The Other Golden Rule

The “do unto others” maxim is about as well known as any in the world, but there is another Golden Rule that will become more apparent as healthcare reform begins its trek towards implementation. That new Golden Rule is this: He what gots the gold makes the rules.

Most would agree that one way to lower medical costs in the short run is to live healthier lifestyles. (Note: I personally question whether this would be true in the long run. Example: Smokers die younger than non-smokers and therefore shave years off Social Security obligations and ongoing medical expenses.) If the government is the source of funding for medical expenses, it won’t be long before they begin a program of “incentives” for healthier living in order to “promote the general welfare”.

This practice of incentives (often leading to “disincentives” for unacceptable behavior) has been standard operating procedure for nearly a century. Home ownership is deemed good, so the government provides special tax breaks to encourage home ownership. College education is good, therefore taxpayers are afforded tax credits for higher education. Saving for retirement is good, therefore we have tax advantaged retirement plans.

In the same way, certain behaviors are deemed negative for the general welfare, and therefore disincentives are put in place. If carbon dioxide is deemed to be a poison (hold your breath on this one), government will impose a carbon tax to discourage release of carbon dioxide into the atmosphere. If nuclear power plants are deemed unacceptable, strangle them with regulations.

If the government funds certain programs, the government will insist on keeping certain strings attached to the use of those funds. If states accept federal education dollars, the Department of Education will mandate what those states may teach or not teach. If a charity accepts funds from the government to fund its programs, they must adhere to government hiring guidelines. If federal construction funds are released, those accepting those dollars must either pay union scale wages or hire the union help.

Because the government gots the gold, the government can make the rules.

So when the government controls healthcare dollars, the government in the name of “general welfare” can rationalize special taxes on products they deem particularly destructive. Do you like cheeseburgers for lunch? Expect to pay a special tax to pay for your irresponsibility to the rest of society. Do you like soft drinks with sugar and corn syrup? Pay a higher tax. Do you weigh more than the charts say you should? How does a "fat tax" grab you?

Don’t think these things aren’t possible. This is way these things will unfold. Maybe you think it’s good when the government regulates private behavior. If you do, remember that a government that is your master cannot be your servant.