The following “report” is fictional. It is intended to paint a picture of the world that could one day exist if ObamaCare becomes law. Once a system is created that requires the Federal Government to pay for care for everyone, cost will eventually become the only relevant concern. There will be only two general ways to control costs. On the treatment side, choices will need to be made over what care is given, and to whom (rationing). Barring rationing, the only remaining cost-control measure will be to avoid adding people to the “treatment” pool, which means keeping them healthy. This is called prevention. Even though preventative ‘care’ can be mandated, people are free to discard or ignore such advice. If people refuse to heed calls to eat better, exercise more, eat less or what have you, then they become part of the treatment burden. So, measures to ‘ensure’ that people heed the preventative advice being offered will be required. Such measures are already being mentioned in Washington; i.e. the ’snack tax’.

How might this all unfold?
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October 4, 2027 New York State

A spokesperson for the National Prevention and Good Health Administration (NPGA) stated today that federal agents raided an illegal sugar refinery and confectionary in upstate New York and seized a reported 3000 tons of raw materials used in the production of candy bars, sodas and other snack foods long illegal in the United States. “This is a huge bust for us”, an NPGA agent was quoted as saying. “The street value alone is measured in billions of dollars and the estimated impact on the obesity index is enormous. We estimate that this seizure saves over 3 million people from potential obesity related eating”. The Obama administration quickly held a press conference claiming credit for the bust and citing this as evidence Mr. Obama should be elected to a 5th term in November so that he may continue his much needed work of ‘healing’ America. Mr. Obama has long been dogged by the legacy of his 2011 Health Care Reform Bill– so called “The Healing America Act”. The administration was quick to argue that Mr. Obama’s vision for a healthy and disease-free America is the vision that will finally enable us to control spiraling health care costs and improve the lives of all Americans. “This is a major seizure and is evidence that there is more work to be done in controlling the vices which are poisoning Americans and leading to an unhealthy population”, The White House said. “Mr. Obama deserves re-election next month so that his good work can continue.”.

Mr. Obama has faced a particularly difficult re-election campaign this time around. Largely seen as unbeatable since his successful repeal of the 22nd Amendment in 2015, Mr. Obama has come under increasing pressure from The newly re-invigorated Republican Party now composed predominately of the ‘Mafia’ faction. That organized crime syndicates have been so successful at legitimizing themselves is largely a consequence of the enormous money they have made in trafficking and creating “snack foods” since they were made illegal under the 2013 Preventative Health Acts. Initial arguments that such acts would lead to increased consumption of junk food and increased crime associated with procuring such foods were initially called reactionary. Now however, the parallels to Prohibition when enacted as the 18th amendment in 1919 are widely considered to be quite prescient and visionary. At that time Mafia groups had limited their activities to gambling and thievery until 1920, when organized bootlegging manifested in response to the effect of Prohibition. A profitable, often violent, black market for alcohol flourished. Powerful gangs corrupted law enforcement agencies, leading to Racketeering. Stronger liquor surged in popularity because its potency made it more profitable to smuggle. Exactly the same scenario unfolded from 2013 through the middle years of the 2020’s as the Mafia began to understand the enormous dollars and power to be had with helping people to circumvent the Preventative Health Acts.

The ‘Mafia’ movement has become a serious challenge to Mr. Obama and ObamaCare as the President has signaled in recent months that perhaps the ever-increasing Government regulation of all things related to unhealthy living is untenable. The Mafia movement senses a genuine threat to their cash flow if Mr. Obama succeeds in limiting the government’s role in regulating behavior. The national Mafia Party Spokesman was recently quoted as saying that “we think government has not gone far enough. There is so much more to regulate. We got virtual reality headsets and the whole internet thing just poisoning kids. There is alot of money for us to be made in managing those things if they were illegal and we strongly advocate for an expansion of the Preventative Health Acts, not limiting or repealing them”. Mr. Obama is struggling to manage this threat from his left coming as it does from the Republicans, long considered to be advocates of smaller government.

The road to a possible historic 5th term for Mr. Obama has been long and he has suffered many slowdowns along the way. The first black President has long desired to outdo the great Democrat FDR and his 4 terms in office. Mr. Obama’s initial success at passing HCR in 2011 catapulted him to a 2nd term with overwhelming majorities in both the House and Senate. Almost immediately however, the costs of the program soared and exceeded 10 year expectations in a little under 18 months, making the Medicare cost overruns from 1968-1973 look trivial. Faced with stiff resistance to additional rationing for those already sick, Mr. Obama instead turned his attention to enforcing the preventative advice being dispensed by Doctors. Doctors, by then reduced to little more than conduits for government care policies and prevention ideas were warm to the idea that someone could compel their patients to follow advice. The 2013 Preventative Medicine Acts (PMA’s) imposed huge taxes and fines on myriad activities thought to be harmful to a persons health. Snack foods and their ingredients were taxed and the ’snack food’ industry collapsed overnight. Mr. Obama again carried a huge mandate for change. His argument then was that our Crisis in Health Care was much deeper than we had appreciated in 2008 and the PMA’s were needed to help control costs. That success allowed him to martial enough support to repeal the 22nd amendment and Mr. Obama handily won a 3rd term in the White House in the 2016 election.

