My dearest Alexander (whose name means “ruler of men”):
I have been referred to you by one of the most infamous Masters of the Universe, Caligula. By way of introduction, my name is Procrustes, the son of Poseidon and a robber-king in my own right. In mortality I was known to some as “The Subduer” and to others as “The Stretcher”; the first title acknowledges my domination of men, the latter describes the means I employed to achieve it – a method I am happy to share with you.
As ruler of the Sacred Way, I received a steady traffic of Athenian pilgrims bound for Eleusis to participate in the Mysteries. Each traveler who ventured within my territory was invited to dine with me on Mount Korydallos, and then compelled to spend the night as my guest. This meant sleeping in one of my iron beds – the first of which was quite small, the other impressively large.
Those who were short were directed to the larger bed; tall visitors were ushered to the smaller one. They were then tied down and re-sized to fit their assigned beds. With a hammer I would “lengthen” those who were too small; by taking an axe to the legs of taller guests I would “shorten” them.
Either approach resulted in the death of the guest owing to his own imperfections; after all, am I responsible for his failure to conform to the rules? And naturally, it was only appropriate that I collect a supplemental fine, and hospitality fees, from whatever wealth the offender left behind.
Such was the order of things in my kingdom, which was prosperous and stable – until the arrival of Thesus, that meddlesome son of Aegeus. With no respect for my authority, Thesus inverted the order of my kingdom by seizing me and binding me to my own Iron Bed, which wasn’t built to accommodate a giant such as myself.
Using the axe with which I had asserted my rule, the usurping Thesus severed my legs and struck the head from my shoulders, destroying my kingdom and sending me to exile in Tartarus.
For millennia I have dwelled in the Underworld, where I have witnessed the antic follies of men – including rulers who failed to appreciate and emulate the wisdom with which I administered my own kingdom.
There has been some encouraging progress in recent centuries, however. Those ruling the land beyond Thrace – I think it’s called Russia now – displayed a keen grasp of my methods. The same is true of many ruling lands even farther to the West. However, I am most impressed by those who preside over the country called the United States of America: They not only understand the devious logic of the “Procrustean Bed,” they actually display a certain depraved inventiveness in refining it.
In fact, recent developments have so encouraged me that I have decided to hire myself out as a consultant to various American regulatory agencies. Alas, my iron beds are gone, but the regulatory scheme impacting American health care more than makes up for my loss. In fact, it is my observation that, figuratively, the regulatory scheme is a Super-Iron Bed.
IDAHO DOCTORS ON THE IRON BED
In modern America, those who belong to the fraternity of Hippocrates – doctors and other medical professionals – often find themselves bound to an institutional version of my Iron Bed. Of the myriad examples I could share, one I find particularly impressive involves medical practitioners in the State of Idaho.
A few years ago, orthopedic surgeons in Boise learned that the state Industrial Commission planned to reduce government-mandated Workmen’s Compensation reimbursements. The new “fee schedule” for reimbursements would figuratively cut off the legs of orthopedic specialists.
As a protest, many of the doctors decided to withdraw from the Workmen’s Comp program – in effect, freeing themselves from the Iron Bed. This apparently worked: A year later, the Industrial Commission raised the reimbursement rate, thereby luring the doctors back to the Iron Bed.
What admirable guile!
Two years after the doctors were enticed back into the Workmen’s Comp program, the State of Idaho – working in league with the federal government – filed a lawsuit against them alleging a “price-fixing” conspiracy. This displayed a sophisticated understanding of my Iron Bed method: It was the government that fixed the prices, but the same government blamed the doctors because those prices were an impossible fit.
Ah, but this wasn’t the limit of the government’s cunning. The threat of a lawsuit hung over the doctors’ heads, much like the sword that was suspended by a thread above the heads of those invited to dine alongside the estimable King Damocles. In that circumstance the doctors were compelled to accept a legal settlement that put them in restraints more unreasonable than any I ever devised.
This is complicated, but in examining the details we’ll appreciate the diabolical brilliance involved in the attack on Idaho’s orthopedic specialists – a campaign similar to others being carried out elsewhere in the country, and one that will escalate into a nation-wide assault in years to come.
Under federal law — as applied in the Supreme Court’s Eastern R. Conference v. Noerr and United Mine Workers v. Pennington decisions – the Idaho orthopedic doctors have a right to conduct joint efforts to influence public officials (including regulators such as those in Idaho’s Industrial Commission) even when such efforts are “intended to eliminate competition.” This helps explain why the federal government exempts labor unions from antitrust actions, or so I was told by one of the many former federal bureaucrats I’ve encountered here in hell.
Pursuant to the so-called “Noerr-Pennington doctrine,” the Idaho doctors acted within their rights when they organized a pressure campaign to raise the Worker’s Compensation reimbursement rate; after all, they weren’t trying to eliminate competition, but rather to receive a more reasonable reimbursement for performing government-dictated treatment. Nonetheless, the government successfully forced the doctors to repudiate their rights as part of the legal settlement.
This much is simple bullying – akin to what I did in employing my fearsome strength to bind someone to the Iron Bed through main force.
To make sure that none of the doctors avoids the strictures of this settlement, each is required to make all of his financial and professional records available for inspection by a government functionary specifically tasked to find violations.
I’ve rarely encountered a more effective application of my Iron Bed method. If the Idaho doctors actually exercise the rights recognized in the settlement, they will be beaten to a lifeless pulp with a bureaucratic hammer, or lethally dismembered by a government-issue axe. If they submit, they’ll find themselves suffering an incremental professional death as the regulatory list grows longer and reimbursements grow shorter.
The only other option for doctors in such circumstances would be to leave the profession outright, something that is likely to happen quite frequently in coming years. The same will likely be true of non-conventional medical practitioners as the government works to bring all health care decisions under its authority.
I am quite sure that through my new consultant efforts, I can influence Attorney Generals and U.S. Attorneys throughout the United States to utilize the Idaho approach to stop those pesky doctors who wish to thwart the will of the regulatory agencies. Red State, Blue State, it doesn’t matter. After all, in spite of the lip service given by Republicans to free speech and the free market, it WAS a Republican Attorney General who collaborated with the Feds to hammer the Idaho Doctors.
I believe that my efforts in this direction will have the effect of placing the entire American population on the Iron Bed – and that, my dear Alexander, is the entire point, isn’t it?
Go Forth and Rule,
Procrustes, son of Poseidon
P.S. I will keep you apprised of my efforts.
(co-written by the inimitable Will Grigg)