Medicare Meets Mephistopheles

Let’s say you’re the devil, and you want to corrupt the American republic. How would you go about it? According to David Hyman, you might create something like Medicare, the federal health care program for the elderly.

Hyman submits that Medicare may be the greatest trick the devil ever played. Medicare feeds on the avarice of doctors and other providers, turns seniors into health care gluttons, and makes regions of the United States green with envy over the dollars showered on other regions. The program exploits the sloth of government officials to increase the tax burden on workers and drag down the quality of care for seniors. Medicare makes Democrats lust for socialized medicine, while its imperviousness to reform makes Republicans angrier and angrier. Most of all, Medicare allows its ideological supporters to bleat and preen their way to the heights of moral vanity.

In the style of C.S. Lewis’ The Screwtape Letters, Hyman writes that Medicare has “freed the self‐​interest of these mortals from its natural restraints. As a result, the seven deadly sins have blossomed.”

With epic political battles over Medicare and the future of limited government looming just over the horizon, Hyman uses satire to cast a critical eye on this mediocre government program.

David A. Hyman is an adjunct scholar at the Cato Institute and a professor of law and medicine at the University of Illinois. Hyman serves on the editorial board of the American Journal of Law & Medicine.

“In a provocative and penetrating satire, David Hyman trenchantly argues that Medicare was flawed from its inception in a devilish plot to ‘corrupt the American Republic’ and plunge the country into ruin. Hyman’s bracing critique reflects the fact that neither Medicare’s problems nor the ascendancy of market‐​based approaches to solving them can be ignored any longer. Anyone interested in provocative (not to mention satanic) commentary will devour Hyman’s monograph. Hyman has a lively and engaging style that he uses to raise perceptive and important questions about health policy.”
— PETER D. JACOBSON, J.D., M.P.H writing in the New England Journal of Medicine

“There is no arguing with Hyman’s facts or first‐​pass explanations for the phenomena he describes. Nearly all of the key teaching points about Medicare’s history, politics, structure, and vulnerabilities are laid out clearly and concisely. The author’s considerable wit and charm are on full display, making the book a fun as well as an informative read.”
— WILLLIAM M. SAGE, Health Affairs

“I’d happily recommend [the book] to anyone with a basic grasp on health care and a desire to learn a bit more about Medicare. Hyman is a felicitous and fun writer, and he conveys an impressive amount of history and data in as accessible and absorbable a manner as one could hope. I know how tricky it is to make health care a quick and gripping read, and I tip my hat to anyone who is capable of enriching the debate and educating readers by doing so.”
— EZRA KLEIN, The American Prospect