Select Page

Medicare for “Y’all” Means Better Deal for Some, Not Others – Commentary

By G. Keith Smith, M.D., Heartland Institute


As more individuals move to freer, less locked-down states (like Oklahoma and Texas, for instance), the number of people saying “y’all” should greatly increase. The federal government, as in the Food and Drug Administration’s (FDA’s) Twitter post on “horse dewormer” (“You are not a horse…. Seriously, y’all. Stop it”), is signaling its attitude toward such people—and our health and safety.

The current overlords have unintentionally provided a glimpse into what socialized medicine will look like. Medicare for All (we’re going to call this Medicare for Y’all here on out), the political version of medical care, will appear no different than denying sufficient monoclonal antibody infusions to individuals in “uncooperative” states. In addition, those in charge will exempt themselves from the political medicine system they would impose on the rest of us, just as they’ve exempted themselves (White House staff, Congress, Postal Union, and probably others) from their recent punitive vaccine mandate.

As we try to uncloak Uncle Sam’s medical scheme, let’s review some history, some examples of laws lawmakers don’t have to follow. It turns out that the federal government has a habit of exempting the “select few” from many of the rules and mandates imposed on its “citizens.”

Social Security/Medicare Exemption

Until about 1983, civilian federal employees were exempt from Social Security taxes. While their exemption was eventually ended, there was no hesitation in providing the exemption in the early days, and this represented a powerful employment recruitment tool for the federal government. While members of Congress pay Medicare taxes, they are not required once they reach age 65 to designate Medicare as their primary insurance. They’ve carved out a special exemption, unavailable to the rest of us, that places Medicare (increasingly shunned by physicians and hospitals) on the backbench.

Obamacare Exemption for Congress

While severe monetary penalties for failure to buy insurance were consequences for the populace at large, Congress members exempted themselves from these same Obamacare penalties. The penalties have been removed for all of us (for now), but clearly, the lawmakers had no intention of complying with what the rest of us had to endure when the Unaffordable Care Act was passed.

Vaccine Mandate Exemption

 The most recent and blatant example of “yes for thee, not for me,” is the Occupational Safety and Health Administration (OSHA)-enforced vaccine mandate decreed by the current occupant of the Oval Office. The mandate does not apply to the White House staff or members of Congress and their staff. When the postal workers’ union bowed up, they received an exemption. This would be laughable if the consequences of non-compliance were trivial, but no tyrant worth his salt would threaten his subjects with a feather. The $14,000-per-violation penalty has the attention of employers nationwide, many of whom are hoping the legal resources of their state governments can derail this federal invasion, an invasion from which the ruling class is exempted.

Public Health Rules

Disturbing as federal intrusions into all aspects of our lives might be, even more galling are the exemptions our overlords grant themselves to the rules inflicted on the rest of us. Exemptions that predate and encompass the pandemic timeline portend more to come.

Increasingly we see the “us” and “them” display, where rules are conspicuously violated by those who make the rules. A governor dining at the French Laundry during the height of the California lockdown; the husband of a governor on a boating excursion when all boating activities were banned for anyone else who lived in Michigan; a confiscatory tax plan supported by a president who may very well owe $500,000 in back taxes. While the mask-less display at the Emmy awards was hypocritical, the exemptions lawmakers routinely provide for themselves are tyrannical. Indeed, the government commits crimes (robbery by taxation and inflation, murder by drone, counterfeiting by Federal Reserve) every day, the committing of which would land any individual in jail, but the explicit exemption of the shafters from the laws the shaftees must obey defies any concept of the rule of law.

When my father asked the late Walter Williams years ago whether state actors were stupid or evil, he responded, “both.” However, state actors can’t effectively hide behind stupid or the “law of unintended consequences” when they explicitly shield themselves from the same consequences they inflict on the rest of us. I have no doubt that the past and current conduct of federal officials portends future legislative meddling in our medical affairs, the non-compliance with which will hold no consequences for those who run the predator state.

“Medicare for All” is what they will call it. I say we call it “Medicare for Y’all,” as it is meant for us, not for them.


G. Keith Smith, M.D. is the medical director, CEO, and managing partner of The Surgery Center of Oklahoma, and a member of the Association of American Physicians and Surgeons.