Saturday, March 20, 2010

"...quite mad"

Some recent health care debate comments.

In our world of infinite wants but finite resources, there are only two ways to allocate any good or service: either through prices and the choices of millions of individuals, or through central government planning and political discretion. This choice is inexorable. Stripped of its romantic illusions, ObamaCare is really about who commands the country's medical resources. It vastly accelerates the march toward a totally state-driven system, in contrast to reforms that would fix today's distorted status quo by putting consumers in control.

As in the Western European and Canadian welfare states, doctors, hospitals and insurance companies will over time become public utilities. Government will set the cost-minded priorities and determine what kinds of treatment options patients are allowed to receive. Medicare's price controls will be exported to the remnants of the private sector.

All bureaucratized systems also restrict access to specialists and surgeries, leading to shortages and delays of months or years. This will be especially the case for the elderly and grievously ill, and for innovation in procedures, technologies and pharmaceuticals.

Eventually, quality and choice—the best attributes of American medicine in spite of its dysfunctions—will severely decline.

Democrats deny this reality, but government rationing will become inevitable given that overall federal spending is already at 25% of GDP and heading north, and Medicare's unfunded liabilities are roughly two and a half times larger than the entire U.S. economy in 2008. The ObamaCare bill already contains one of the largest tax increases outside the Great Depression or the world wars, including a major new tax on investment income—and no one seriously believes it will be enough.

WSJ editorial, 3/20/2010

During the (recent health care) summit, Obama insisted that bare-bones insurance coverage — insurance that protected only against financial catastrophe — was not insurance at all.

The truth is closer to the reverse. As Nobel Prize–winning economist Kenneth Arrow pointed out nearly five decades ago, using insurance to pay for routine and predictable expenses makes no sense. The market can provide catastrophic insurance. It cannot provide comprehensive insurance. If the government insists on comprehensive insurance it will have to interfere in markets again and again. This is why liberals are dead-set against letting people buy insurance from out of state. If healthy people can evade their states’ mandates that insurance provide comprehensive coverage by buying insurance in less regulated states, they will raise the price of that comprehensive coverage and thus make it unsustainable.

Ultimately, to make this system work, people have to be forced not to buy catastrophic insurance or forgo insurance altogether: They must be forced to buy comprehensive policies. Those who can’t afford them must be subsidized. Such policies come with built-in incentives for overconsumption, so eventually government experts must swoop in to ration care.

National Review 3/22/2010 issue

Obamacare will result in the creation of at least 16,500 new jobs. Doctors? Nurses? Ha! Dream on, suckers. That’s 16,500 new IRS agents, who’ll be needed to check whether you — yes, you, Mr. and Mrs. Hopendope of 27 Hopeychangey Gardens — are in compliance with the 15 tax increases and dozens of new federal mandates the Deemocrats are about to “deem” into existence. This will be the biggest expansion of the IRS since World War II — and that’s change you can believe in. This is what “health” “care” “reform” boils down to: fewer doctors, longer wait times, but more bureaucrats.

Investor’s Business Daily argues that the “health” debate is really a proxy fight on the size and role of government. According to their poll, 64 percent of people think the federal government has “too much power.” Correct. But a big chunk of that 64 percent voted less than 18 months ago for a man and a party explicitly committed to more government with more power, and they’re now living with the consequences. Obama is government, and government is Obama. That’s all he knows and all he’s ever known. You elected to the highest office in the land a man who’s never run a business or created wealth or made a payroll, and for his entire adult life has hung out with guys who’ve demonized (deemonized?) such grubby activities.

Whatever is “deemed” to have passed in the next few days doesn’t end the debate but begins it. If you’re sick of talking about health care, move to Tahiti, because in the U.S. we’re going to be talking about it until the end of time, or at least until the Iranians nuke Cleveland.

Mark Steyn, NRO

The grip of progressivism is probably the best explanation for the Democratic Party's astonishing campaign to nationalize the U.S. healthcare sector by all means necessary. To attempt to enact a radical and unpopular program in a bill that includes many corrupt provisions, on a party-line vote and through a procedural trick (if the "Slaughter solution" is employed) that seems clearly unconstitutional, appears quite mad and self-defeating to the outsider. But it is not mad ... to those who think it is ... historically inevitable that the government must administer medical care.

Christopher DeMuth, on the AEI Enterprise Blog

It was dispiriting, to say the least, to watch George Mason University students cheering wildly while listening to the president's shameful lies about the fiscal effects of his health care bill. Obama clearly understood his credulous audience and played it like a Stradivarius. Ironically, those fawning, ignorant students will bear the brunt of the bill's exorbitant costs while their aging parents and grandparents struggle with an increasingly overburdened and overregulated health care system.

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