THE "BOLSHEVIK PLOT" THAT IS DESTROYING AMERICAN MEDICINE: "At a time when the movement toward innovative and personalized care is moving forward, care via government control is taking us backwards." .

• Author: Singleton, Marilyn M.
• Position: MEDICINE & HEALTH

DURING the Supreme Court oral arguments in the challenge to the Patient Protection and Affordable Care Act's mandate to purchase health insurance, there was laughter when the late Justice Antonin Scalia asked whether the government could make you buy broccoli. It could never happen, right? Well, the laughable has become reality. A California bill forbids restaurants from serving any beverage other than water or unflavored milk with kiddie meals. As of yet, the meal's purchasers, unlike the restaurant, will not be fined for ordering another beverage for their child.

Shrugging off assertions that PPACA was about control, not care, then-Pres. Barack Obama quipped that his opponents acted like PPACA "was a Bolshevik plot." That supposedly ludicrous plot is embodied in a too-good-to-be-true congressional bill, H.R. 676, the "Expanded and Improved Medicare For All."

Vote-seeking members of Congress have breathed new life into this 2003 creation. With no dollar amounts in sight, the bill gives the government a blank check to exert total control over our medical care.

H.R. 676 provides that all individuals residing in the U.S. showing up at the doctor's office are "presumed to be eligible" for benefits. The Federal government will pay for unlimited "medically necessary" health expenses, including pharmaceuticals, mental health, substance abuse, vision, dental, hearing, and long-term care--with no deductibles or other cost-sharing. Unless a patient opts out, all interactions will be memorialized in a "standardized, confidential electronic patient record system." Yes, those same electronic records that have been hacked and are contributing to physician burnout.

Overseen by regional offices and the presidentially-appointed 15-member National Board of Universal Quality and Access, participating institutions will receive separate monthly fixed sums for capital expenses (e.g., buildings, improvements) and for operating expenses (including physician salaries). Non-salaried physicians can be paid based on a national fee schedule that is "fair and optimal" as decided by the government. Finally, each geographic region would receive a single allotment to cover long-term care.

There are some restrictions. Only public or not-for-profit institutions may participate. Private physicians and clinics can exist, but cannot be investor-owned--and to keep the patients on the reservation, private health insurers are prohibited from selling health insurance coverage that...