Dr. Fein began working on health issues as a young aide in the administration of Harry S. Truman, health care accounted for about 3 percent of the American economy. By the time he weighed in as a respected elder in the field during the debate over President Obama’s health care proposals, the expenditures had risen to 18 percent, an amount roughly equal to the economy of France.
The implication, of course, is that health care costs sextupled as a percentage of the "economy," and that this fact should trouble the ethical humanitarian in each of us. Sacré bleu, France!?
Might I suggest that those who wring their hands over this disturbing datum visit my new clinic -- the Truman Health Emporium -- where we'll offer inexpensive diagnoses and therapies, the costs of which are kept reasonable through the modest expedient of avoiding the use of any medical advances which took place after about 1953 (coincidentally, the year Watson and Crick described the structure of DNA).
So, do I have any takers for the clinic? After all, it's cheap.
[Tick. Tick. Tick.]
Perhaps you need a bit of persuasion to bring you in.
At our clinic, we're intentionally ignorant about artificial heart parts, kidney transplants, vaccines for nearly anything, and about what causes AIDS or mitigates its effects. After all, those are all post-1953 phenoms.
We CAN do knee and hip replacements, but a brief description of our methods, materials and outcomes may make you content with your existing natural joint pain. Our cardiac surgeons practice what might today be called "maximally invasive heart surgery." They're delighted, and often surprised, when the patient survives. Our most progressive doctors have actually read of experiments in one-dimensional magnetic resonance imaging (MRI), but of course we don't have an MRI machine. Nobody did.
You say you'd like a CT scan? How do you spell that?
No, we don't have any Lipitor or Nexium? ¿Habla inglés?
You want me to use a laser beam to reshape your cornea and give you 20/20 vision? That's not even a thing.
You see, the advocates of the deceptively named "universal health care" always portray the expense side of the ledger, but rarely invoke the near-miraculous nature of medical advances made possible by the (partially) free market, and by the profit motive. Of course, doctors and patients weren't the only ones to benefit.
As the money Americans spent on medical care increased, so did the role of economists specializing in health issues. Dr. Fein moved between government and academia, offering research and views on issues like meeting the demand for physicians.
Ironically, Rashi Fein's obituarist credits the healthy growth of medical spending for Fein's blossoming career opportunities. It seems someone always wants to issue a grant to an economist to study the runaway cost of healthcare.
I've come to view the term "economist" as a synonym for "elitist," or "socialist," or "Utopian." If we're to believe the New York Times, Rashi Fein was all three.
“A new language is infecting the culture of American medicine,” [Fein] wrote in The New England Journal of Medicine in 1982. “It is the language of the marketplace, of the tradesman, and of the cost accountant. It is a language that depersonalizes both patients and physicians and describes medical care as just another commodity. It is a language that is dangerous.”
I'm sure in the halls and cubicles of the Hubert H. Humphrey Building, at the foot of Capitol Hill, the staffers in the U.S. Department of Health and Human Services never bandy about such crass, impersonal concepts as price or supply.
No, our benevolent government health officials surely speak in near-poetic terms of intimacy and empathy, always balancing the science of medical technology with the art of human compassion -- always striving to deepen the relationship between a physician and her patient.
After all, medical care is not "just another commodity," it's a government function, with all of the warmth that that term can conjure.
So, I bid farewell to Rashi Fein. Would that I could to the rest of his kind.