Hostages to Insolvency

The New York Times published a melancholy article Monday on the disintegrating Greek health care system:

Greece used to have an extensive public health care system that pretty much ensured that everybody was covered for everything. But in the last two years, the nation’s creditors have pushed hard for dramatic cost savings to cut back the deficit. These measures are taking a brutal toll on the system and on the country’s growing numbers of poor and unemployed who cannot afford the new fees and co-payments instituted at public hospitals as part of the far-reaching austerity drive.

At public hospitals, doctors report shortages of all kinds of supplies, from toilet paper to catheters to syringes. Computerized equipment has gone unrepaired and is no longer in use. Nurses are handling four times the patients they should, and wait times for operations — even cancer surgeries — have grown longer.

Access to drugs has also been affected, as some drug manufacturers, owed tens of millions of dollars, are no longer willing to supply Greek hospitals. At the same time pharmacists, afraid that the government might not reimburse them, are asking for cash payments, even from those with insurance.

This cautionary tale comes to us from a nation further down the insolvency slide than America, but it’s an open question exactly how much farther, once allowances are made for scale.  One of the consistent threads running through stories about Greece is how the speed of their fiscal collapse took so many Greek citizens by surprise, even though it was quite obvious to outside observers for many years, and not all that difficult to predict with a spreadsheet. 

Don’t laugh at the Greeks.  We’ve got doomsday spreadsheets all over the place in America, and plenty of people who refuse to look at them.  The same people will spend the next decade complaining about how sudden American fiscal collapse was, and bitterly protesting the brutal unfairness of the austerity measures, after they become unavoidable.

The sad tale of Greek health care teaches us an important lesson: Don’t “loan” the government anything you aren’t prepared to lose.

As we bump and skitter along our debt ceiling, we should take careful notice of how eagerly the government puts vital services on the chopping block.  As soon as there is serious talk of spending restraint, Big Government sighs and throws some cops and firefighters at the budget cutters.  A vast army of bureaucrats works in Washington.  Their immense compensation has made the nation’s capital the richest city in America.  But when the debt limit approaches, nobody talks about cleaning out the second assistants to the third deputies of the Associate Under-Secretary of Whatever.  No one speaks of the money wasted on summits to plan meetings in advance of conferences.  The caretakers of the leviathan State speak often of their passionate desire to cut “waste, fraud, and abuse,” but Senator Tom Coburn (R-OK) never has any trouble finding a few billion dollars of ridiculous crap to chronicle in his annual “Wastebook.”

Big Government exposes its jugular to every swing of the budget-cutting axe.  Knowing this makes it exceptionally foolish to place even more vital aspects of our lives, such as health care, under its control… because we can be absolutely certain that those vital affairs will be taken hostage the next time Americans balk at handing over another trillion dollars of tax money or debt.

Those ObamaCare “public exchanges” are guillotines in which countless necks will be laid.  The blades will begin quivering at the first mention of fiscal restraint.  Today’s tragedies from the Greek health care system will become dire prophecies of what waits for Americans if the next trillion dollars of debt is not swiftly approved. 

“Of course we can significantly reduce the rate of government growth!” the people of 2014 will be told.  “That is, assuming you don’t mind having the streets clogged with the corpses of the poor and their children.”

Every time we increase our dependency upon government, the power of the political class grows.  Even if politicians weren’t inclined to exploit the tethers of dependency for electoral gain, it’s risky to wire everything into a single budgetary power plant that could melt down at any moment.  Centralization brings vulnerability, not only because everything might fail at once… but because programs the greatest number of people are most deeply dependent upon are just about guaranteed to fail first.