If government gains a foothold in health care, mission creep could put more and more at risk

Two words, strangely missing from the health care debate, deserve a place.

The words are "mission creep."

Few enactments escape the reach of mission creep, the tendency of small, modestly priced and limited government programs to grow, over time, into expensive, wasteful, far-raching and instrusive programs that bust budgets snd rain unintended consequences on citizen-victims.

The Korean War, the U.S. military adventure in Somalia, and the Afghanistan and Iraq wars are leading military examples of mission creep. But the phenomenon has spread throughout the universe in which congressional legislation plays a role.

The Community Reinvestment Act, enacted during the Carter Administration in the 1970s, was a response to a court order designed to make more low income people eligible for home ownership. Over time, the CRA led to prolonged low-interest-rate schemes by the Federal Reserve and the creation of Freddie Mac and Fannie Mae. In the hands of Democrat social engineers, Freddie and Fannie stood traditional economics on its head by destroying the gatekeeper function of local lenders.

Before Freddie and Fannie came on the scene, local lenders had to scrutinize the viability of borrowers to safeguard their own institutions. With Freddie and Fannie on hand, those lenders no longer faced any risk. They could immediately offload new mortgages to Freddie and Fannie.

The new system not only eliminated local risk, but encouraged recklessness because the more mortgages the lender wrote, the more money the lender would make.

Meanwhile, Freddie and Fannie sold the mortgages to investment banks, which bundled and sold them to big investors throughout the world.

When the mortgage defaults began to swell, the financial industry entered its meltdown phase, eventually taking down the economy.

Now, the Obama administration is campaigning for what seems to be a simple tightening up of the health care system. But his past statements indicate that he favors an eventual single-payer provider of health insurance.

More ominously, Obama's director of the Office of Management and Budget, has as an advisor Ezekiel Emanuel, a brother of White House Chief of Staff Rahm Emanuel.

Dr. Emanuel is a fellow at the Hastings Center, a bioethics research center, that has published articles and books on the patient's right to die, as well as promoted "Assisted Dying" policy as a component of healthcare reform.

Dr. Emanuel's June 2008 article in the Journal of the American Medical Association criticized the Hippocratic Oath as an unwelcome "imperative [for physicians] to do everything for the patient regardless of cost or effect on others."

In the article, titled "The Perfect Storm of Overutilization," he instead encourages a "move toward more socially sustainable, cost-effective care."

This philosophy of "socially sustainable care" for older Americans is reflected in nine pages of the bill devoted to a description of a new Medicare benefit: 'Advance Care Planning Consultation.'"

In other words, the fox already is inside the chicken shack.

As of now, the government has no say in how doctors practice medicine. That matter is up to patients, doctors and insurers.

Under any likely health care reform, however, that is likely to change. Once government seizes some control of the health care system, mission creep would come into play.

Bit by bit, it is reasonable to assume that the worst expectations of government medicine - rationed treatment, evaluations of patient worthiness, etc. - would become standard features of American health care.

Bear that in mind as Obama and his social engineers emphasize the limited scope of their project.