Here is the opening:
The essence of a dictator's method is not to write harsh laws and enforce them rigidly. The world's most destructive thugs have wanted something different. They have wanted to impose their wills on a compliant populace using arbitrary power -- power not limited by laws or constitution, but power that was open-ended, ill-defined, and could be expanded based on the whims of the moment.Professor Lewis then proceeds to show how the current ObamaCare health bill gives an unprecedented degree of arbitrary power to bureaucrats to determine what sort of health insurance you may buy and what sort of health care you may receive.
Well-written laws are the enemy of the dictator. As philosopher Ayn Rand put it, "When men are united by ideas, i.e., by explicit principles, there is no room for favors, whims, or arbitrary power: the principles serve as an objective criterion for determining actions and for judging men, whether leaders or members." Laws, properly formulated, are based on principles, and serve to translate those principles into firm criteria for judging particular cases. What a dictator wants is to be free of such principles and to use his power as he wishes.
If you are an employer, you will not escape punishment if a bureaucrat decides that your health plan is not "acceptable" and that you must be fined for your failure to meet his decision. If you are an individual who does not want to purchase full-coverage health insurance, but would rather buy catastrophic insurance that covers hospitalization only, your decision will not be "acceptable" and you may face a government audit and a new tax.(Read the full text of "Arbitrary Power, Dictatorship, and Health Care".)
Do you have a serious disease? Does your doctor wish to readmit you to the hospital? A bureaucrat will decide whether or not you get treatment, based on a statistical analysis of the number of such readmissions by the bureaucrats: "excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the secretary) of discharges for such applicable condition for the applicable period and such hospital" (Sec. 1151).
As Dr. Lewis notes, the current health care debate is not just about health care. It's about basic American freedoms.