Grim symptoms reveal Nanny State Syndrome

When did your medical bills become my problem?

Or to put it more sensitively: When did my medical bills become your problem?

A diagnosis from this longtime Medicare "contributor":

The seed of that insidious mindset was planted in 1965, when Medicare (health coverage for old folks), including Medicaid (health coverage for poor folks of all ages), was passed by Congress as a cornerstone of President Lyndon B. Johnson's "Great Society."

Not so great: Medicare and Social Security are relentlessly accelerating our nation down the entitlement rails toward a demographic train wreck. We aging Baby Boomers pack a heavy fiscal load.

Forty-three years ago, prescient warnings that a Medicare program would spark a sharp, enduring, upward spike in health-care costs were no political match for tear-jerking appeals on behalf of old folks. So it passed Congress.

Eleven years ago, prescient warnings that the State Children Health Insurance Program would cost too much was no match for tear-jerking appeals on behalf of young folks. So it passed Congress.

Squeeze play: First the elderly, then the kids, were deemed "entitled" to health care. Who's next?

Everybody in between.

Save the semantics scrap about what is and isn't "socialized medicine." If Big Brother raids your paycheck to pay medical bills needlessly swollen by his inefficiency, that's close enough.

Ten years from now, our ability to cover the tabs of Medicare and SCHIP will be no match for their price tags.

So what do we demand?

More government-mandated health-care coverage.

OK, so technological advances and wonder-drug development also fuel medical-bill inflation.

Yet so does the overdose of administrative expense induced by government's intrusion into what used to be a private-enterprise zone. So does that intrusion's inevitable undercutting of medical-charge scrutiny by patients.

A steep climb in administrative ranks triggers a steep climb in costs.

Sounds like public education.

And as the ratio of doctors, nurses, technicians and orderlies to administrative personnel has fallen, so has the ratio of Medicare (and Social Security) "contributors" to beneficiaries.

Another grim cycle:

1) Pandering politicians promise greedy voters more than they can deliver. 2) Those promises predictably aren't kept. 3) Greedy voters turn to other pandering politicians who promise even more that they can't deliver. 4) Those promises predictably aren't kept, either. 5) Back to 1).

Behold the Nanny State breeder reactor. Fire it up for a few generations and the price tags for an ever-expanding public-perception array of cradle-to-grave "rights" — to health care, prescription drugs, college tuition, retirement funds, even "meaningful" employment — mutate far past balance-sheet reality.

Our political landscape reflects that warping of the original can-do, self-sufficient, proudly individualistic American spirit.

Ponder the presidential candidates' extravagant, escalating health-care pitches.

Ponder this rallying cry from a prominent member of Congress on ABC's "This Week" last week:

"We've got to prove to Americans that we can deliver real change on health care that will cover all Americans, that will put Americans and their doctors back in charge of their health care."

That was House Minority Leader John Boehner, R-Ohio. So now the "conservative" half of our two-party system vows to "deliver real change on health care that will cover all Americans."

Despite Republican vows that they'll use the "free market" to "deliver" that "real change," government-imposed 'health care that will cover all Americans' is no "free market." And Republicans who promise big government generally lose bidding wars against Democrats who promise bigger government.

Then again, any current U.S. politician of any party who doesn't make such lavish promises seems condemned to ballot-box oblivion. The entitlement mentality has clamped a tight grip on the American consciousness and won't let go.

Yes, socialized medicine apparently works well in some nations — or at least that's what we're repeatedly told by the people who prescribe it here.

No, the good old days weren't so good for those who couldn't afford health care.

Yes, today's politics of 'compassion' demand that the world's richest nation erect a reasonable 'safety net' for the less fortunate.

But why must that net also catch the more fortunate? How widely must we stretch that net? How long can our shrinking middle class bear the growing burden of our middle-class welfare state?

And a non-medical question:

When did your reckless risk of borrowing — or lending — on a long-shot mortgage become my problem?

2008.

Frank Wooten is associate editor of The Post and Courier. His e-mail is wooten@postandcourier.com.