Unfortunately it was clear almost immediately that taxes were not enough to stem the tide of evil from causing ill health and disease. Mr. Obama expanded the PMA in 2019 and imposed very harsh, some said even draconian penalties for eating snack foods and engaging in unsafe behavior. The three strikes law for felons was expanded to include violations of the PMA and anyone found guilty of 3 eating or behavior related offenses was sentenced to a minimum of 2 years in what many called “ObamaCamps”. Ostensibly billed as ‘health retreats’ where people could learn the virtues and importance of good preventative behavior, many former ‘campers’ described these places as nothing more than forced-starvation work camps where people were starved until they attained a BMI of less than 25 and signed a promissory note to not re-establish poor habits in the future. “These people signed their life away”, one Republican noted in 2021. These camps were eventually expanded when in 2023 the PMA was again re-written to give the newly created National Prevention and Good Health Administration (NPGA) sweeping powers to forcibly remove children from homes considered “unhealthy” and likely to be contributing to the ill-health of their children. These children were placed into federal foster custody and forced onto a strict diet and exercise program intended to instill good preventative mores. The program was considered so successful that many believe it contributed to Mr. Obama winning a 4th term in the White House in 2024.

Many doctors were still confused though as to why they were still seeing so much obesity and sickness. The AMA stated that it was “almost as if people were actually still eating junk food”. The AMA and the NPGA began a controversial joint program to hand out to patients ‘ObamaBars’; nutritional food supplements that were intended to contribute to the healthy living deemed so important for good preventative health. Doctors were paid thousands of dollars to give these ObamaBars to their patients but many felt that there was no effective way of ensuring that patients actually ate those bars. Although some called for home monitoring and stiff deportation laws for people found not to be eating them, such measures were never enacted thanks to organized opposition from a weakened Republican Party. There have since been numerous, but always unsubstantiated reports of huge piles of discarded ObamaBars in various places in the US. No photos exist of these, but one person who wished to remain anonymous out of fear of reprisal by the NPGA and the Prevention Police said that “it was like a wasteland man, miles and miles of unopened ObamaBars, it was amazing and sad to see”. There have been scattered videos documenting people trading jewelry, deeds to their homes and even selling themselves like prostitutes to ‘Mafia’ members just so that they could get rid of the ObamaBars and instead have a good old-fashioned Snickers bar. Street trade or second-hand sale of ObamaBars was made illegal under the PMA in 2024.

It is now widely believed that the Mafia gained much of their political clout from the dollars associated with these transactions. Indeed, one Mafia insider called the ObamaBar “the greatest thing since Prohibition and the Preventative Medicine Acts better that the Volstead Acts!!”.

Today’s raid and seizure in New York therefore is seen as a mixed blessing for Mr. Obama. His re-election prospects are looking increasingly uncertain. He has been arguing for years now that American Preventative Health Care is in crisis. Costs are spiraling up, people are fatter and less healthy than ever and the Government needs to do more to encourage people to be healthier. These arguments are similar to the ones he used twenty years before during the great HCR debates at the turn of the century but are now ringing hollow. Indeed, Obama insiders readily acknowledge that the increasing trend of making foodstuffs and behaviors illegal is not only a huge drain on resources (the NPGA consumes over 60% of the Federal Budget) but also a big enabler of the Mafia Party, a direct threat to the Obama Presidency. Some have called for a scaling back of the NPGA and a downsizing of the Enforcement Police. Legislation being considered by Congressional Democrats, especially the Prevention wing (very similar to the Temperance wing of the 1910’s), would extend the PMA laws to include things such as excessive dancing, too many hours spent working and adding penalties for those believed to be not reading enough to stave off age related cognitive disorders such as Alzheimers. Democrats say that such measures are their best hope of defeating the Mafia insurgency and challenge to the President.

In what could be considered an ‘October Surprise’, an underground video has surfaced showing what appears to be a black market in the trading of children. Ever fearful that the government would impose huge taxes and penalties on families with slightly obese children, parents have been seen ‘trading’ their slightly overweight children for much slimmer, svelte ones.

If true, this could spell the Endgame for Mr. Obama and his vision of ObamaCare. For now, the debate continues over how to force people to live well, eat well and prevent disease. Without such measures, costs of treatment for the sick and infirm will threaten to consume all available discretionary dollars and bankrupt the nation. Recently, a Republican from the ‘Old School’ Wing of the party recently reminded all of us about the lessons learned over 100 years ago when we attempted to ban alcohol completely from the public stage.

He said that by the end of Prohibition, some supporters openly admitted its failure. A quote from a letter, written in 1932 by wealthy industrialist John D. Rockefeller, Jr., states:

When Prohibition was introduced, I hoped that it would be widely supported by public opinion and the day would soon come when the evil effects of alcohol would be recognized. I have slowly and reluctantly come to believe that this has not been the result. Instead, drinking has generally increased; the speakeasy has replaced the saloon; a vast army of lawbreakers has appeared; many of our best citizens have openly ignored Prohibition; respect for the law has been greatly lessened; and crime has increased to a level never seen before.

Perhaps this is the lesson we should take into next month’s election.