Too Many Squirrels, Not Enough Attention to Their Food Source | Robert Nelson, MD

Locating the food source for this second group of squirrels is pretty easy. All they have to do is show up and collect their sustenance, like fat squirrels would by taking the path of least resistance for nuts put out for them by a well-meaning homeowner.

And just who is responsible for this obesity epidemic among squirrels? For starters, we can thank a systemically perverse tax code. Since the 1940’s, tax laws favor employer-sponsored benefits while suppressing and punishing the individual/small business market into submission; and recently straight into the waiting arms of either the ACA or MCO’s of Medicaid.

It took 50+ years of crony deals between special interests and state & federal legislators to hitch and load the cars of this health-care gravy train. It won’t uncouple easily.

Relocating the squirrels or giving them more nut-gathering rules will not fix this. This cartel of fat squirrels will only disband by removing the food source provided by this government sanctioned and partially financed oligopoly.

But back to the first group of combative squirrels, i.e. the mouth pieces of the status quo. Why do they continue to lobby for more of the same – even to their own detriment as patients and citizens?

They beat the drum for more regulations, legislative relief, price controls and mandates (that includes the ACA) in various forms, such as Value Based protocols, Single payer (i.e. streamlined,efficient rationing), higher taxes and various other re-distributive schemes.

Sure, when viewed in isolation any of the models listed above can be found to have some laudable benefits in and of themselves. But just as pushing on one end of a balloon causes it to bulge on the other, it is the unforeseen moral hazard and downstream unintended consequences that doom many of these Utopian ideas.

None of which are necessary, by the way, if we focused on the root causes of our current dilemma: Costs! Rather than how to “cover” people within the current dysfunctional system, which amounts to just applying pressure to one end of the balloon and expecting nothing to happen on the other.

There are common-sense market-based incentives that would reset the current system and solve the majority of the cost challenges we face. It will burst the balloon which will scare the squirrels, though.

Here is an abbreviated list of reasons why I believe these ineffectual models are often championed by well-intentioned individuals and groups, even when they have no direct financial stake.

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