Obamacare, We Hardly Knew Ye
Published on: November 17, 2011
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  • Bart Hall (Kansas, USA)

    For eight years, once upon a time, we had a superb demonstration of how to avoid the potential troubles of delayed court rulings about the constitutionality of legislation.

    In his two split terms, Grover Cleveland — a Democrat, I would add — vetoed many hundreds of bills passed by Congress, usually with some variant of the same statement:

    “I find no place within our Constitution granting Congress the power to legislate on this matter.”

  • Mrs. Davis

    I rub my eyes in disbelief when I read that the Supreme Court interpreted the commerce clause to mean that a farmer couldn’t grow food for his own family to eat. And that didn’t come from the Boomers.

    If Wickard is overturned, future generations will marvel at how well the economy prospered in spite of the heavy hand of central regulation and wonder what might have been had the Boomers, X’ers and Millenials inherited the true freedom of their grandfathers.

  • Jacksonian Libertarian

    Without the feedback of competition, health care can never be fixed. When third parties (Government or Employers) are paying for wall to wall coverage health insurance, there is no reason for patients to shop. No competition means none of the improvements in Quality, Service, and Price which the free enterprise system is known for will occur.

  • Kenny

    “… it is easy to see why the Baby Boom is looking more and more like a generation of clowns.”

    Exactly.

    See what too much drugs, sex, amnd rock ‘n roll will do to you.

  • charles austin

    “Until the Court rules — something of a throw of the dice — nobody really knows what will happen to the health care law.”

    Perhaps there’s never been a better, if unintentional, summary of the uncertainty and regulatory burden holding businesses down in this country.

  • Mahon

    Bear in mind that the ACPPA was never intended to work properly. It was intended as a stalking horse for single payer – to forever implant the federal government in the middle of all health care decisions and to make such a hash of the health care industry that the only alternative would be a British-style national health service (with SEIU-represented employees, etc.) If you remember that, all these little “drafting errors” make perfect sense.

  • Boyd

    “Unless millions of people who don’t think they need insurance are paying into the system, those who know they need it (mostly, the sick) will be faced with unpayable premiums.”

    Lets change a couple words. “Unless millions of people who don’t think they need government are paying into the system, those who think they need it (mostly, the Socilists) will be faced with unpayable taxes.

    See how that works?

  • nerdbert

    “Writing a bill that successfully improves American healthcare delivery while controlling costs, on the other hand, is hard.”

    This is why the free market is so successful in general: millions of people are free to choose the best solution for their own needs from a multitude of suppliers. And from a multitude of choices you get innovations that central control even by enlightened and intelligent bureaucrats can’t match. (Not that bureaucrats have much incentive to be innovative and daring.)

    Compare your choices in cellphones to what you have in healthcare. Would you prefer companies operating in a relatively unregulated environment to what we current have in the heavily regulated healthcare segment?

    Anyone who thinks we currently have a free market in healthcare is obviously not familiar with the situation or how we got here.

  • “If the authors of this historic reform were that careless and clueless about the central pillar of their plan, what else did they get wrong?”

    All of it.

    Rich Vail
    Pikesville, Maryland
    The Vail Spot dot Blogspot dot Com

  • tom beebe st louis

    I havewhat is perhaps a more cynical view. Obamacare is but a step to a completely government run health care system wherein nodody can obtain anything but standard, and inadequate health care. The record of this administration in fiscal matters is when something doesb’t work, try more of it (aka “stimulus”). Why would it be different in health care? Let this program fail a test, either before the courts or by being unworkable, just where do you think the Won and his minions will go next? Be careful what you wish for.

  • Richard S

    I’m not sure why this change was “not a natural one” for Obama? In the years before his campaign for President he said he preferred a single payer system (in that case, would it still be “commerce”?), and, if memory serves, he said what Mahon suggests, he realizes that the U.S. won’t support a single payer system yet, but his plan is designed to move us toward one.
    And Obama’s ability to repudiate positions he took in his campaign is well documented. The tactial positions can change, but his goals, as far as I can tell, have been remarkably constant.

  • lord garth

    The obamacare bill was not Obama’s bill. It was developed by Congress, principally by staffers of Pelosi, Reid and some others.

    and, yes

    the overwhelming consensus is that a national single payer health care system would be constitutional.

  • You could say that since the government put men on the moon
    That they’ll handle all this stuff just fine …
    But I recall all the effort that it took to put ’em there
    Just a half a dozen times …

    What makes our leaders think they can even come close
    To gettin’ all the answers right …
    When all the answers have to be right over each and every one
    Of three hundred million lives …

    Despite their erudition …
    And academic pedigree …
    The Best and the Brightest look instead
    Like a box of dim bulbs to me …

    They can barely handle stuff that’s one-size-fits-all
    Let alone for you specifically …
    The Best and the Brightest look instead
    Like a box of dim bulbs to me …
    … Like a box of dim bulbs to me

  • Milwaukee

    Fruit of a poisoned tree. Under FDR wage freezes were implemented. To get around the wage freeze, employers offered benefits, including health insurance. Were health insurance separated from employment, we would be better off. Between insurance companies and employers, people are stuck.

    In India patients work out payment with the health care provider, and then get re-imbursed by their insurance. Patients know what services cost. It has been many years since I left a doctor’s office knowing what my “encounter” cost.

