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Medicare for Y’all: Rules For Thee But Not For Me

By G. Keith Smith, M.D.

October 7, 2021

It turns out that the federal government has a habit of exempting the “select few” from many of the rules and mandates imposed on its “citizens.”

As more individuals move to freer, less locked-down states (like Oklahoma and Texas, for instance), the number of people saying “y’all” should greatly increase. The federal government, as in the Food and Drug Administration’s (FDA’s) Twitter post on “horse dewormer” (“You are not a horse…. Seriously, y’all. Stop it,”) is signaling its attitude toward such people, our health and safety.

The current bureaucrats have unintentionally provided a glimpse into what socialized medicine will look like. Medicare for All (we’re going to call this Medicare for Y’all here on out), the political version of medical care, will appear no different than denying sufficient monoclonal antibody infusions to individuals in “uncooperative” states. In addition, those in charge will exempt themselves from the political medicine system they would impose on the rest of us, just as they’ve exempted themselves (White House staff, Congress, Postal Union and probably others) from their recent punitive vaccine mandate.

As we try to uncloak Uncle Sam’s medical scheme, let’s review some history, some examples of laws lawmakers don’t have to follow. It turns out that the federal government has a habit of exempting the “select few” from many of the rules and mandates imposed on its “citizens.”

Social Security/Medicare Exemption: Until about 1983, civilian federal employees were exempt from Social Security taxes. While their exemption was eventually ended, there was no hesitation in providing the exemption in the early days, and this represented a powerful employment recruitment tool for the federal government. While members of Congress pay Medicare taxes, they are not required once they reach age 65 to designate Medicare as their primary insurance. They’ve carved out a special exemption, unavailable to the rest of us, that places Medicare (increasingly shunned by physicians and hospitals) on the back bench.

Obamacare Exemption for Congress: While severe monetary penalties for failure to buy insurance were consequences for the populace at large, Congress members exempted themselves from these same Obamacare penalties. The penalties have been removed for all of us (for now), but clearly the lawmakers had no intention of complying with what the rest of us had to endure when the Unaffordable Care Act was passed.

Vaccine Mandate Exemption: The most recent and blatant example of “yes for thee, not for me,” is the Occupational Safety and Health Administration (OSHA)-enforced vaccine mandate decreed by the current occupant of the Oval Office. The mandate does not apply to the White House staff or members of Congress and their staff. When the postal workers’ union bowed up, they received an exemption. This would be laughable if the consequences of non-compliance were trivial, but no tyrant worth his salt would threaten his subjects with a feather. The $14,000-per-violation penalty has the attention of employers nationwide, many of whom are hoping the legal resources of their state governments can derail this federal invasion, an invasion from which the ruling class is exempted.

Public Health Rules: Disturbing as federal intrusions into all aspects of our lives might be, even more galling are the exemptions these bureaucrats grant themselves to the rules inflicted on the rest of us. Exemptions that predate and encompass the pandemic timeline portend more to come.

Increasingly we see the “us” and “them” display, where rules are conspicuously violated by those who make the rules. A governor dining at the French Laundry during the height of the California lockdown; the husband of a governor on a boating excursion when all boating activities were banned for anyone else who lived in Michigan; a confiscatory tax plan supported by a president who may very well owe $500,000 in back taxes. While the mask-less display at the Emmy awards was hypocritical, the exemptions lawmakers routinely provide for themselves are tyrannical. Indeed, government commits crimes (robbery by taxation and inflation, murder by drone, counterfeiting by Federal Reserve) every day, the committing of which would land any individual in jail, but the explicit exemption of the shafters from the laws the shaftees must obey defies any concept of the rule of law.

When my father asked the late Walter Williams years ago whether state actors were stupid or evil, he responded, “both.” However, state actors can’t effectively hide behind stupid or the “law of unintended consequences” when they explicitly shield themselves from the same consequences they inflict on the rest of us. I have no doubt that the past and current conduct of federal officials portends future legislative meddling in our medical affairs, the non-compliance with which will hold no consequences for those who run the predator state.

“Medicare for All” is what they will call it. I say we call it “Medicare for Y’all,” as it is meant for us, not for them.

About The Author:
Dr. G. Keith Smith has been a board certified anesthesiologist in private practice since 1990. In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Oklahoma, owned by over 90 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice.

In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention. Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available. His most recent effort is the launch of the Free Market Medical Association which provides a platform where those seeking to obtain high quality and affordable health care can find free market-minded providers, both physicians and facilities.

Operation of this free market medical practice, the standard for all who have embraced this practice approach, has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith's pricing model resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs and improve quality of care for all.

He has made appearances on the John Stossel Show, CNBC, Huffington Post, The O'Reilly Factor, Capital Account, The Ron Paul Channel, NBC Nightly News and has been featured by Reason Magazine's TV division. The New York Times, Time Magazine, ABC news, Forbes and many others have written articles featuring Dr. Smith's revolutionary approach to the pricing of healthcare and uncompromising free market principles.

Dr. Smith resides in Oklahoma City, Oklahoma and his direct email is and website:

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