I was looking for an appropriate “Night Before Christmas” post and found this instead, a parody I wrote on Christmas Eve in 2009, the very first year of Ethics Alarms, in reaction to the ethically-tainted passage of the “Affordable Care Act,” which didn’t make health care affordable. I knew the bill was smoke and mirrors and that it would not accomplish what it was supposed to do. I knew that we would be in one mess or another as a result of the ugly thing, supposedly the signature legislation of the Obama Administration…and sad thing is that it probably was. What does that tell you?
I was struck, as you will be, how much of my mordant satire seems relevant today, and how little has changed.
So let’s travel back to that halcyon year, and the day before Christmas…
‘Twas the day before Christmas, and in the U.S.
Senate health care reform proved our ethics a mess.
A party line vote on a bill of such scope?
Where’s integrity? Principle? Competence?
Hope?
Not a single Republican willing to bend?
Nor a Democrat rejecting means for the end,
Like mass state exemptions, abortion support,
Constitution defiance (bound for Supreme Court),
Or Medicare cuts so the cost can be paid,
Although no one believes that the cuts will be made?
Why undertake health care reform; why begin it,
If nobody honestly cares what is in it?
Or knows what is in it, since all will admit
They’ve read the staff summaries, maybe, a bit.
It’s all about power; it’s all about spin
“Must “win” for Obama!”
“No! Stick it to him!”
And while bill opponents caused panic with lies
About euthanized seniors and fascism’s rise,
The bill’s young supporters offered sex for persuasion,
Harry Reid thought race-baiting would suit the occasion…
And the media, its objectivity busted,
Cheered one side or the other, and could not be trusted.
It’s not rising health care costs threat’ning this nation
Or who to insure, or how much to ration;
It’s the absence of principle, courage, respect,
And trustworthiness in all those we elect.
But despair not, you ethical women and men!
Let’s try to do better in two-thousand ten!
Staying true to our values will help make things right.
So Merry Christmas to all, and to all, a good night!
Ethics Alarms 
Very prescient. May many good things be in your near future.
One thing… In your intro to the feature you stated, in part, “… it would not accomplish what it was supposed to do.” I disagree– the ACA placed much of the delivery of medical care in the hands of the politicians and their unelected minions. They had no intention of actually reducing the cost of care OR increasing the availability of it.
They never addressed the cost of medical care. Every time the government pays for something, whether its to military contractors, colleges and universities or for healthcare, it gets gouged. Everything that happened after that was predictable.
The pushers of the ACA had to know that costs would rise. I’ve always been of the opinion that they pushed it through anyway so that they could blame greedy health insurance companies and argue that this is why all health care should be so-called single payer.
Why is it, do you think, that so many other first world countries are apparently getting “gouged” a whole lot less than we are, even though some of them have universal health care and we do not?
There is some evidence (life expectancy) these countries are getting better macro-level health outcomes at a lower cost.
An International Comparison of Healthcare Costs
Published Monday 07 July 2025
We all know, of course, that healthcare costs vary widely from country to country. To find out more, I conducted a few searches. Here are the per capita healthcare costs in several countries (data from 2022):
Extraordinary! The US spends 4 times more than Italy? Does that correlate with life expectancy? The short answer is NO! Here are the life expectancy averages for men and women (data from 2023/4):
So, the United States have the highest per capita healthcare costs but ranks lowest in life expectancy. The UK has lower healthcare costs per capita while achieving higher life expectancies. Germany has higher healthcare costs per capita and relatively high life expectancies. France has moderate healthcare costs per capita ($6,400 and $6,600) and higher life expectancies.
Source: https://edzardernst.com/2025/07/an-international-comparison-of-healthcare-costs/
What do I think? I think US mortality rates, as always, are the result of a high risk, ambitious, individualistic, free and particularly stress-oriented and often violent culture that accounts both for what is uniquely good and uniquely bad about the culture. The large (compared to Europe) A-A community lowers those numbers significantly here, and anyway, I wouldn’t trade the privilege of living in the US for a few years at the end of my life.
Well, good that you find the situation acceptable, I guess (?) Personally I would like to see the country be a little lower risk for infants and children, who have higher mortality here than many comparator countries.
That likely has a disproportionate impact on the lower life expectancy numbers, as I believe these are the expectancies at birth.
Not acceptable but better than the alternative.We have a subpopulation with social patholgies that other nations don’t have. Cross-nation comparisons are facile and misleading.