A funny story about the advent of nationalized health care

Let's say you've got a massive organization (we'll call it "government", just for kicks) which has a monopoly on the health care providers and payment system of a particular country (which we'll call "America").

Now suppose you are in charge of running said health care monopoly. Now you got a degree in business from a prestigious school and you remember your professors saying the way to make a business grow is to exercise good financial management: to wit, hold down costs and increase revenue.

Increasing revenue is easy. Since the same "government" that runs the health care monopoly is the one that can raise taxes, just raise taxes and designate a portion of those taxes (less government employee salaries, kickbacks, bribes, and other related costs) to fund the health care monopoly. (For the sake of this argument, we'll assume that you went to an Ivy League business school where your professors didn't teach the Laffer Curve, the Austrian School of Economics, free-market capitalism, von Mises, Hayek, or Friedman. Plus, you work in an Administration that eschews such economic drivel, preferring to pursue an Agenda, and economics be damned.)

So. If you were going to hold down costs related to health care, you'd look at two places - the health care providers and the health care recipients. Now in an actual competitive business environment, you can't consider the health care recipients as a "cost", since they are the consumers - the source of revenue. But in a health care monopoly run by "government", health care recipients are a cost driver, not a revenue source. How do you lower costs associated with health care recipients? Easy: You want them to be healthy; you don't want them using the health care services. In a health care monopoly, how do you accomplish that? Two potential ways.

1) Raise the price of items, services, and activities that you deem "health-averse". Or mandate against (i.e. ban) items, services, and activities that you deem "health-averse". This would be anything from fast food (too fattening, leads to obesity, increasing the need for health care) to motorcycles (too dangerous, no seatbelts, higher incidence of accidents, increasing the need for health care) Since the health care monopoly is run by the same "government" that can pass laws banning such items (or heavily taxing "health-averse" items, services, and activities, making them so expensive as to essentially remove the consumer market for same), this course of action should be of primary importance. All you need to do is make a list of characteristics exhibited by habitual health-care users, then make a list of items, services, and activities that contribute (in one form or other) to said characteristics. Ban or heavily tax such items. Which leads to the second way to lower costs related to health care recipients...

2) Note that elderly adults are disproportionately disposed to need health care, and at a typically higher-level (read: more costly) version of health care than their less-senior counterparts. Ergo, advanced aging is bad, and should be discouraged. Since outright murder of elderly citizens is not politically efficient, in practical terms "discouraging aging" means withholding (or making so costly as to effectively prevent the use of) health care for certain "high-risk" health care recipients, the elderly being among those considered "high-risk". Also, diabetics, AIDS patients, and preemie (the so-called "Million Dollar") babies.

To summarize: a health care monopoly run by "government" is one predisposed to pick winners and losers (those who can receive a modicum of health care, and those who cannot, respectively). Winners being young, healthy, wealthy, and/or risk-averse citizens. Losers being elderly, chronically ill, low-to-moderate income, and/or thrill-seeking citizens.

A modest proposal? A brave new world? No. Look no further than the first paragraph of this AP article:

Smoking takes years off your life and adds dollars to the cost of health care. Yet nonsmokers cost society money, too -- by living longer.

Not such a funny story is it?

UPDATE:
Heh. Hannity and British MEP Daniel Hannan discuss the topic. The Brit knows whereof he speaks.