When you boil off all the frothy rhetoric, what health reform is really all about is a power grab. It is 16 percent of the national economy and $2.7 trillion in annual spending. It is the biggest opportunity politicians and their cronies have ever seen for enriching themselves.

For a sneak peak at what lies ahead, look at the city where Barack Obama cut his teeth first as a community organizer then as a state legislator, then as U.S. Senator: Chicago. Extortion, bribery, back scratching, and nepotism are all coins of the realm in Chicago. It’s how business gets done.

It’s been going on since the days of Al Capone and isn’t much better today. Except today it isn’t confined to bootleg whiskey, prostitution and the numbers racket. No, today it involves hospital construction, the state Medicaid program, and other areas that have yet to be exposed.

Take Medicaid, the federal/state program to provide health care coverage to the poor. In 2005, Illinois Governor Rod Blagojevich decided to take personal credit for the program as his re-election campaign was gearing up. So he used state funds to send a letter to each of 236,000 recipients explaining how glad he was that he was able to help them in their time of need.

The gambit worked so well that two years later he decided to expand Medicaid to an additional 717,000 people at a cost of $463 million.  The state legislature decided the state couldn’t afford it and voted it down, so he used his “executive authority” to do it anyway.

Medicaid is a good way to garner votes, but what good are votes if you can’t get any money out of it? People on Medicaid don’t have the money to enrich a politician. That kind of dough has to come from people with business interests before the state. Not to worry. As governor, Mr. Blagojevich had the power to appoint all the members of the state’s Health Facilities Planning Board, which must authorize any new services a hospital or nursing home would like to provide to the community.

In 2004, Edward Hospital in Naperville wanted to build another facility in Plainfield, but it was required to get approval from the state planning board. A member of the board told hospital CEO Pam Davis that the request would be denied unless she agreed to hire a specific company for the construction work. She alerted federal authorities and ended up wearing a wire for the FBI to gain evidence of the extortion.

The man she taped, Stuart Levine, was convicted and imprisoned as a result of the shake-down, but in 2008 the planning board rejected the application anyway, this time ostensibly because rival hospitals objected to have a competitor on their turf.

But also in 2008 Provena Health was approved for a new heart program by the board after it donated $25,000 to the governor’s campaign fund, and Children’s Memorial Hospital was threatened with the withholding of state funds unless the CEO ponied up $50,000 for the campaign fund.

The planning board also approved an application for a new proton-therapy cancer treatment center for Northern Illinois University, but denied one for Central DuPage Hospital. Who knows why? The Chicago Tribune editorialized that the whole process is “a vestige of a command-and control era of health care.”

The planning board was set to expire this year, but the politicians just can’t let go of something that delivers such power to them. So the legislature has not only extended it but expanded it – from five members to nine, all appointed by whoever happens to be governor. The abuses are not confined to the discredited governor Blagojevich, but will continue many years into the future.

It isn’t just Medicaid and health planning that are subject to this kind of corruption in health care. There is state insurance regulation. Which insurance companies get approved and which are denied? There are mandated benefits requiring coverage of certain services. How many campaign donations are required to get a particular service mandated on insurance customers? There is the state employee benefits program. How much money is paid out in bribes to get those contracts?

We are already seeing Chicago-style shenanigans in Washington as deals are cut with special interests to buy their support. What kind of deal did Obama make with PhRMA to secure its promise of a $150 million advertising campaign in support of ObamaCare? What threats were made to the AMA to get them on board?

If a bill passes that will just be the beginning of the corruption. There will be hundreds of commissions, panels, advisors, and thousands of bureaucrats, all with life or death power over private businesses. How well a business pleases its customers will take a back seat to how well it pleases the politicians.

Even beyond outright corruption, the whole premise of controlling the entire health care system from an office in Washington is, as the Chicago Tribune writes, “a vestige of a command-and control era of health care” that fails every time it is tried.

All of the rest of the world and all of the rest of the economy has entered an era of individual empowerment, choice and competition. This is not the time for “standardized” treatment, but customized care, where we each get the treatment that is precisely tailored to our individual needs.

The world of health care is bursting with innovation, both in treatment and in service delivery. This is not the time to slam the breaks on new ideas by imposing old-style bureaucratic influence peddling.

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Greg Scandlen is director of Consumers for Health Care Choices (CHCC), national nonprofit organization devoted to empowering health care consumers to preserve individual freedom and the quality of care in America’s health care system. CHCC is a  project of the Chicago-based Heartland Institute. This article will be posted on Scandlen’s Web site, http://www.chcchoices.org/ Aug. 26, 2009.

image St. Anthony Hospital Chicago, 19th and Marshall, Architect Henry J. Schlacks