According to Rush Limbaugh, the health care reform that may be passed by Congress is that terrifying word: 'socialism'. Yet, it bears a striking resemblance to the universal healthcare system that just treated him in Hawaii that prompted his remark: "there is nothing wrong with the American health care system. I received no special treatment."

Yes, Rush. That's the point! American medicine is superb--for those who can get it. And, in Hawaii, no one gets special treatment, because everyone can get it.

[Er, by the way, just to help you out, Rush, a fair percentage of your listeners do not seem to know Hawaii is part of the United States, so clarify that for them...otherwise, they will wonder about you]

By accepting socialist medical treatment in Hawaii, therefore, Rush Limbaugh has shown that, when one is ill, what matters is the availability of quality health care, even if it is socialist.

Rush follows a long litany of conservatives, such as all Members of Congress that have a medical office paid for by taxpayers available in the Capitol, by Dick Cheney who had socialist pacemakers implanted paid for by the government, and George W who had a government-paid socialist colonoscopy while in office. Members of Congress over 65 get single-payer socialist medical care from Medicare.

Hawaii has had nearly-universal employer-mandated health insurance since 1974. Although its Pacific Island location makes the costs of everything--from gasoline to milk to ice cream to housing--the highest in the nation, health care premiums in Hawaii, for comprehensive care with small co-pays and deductibles, are nearly the lowest and their costs per medicare beneficiary are the lowest in the nation.

Why? There are a variety of reasons, most traceable to universality. With everyone covered by primary care, emergency room visits tend to be for real emergencies, not the non-emergent care mainland ERs dispense for people without coverage. That reduces the costs of ERs and the costs of non-emergent medicine since patients can be handled less expensively and more effectively by their primary doctors. Hospitals have not overbuilt, acquiring expensive machines to compete with their neighbors for patients. Insurance companies have instituted screening and other measures to improve wellness among their covered populations.

We can all be pleased that Rush appears to have survived his encounter with socialist medical care. He seems to be very happy himself, commenting on the results of a socialist angiogram that showed no disease in the arteries that feed his heart muscle.

Now, of course, Rush does not live in Hawaii and so his costs are not covered by the Hawaiian insurance system, but having that "socialist" system for more than 3 decades now has not reduced the quality of the care he received in the slightest. Who would have thunk it!

If Hawaii-style medical care is good enough for Rush Limbaugh, it is good enough for me.

Thanks Rush, and with it my hopes that your medical insurance covers all your costs and that the greatest country in the world can make that same care available to everyone.

Happy New Year! –Dr. Paul Abrams