The issue isn’t whether “death panels” are a rational criticism of Obama’s health plan, or merely a paranoid hallucination. The issue is whether you want government to have a monopoly power over the practice of medical care. Thinking about end of life issues is painful, both in the abstract and to people whose loved ones have already been through it. It’s hard enough to deal with the trauma, grief, other complex emotions and, at times, health insurance or funding issues regarding the end of life. Now imagine a government body with monopoly power over all that goes on in health care, including at the end of life, totally in charge of deciding what will happen. Maybe the people on that government body will be reasonable, or maybe they won’t. Maybe you’ll agree with them, or maybe you won’t–either way, you will abide by their judgments. The point is: The government health care boards will have the power of the police. They will have the power of the army. You have no say in the matter. You have nowhere else to turn. To some extent, I recognize we already have elements of this with health care as we know it. But insurance companies do not have the power of the police. We need to have a totally deregulated market for health care and medical insurance, and until or unless that happens, we’re all going to feel at least a little bit trapped or enslaved. But handing everything over to the government is the absolutely worst thing to do, and the worst way imaginable to address the present problems. Think of what our politicians are proposing: “It’s true that 90 percent of you are covered. But you could lose that coverage in a heartbeat. So we have to outlaw all insurance except government insurance.” Now, they deny they’re going to shut down the private marketplace, but this is absolutely what giving everyone a medical plan by birthright will do. The hampered and regulated private sector cannot compete with a “free” government plan. It might take a few years, but private insurance (and fee-for-service) will all disappear. In the end, the government will probably just outlaw it anyway, once we give them the green light for everything else. So before you sign on to any health care bill other than one of deregulation, and opening up the marketplace for medical care as it’s already open for iPhones, make sure you really want Uncle Sam to be the health care provider of first, last — and only — resort. This is what “monopoly” means.