Viewpoints: With health care put in federal hands, is rationing in our future?

President Ronald Reagan used to tell this story during the Soviet era when government central planners took charge of the economy:

A Russian man wants to buy a car. The man goes to the official agency, puts down his money and is told that he can take delivery of his automobile in exactly 10 years. "Morning or afternoon?" the purchaser asks. "Ten years from now, what difference does it make?" replies the clerk." Well," says the car buyer, "the plumber's coming in the morning."

Igor Berman, Congressman Tom McClintock's chief of staff, who emigrated with his family from Russia in 1994, recalled Reagan's story at a recent "Town Hall Meeting on Obamacare" in El Dorado Hills, sponsored by the local tea party. The state and national experts at the podium and the standing room only crowd showed that the Affordable Care Act is likely to be as potent an issue this November as it was in 2010, when opposition to the law helped engineer the biggest midterm election turnover in the House of Representatives since 1938, with Republicans gaining more than 60 seats, many candidates backed by the tea party. A recent Rasmussen Poll found that 55 percent of U.S. voters still want the law repealed.

Berman told the group that he and his mother nearly died in a Soviet hospital due to a shortage of antibiotics. They survived only because two doctors in their extended family had hoarded the needed medications.

Berman also remembers standing in line for five hours to scrape together fragments of food. The only time he ever got a banana was on his birthday. He had seen pineapples only in pictures. The first night he and his family arrived in the United States, they went to a Safeway store, where he could not believe the "cornucopia of colors" and abundance of fruits and vegetables. His mother, 88 and blind when she became a U.S. citizen, revered to her last day the "liberty in America."

Of course, the United States is not the Soviet Union, but with Obamacare handing over the reins of the health care system into federal hands, "is rationing really far from our shores?" he asked.

He pointed to the British National Health Service's recent denial of cataract eye surgery to many elderly, a decision the UK's Telegraph reports will affect "thousands of patients struggling to drive and even read" who "are wrongly being denied sight-saving surgery." The BBC reports "creeping rationing" of care in England, which, say doctors, includes forcing those needing knee and hip replacements to "wait longer in pain for operations."

Sally Pipes, president of the Pacific Research Institute, came from Canada, where under its nationally run health care system, she said, her mother died from colon cancer only months after being denied a colonoscopy because she was "too old." The average wait time to see a specialist in that country is now five months.

But we do not need to look overseas or across the border to see the handwriting on the wall. Already the federally run Medicaid and Medicare programs are causing major cost-shifting to private insurance, doctor shortages and less access to services, according to local health providers. Pam McDonald, manager of Midtown Primary Care Associates of east Sacramento, said that under Medicare, physician fees have been reduced so much – 27 percent last year – that many won't be able to "stay in business much longer." Marshall Hospital in Placerville has lost millions of dollars due to cuts in Medicare reimbursement rates, as have many other hospitals.

Health providers fear the extraordinary power over future funding decisions handed to an unelected 15-member Independent Payment Advisory Board. Under Obamacare, McDonald said, there is going to be "rationed health care."

"This is the most serious domestic policy issue facing America today," Pipes said. We all want affordable, accessible health care, she said, but "there are two visions of how to get there: put choices in the hands of patients and doctors, or government central control."

Pipes proposes to replace Obamacare with alternatives that harness the "power of competition to lower costs and improve access to affordable coverage," including increasing the availability of affordable high-deductible plans; expanding health savings accounts, where patients keep any unspent money; and allowing consumers to purchase insurance across state lines.

Immigrants from oppressive countries often seem to sense most deeply threats to our freedom. During all the years he and his family endured desperation in Russia, Berman told the group, they always had hope. "That hope," he said, "was the United States of America."

"History is now giving us a chance," he said, to save our freedoms.

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