eplaced by paternalism, and, predictably, unrestricted health care for older Americans lead to frenzy of spending by patients and doctors. Those who had clamored for Medicare argued that, since the state subsidizes seniors' medical care, the state ought to pay for everyone's health care. In an act of pragmatism, President Nixon proposed the HMO Act, which Congress passed in 1973. The law gave millions of dollars to HMOs, which, until then, had constituted a small portion of the market.HMOs multiplied rapidly with the new federal giveaways. Managed care, now including PPOs, mushroomed. Employers initially perceived managed care plans as cheaper than traditional fee-for-service insurance. Gradually, they stopped offering a choice of health plans, making individual policies more expensive. HMOs' penetration of the industry had been subsidized into existence. Government had instituted managed care. Today, while overall quality of patient care remains the best in the world, doctors practice medicine in an increasingly intricate web of rationing and regulations: Physicians are stripped of professional autonomy. As patients wander the maze of managed bureaucracy, costs rise and quality deteriorates. Every American dependent on a third party for health coverage is a potential victim of managed care. And state sponsored management of medicine is growing. Last year, Congress and the President increased regulations on the medical profession with the Kennedy Kassebaum legislation. This year, Congress approved the President's $24 billion in "kiddie care" state subsidies. A few politicians (Senotors Kennedy and Wellstone), demand national health care on the grounds that health care is a right.Is health care a right? The Declaration of Independence protects the inalienable right to life, liberty and the pursuit of happiness; it does not guarantee happiness or health care. The right to act in your self-interest and provide necessities for yourself mean...
