The U.S. Preventive Task Force caused quite a stir recently when they revised their recommendations on the frequency and age for women to get mammograms. Many have speculated on the timing for this government-funded report, with the Senate vote on health care looming, and cost estimates being watched closely. Just the hint that the government would risk women’s health to cut costs is causing outrage on both sides of the aisle.

Even the administration is alarmed at its own panel’s recommendation. One official, the Secretary of Health and Human Services, Kathleen Sebelius told women to ignore the new guidelines, keep doing what they are doing and make the best decisions for themselves after consulting with their doctors.

This sounds like an excellent idea to me. As a physician myself, I understand the importance of ensuring that patients are able to consult their doctors and make their own decisions without interference from government bureaucrats or government-favored corporations.

However, I am confused by the administration’s reasoning and apparent change of heart. Have they reversed their position on healthcare reform and now decided that patients and doctors should be in control of individual healthcare decisions? Or are they still in the healthcare central planning business?

The healthcare reform plans currently aim to empower Congress to dictate to insurers minimal standards of coverage. Those government standards will ultimately be determined by politicians and bureaucrats, not individual patients and doctors.

It is naive to think that recommendations by an authoritative government panel will never be used to deny services to people that want them. It is sad to think that people will be forced to spend their hard-earned money for a one-size fits all, government mandated healthcare delivery model, but then have to scrape together additional funds to pay out of pocket for healthcare they really want or need – that is, if the government allows them to at all.

After all, the federal government currently forbids Medicare beneficiaries from spending their own money on services covered by Medicare, if for whatever reason they need to. Why wouldn’t the government eventually apply these kinds of restrictions to everyone, if they are successful with this takeover? Beware of the supposed gifts offered to you by government, for when it gives you things with one hand, the other hand takes away your liberty and independence.

It remains to be seen what provisions will be in the final bill. We do know we have no funds to pay for it except for debt and money printed out of thin air. We know that the nation’s creditors are getting very nervous about the government’s continuous spending sprees and bailouts. We know this healthcare bill, like all government programs, will be expensive.

There will be a day of reckoning when the credit stops and the bills for all this spending come due. When that day comes and politicians and bureaucrats have to deal with reality, it will be very uncomfortable to find yourself in their liability column, which is where healthcare reform will put many more Americans.

Easier said, but it can be done.  It starts with the new CEO of the Federal Government, the President, telling all those who work for the Executive Branch there will be no more hiring, except for the military.  That means when people die or retire, they will not be replaced by anyone from the outside.  If necessary to replace them, it will be from people already working in other departments of the government, like musical chairs.  That is when you will see impending shrinkage of the bureaucracy.

In addition to that, you eliminate the Cabinet Departments by telling them they may neither hire nor replace at all, ever again, for certain, and if done, heads will roll. Each Cabinet chief comes into the administration for the sole purpose of eliminating the department in, say, four years.  The result is departments will ultimately disappear and have to share necessary functions, if there are any, with the states until they are out of the loop.  This is kind of a Tenth Amendment thing, gradually accomplished by deaths and retirements, and no replacement of those working in the Departments.

Which Departments are we discussing?  Let us begin with the ones we should keep, those organized earliest under our Founding Fathers.  That would be four of the fifteen to remain.  The Departments of Defense (once the War Department), Justice, State and Treasury should stay.  That leaves eleven to eliminate, whose duties are sent back to the people and the states where they belong.

The Departments of Agriculture, Commerce, Education, Energy, Health and Human Services, Homeland Security, Housing and Urban Development, Interior, Labor, Transportation and Veteran’s Affairs.  We should eliminate all of these, perhaps over one Presidential term of four years. The anger at losing these departments, their power and their largesse for special interests, would be so great that the President who carries it off will never get re-elected.

All you have to do is look at the activities of each of those departments and ask yourself if their responsibilities, if even needed, are beyond the capabilities of the people and their states.  In other words, are people at the Federal level more efficient, more in tune with how our nation should work than Americans in a state?  I should not think so!  Basic government is the County, and the states exist to do what is commonly needed by the counties, such as that which they could not do for themselves.  The Federal Government, as it was originally organized, was an association, a union, a confederation of sovereign states that did only what those states were unable to do alone.

The functions acquired by the Federal Government, by adding those departments, took place while the people slept.  If they knew the horrors that would arise as these departments grew and sucked up the people’s private resources, they would have said no.

