Rationing heath care is first achieved by progressively cutting the money paid to the principal providers of the health care, especially the physicians. We have seen this happen with both Medicaid and Medicare. With each cut, some physicians will elect to opt out of the health care plan, as they can no longer afford to provide the services needed by the patients in the plan, pay their employees, and keep their doors open for business.

The decreasing numbers of physicians participating in the health care plan makes it more difficult for the patients in the plan to make appointments with physicians. In many towns and small cities there are currently no physicians who will accept appointments with Medicaid or Medicare patients.

Malpractice litigation is another effective way of rationing care. Unwarranted malpractice cases have driven many physicians, especially obstetricians, from their small rural practices. Many women must travel far for obstetrical care and the delivery of their babies.

The poor, elderly, racial minorities, rural residents, and veterans are the first to experience the full brunt of the rationing. They can often not afford to seek other sources of health care.

Rationing is increased to allow the diversion of more funds to the bureaucrats administering the plan. The bureaucrats use the money intended for health care to expand their own ranks and to increase their importance in their health care plan. Managers and bureaucrats soon outnumber the health care providers. Management and bureaucracy usurp an ever-increasing proportion of health care funds.

The medical bureaucracy of the health care plan creates extremely complex problems. These problems require more bureaucrats and ever increasing numbers of regulations. This is the secret of socialism. It is a self-perpetuating process.

Regulations replace the free market. Physicians and other health care providers are buried under paperwork, red tape, and bureaucratic regulation.

The next time you are in a hospital, notice how nursing personnel spend almost all of their time at the nursing station documenting patient care in charts and almost no time delivering care and comfort to the patients. The bureaucracy judges nursing care by the records the nurses keep. Individuals with far less training deliver most of the direct patient care. I am of the opinion that this is the source of many health care problems. This is a major change in the delivery of nursing care from the time I was in medical school.

The demand for health care from the plan always exceeds the projected costs. Patients demand more care when they perceive that the price of the health care is low. There are no human limits to health care “need.” With increasing demand, the rationing of health care services becomes the primary goal of the health care bureaucracy.

A government-run health care plan increases health care costs, reduces health care quality, and rations health care services. Monetary and criminal penalties are added to insure compliance with the plan and the expansion of the rationing.

The bureaucratic solution for physicians not participating in the plan is universal health care coverage, which will force all patients and physicians to participate in the plan. As little is effectively being done to halt the progression of socialized medicine, its eventual implementation  is all but assured.

Medicare Part D, pushed into place by otherwise conservative capitalistic Republicans, added the largest socialist medical plan ever.

By the time patients and physicians both began to experience progressively decreasing levels of satisfaction with socialized medicine, it was already too late. The social health care plan and bureaucratic job security are what really matters, and both are already firmly in place.

There has been little courage on the part of physicians or politicians to reverse the process. As long as voters do not understand that government is the problem and not the solution, health care quality will continue to deteriorate and costs will continue to rise.