Look closely at those departments and their functions.  They assume the people and the free market are incapable of discovering the right kinds of energy to use, how best to educate children, or transport goods and people from place to place.  They assume farmers would be lost without the Department of Agriculture, and certainly could not sustain growth if relying only on states or created associations.  Every one of those eleven departments started because politicians believed the people were incapable closer to home.

Some of their functions may have to be shifted to the four remaining departments, such as Homeland Security may have to go totally into the Department of Justice.  Veteran’s Affairs goes to the Defense Department where it belongs.  Much of the rest goes back to the states, and where redundant, they can be eliminated.  This may sound simple and perhaps naïve, because the bureaucrats and politicians who build their personal prosperity on the department programs will scream bloody murder. Further, if the redistribution of income for equal outcome is more important, they will want to keep things as they are.

Once all these functions and programs are shifted closer to the people who vote for those who vote for them, we will see how generous the flow of money.  The Federal Budget will have to be reduced significantly in a manner that leads the way back to the states. The methods of taxing will have to be modified.

It is conceivable that the lower federal take on the income and productivity of private citizens will be so significant as to create a completely new economic boom.  Such a boom will be the fastest way of income redistribution respecting effort and merit, rather than special interest bloc voting.

It is a project long overdue. We know how America runs best, when it worked best and what levels of government are most appropriate. We just need to back up and pare down. I do not know anyone who thinks the Post Office mentality operates any organization better than free people do.

We know our Declaration of Independence qualifies the role of free people and their government, and we know our Federal Constitution, as originally put forth, helped shape the way America functioned organizationally. If that is so, then we need only move back to a time when everything was best. America proved best for all people when compared to all other styles and forms of civil organization.

We know, from our history, government closest to the people works best. When a majority decides how things must run and those elected to do it, people do best. The Cities and Counties are the basic seats of government. Beyond those levels, responsible for the tasks involving everyone in all the cities, counties and even the states, are the State and Federal Governments.

The people-to-people relationships once defined in local charters, state constitutions, and the Federal Constitution and its first ten amendments, suited our needs. Most everything beyond these early charters has been to confuse, disrupt, meddle and dislocate, and to assign to free people a view of their inability to care for themselves.

The growth of Federal Departments, with Cabinet Secretaries, has served to confuse and disrupt duties, which are, for the most part, 10th Amendment functions for the local and state governments, and the people.

We need a State Department to deal with our foreign relations. We need a Defense Department to be responsible for defending our nation. We need a Treasury Department to make certain our monetary relationships are stable. We can even say we need an Interior Department to coordinate relationships between homeland governments. We need a Justice Department to handle federal laws, courts and the FBI.

How can we justify all the other Departments, such as Education, Energy, Housing and Urban Development, Commerce, Labor, Health and Human Services, Transportation and Veteran’s Affairs? Most of their functions ordinarily belong, if at all, to the local governments and the people.

Get rid of the excess Departments and pare the Fed down. All those departments do is duplicate functions of local and state governments, and interfere with them. They contribute nothing to the efficiency or operation of local agencies involved in their responsibilities. Things worked well before they got involved.

The 10th Amendment to the Constitution was right and proper and should be observed.

Ridding the Fed of these Departments removes much of the money-magnets attracting lobbyists and corrupting Representatives, Senators and bureaucrats. A Constitutional Convention called to do this job would invite irreparable harm by special interests and social tinkering. Too many altruistically bent do-gooders out there see themselves as needed elite to manage the affairs of Americans.

Give them a hand in the process and we are back to communalism, socialism and communism, where the representatives of the unwilling and incapable crush the efforts of the doers and builders of a free society. Allow the contents of the Treasury to shape the process, and greed sets the tone. Avoid revocation of Constitutional Amendments, as it would slow the process in getting enough people to accept changes. I speak here of the 16th Amendment, allowing direct taxation, and the 17th Amendment allowing direct election of United States Senators.

To simplify it all, just revoke laws establishing departments and bureaus that have no real value to liberty. It would be an easier task. Only those who now profit from one or another agency will fight when their purses are deprived.

A Party Convention should find and nominate candidates who will pledge to reduce the size and scope of the Federal Government. They would provide voters with a plan and approach to stop all new hiring at the Federal Level, drastically cut the budgets for each Department to be phased out, sending whatever essential functions they have back to the states. They would campaign on returning the Republic back to its best times, keeping whatever changes do not conflict.

It would be a tall order. It would require each candidate to step out and sing the praises of the Republic in its hey-day, not the rewritten historical views of Hollywood and the left.

This would be the approach least encumbered by legal roadblocks, but it would be the program demanding the most courage and commitment on the part of candidates. It would also require control of both Houses of Congress as well as the White House.