    Insurance companies and health providers play a constant game of “tit-for-tat”. Insurance requires co-pays of different amounts to move patients towards generic drugs. Pharmaceutical companies give doctors for rebats so patients can get their co-pay for free, and the insurance company gets stuck with the more expensive medicine. A friend passed away recently. He had health insurance, but it didn’t cover outpatient cancer treatment. That was the only way the doctor would provide cancer treatment. Thanks for nothing.

  • alanstorm

    lord garth, you must be a liberal – you exhibit the typical liberal’s pathological ability to miss the point.

    Obamacare was written by congressional staffers – to a first approximation, all lawyers. Lawyers live and die by precise language, yet they goofed up the state exchange issue and failed to include a severability clause, while including essential health issues like student loans and gold transaction rules. What other delights await us?

    And, although he didn’t write it himself (ran out of crayons, I heard), he campaigned for it, promoted it, signed it, and owns it.

    BTW, good to know that the voices in your head have reached a consensus.

  • Soviet of Washington

    Dr. Rich (http://covertrationingblog.com/rebuilding/limiting-individual-prerogatives-in-healthcare) has been on record since passage that the real fight is “will consumers be able to spend their own money on health care.” His opinion is that the powers-that-be and their insurance company lackys will have to restrict that ability for any coherent system to continue to exist.

  • VA Teacher

    There are two fundamental problems in health care.

    1) A purely free market system would mean that some people would face a situation where their wants/needs exceed their ability to pay. This offends America’s sense of fairness and compassion.

    2) In the absence of a free market price structure, the only way to control costs is some kind of rules-driven, one size fits all, open to political manipulation system of rationing. Most Americans believe their own health care would be worse under this kind of system.

    All of the debate has revolved around trying to find the mythical free lunch: ie, how can I get access to all the wonders that modern medicine can invent and get someone else to pay for it? Can’t happen. Impossible.

    So why don’t we provide minimally humane care to everyone free of charge in a state-run system and then give people the option of buying up with their own money if they want more and can afford it. That is essentially the way we handle food, housing and education. Why does health care need to be so different?

  • Boyd

    “the overwhelming consensus is that a national single payer health care system would be constitutional.”

    Actions that would be Constitutional but foolish to pursue are infinate. This would just be one of many.

  • Gene

    Mr. Mead, I know you weren’t born yesterday. Progressives will never see Obamacare, should it be torn asunder, as a BLUNDER on their part. Instead its destruction will be seen as yet another mortal sin of Republicanism and a testament to the soft fascism of the American people, many of whom, in the minds of Howard Zinn or The Nation magazine, must dream fondly of stepping over the bodies of the poor dying in the streets. The repeal of this law will merely be added to the great list of iniquities laid at the feet of the American republic.

    The secondary effects of the mandate, should it be upheld, will soon become apparent. If we are merely forced to buy broccoli I’ll be relieved. The mandate will reach its full flower when citizens are forced to buy Treasury bonds with some percentage (probably starting at 5 and rising inexorably with the decades) of their 401(k)s or other retirement plans. Why raise taxes when you can force people to lend money to feed the beast?

  • I am with Richard S.

    “President Obama campaigned against the individual mandate at the heart of the controversy over constitutionality, and the decision to embrace it was not a natural one for him.”

    Right. It is not natural for Obama to want to expand the reach and power of the government…?

  • Martin Hale

    Lord Garth, perhaps you’re just misremembering things, but a) Mr. Obama was directly involved in the creation of parts of the bill – maybe you’ve forgotten that the WH led the way in the process with early negotiations with Big Pharma, negotiations which secured a viable path toward assuring future profitability for Big Pharms, and b) a large portion of the details of the legislation were created by lobbyists for various special interest groups and later incorporated into the legislation, often with no alterations.

    As to the constitutionality of single-payer, I’m not sure why we need to mention or discuss that – up until your mention of it, nobody else has been discussing it. In fact, as an issue, it’s a distraction. The core question is the constitutional basis for government to require you to make a purchase from a private company. Which in no way can be confused with single-payer.

  • maulerman

    Dear Lord Garth

    It is a good thing that the question of what is constitutional is not determined by “overwhelming consensus”. You may want to refer to Marbury v. Madison as a starting point before attempting to make such a justification.

  • Baby M

    It’s not dead enough yet. Kill it! Kill it with fire!

  • cthulhu

    We have a government that has strayed far from its core competencies — which, necessarily, means that it’s deep in the weeds of its incompetence.

    The Constitution’s simple, straightforward enumeration of Federal duties has become a gateway to a bewildering number of far-flung agencies and departments — many of whom have such little connection with the Constitution that its authors would be aghast.

    We need a massive rollback of Federal intrusion into the life of this country. Obamacare is only the last straw.

  • eintexas

    Calling the Baby Boomers clowns is dangerous and foolhardy. Yes, they behave as clowns, but as a group they have destroyed so much in our nation. Their destructive behavior and needy greed has forced us all into tenuous positions. They own this bill, the protests, and this president. Unfortunately, the rest of us must sacrifice valuable coin and lives to clean up what they have wrought.

  • agathis

    “…and, yes the overwhelming consensus is that a national single payer health care system would be constitutional.”

    Funny, that’s what everyone was saying about the individual mandate. Color me unconvinced.

  • Nancy Pelosi – born 1940 – thus not a boomer.
    Harry Reid – born 1939 – thus not a boomer.
    As with many things blamed on boomers, it’s actually the Silent Generation that’s responsible.

  • RedWell

    Had my doubts, but was willing to accept the health care bill: despite fellow conservatives’ prescriptions for free market solutions to the insurance system, I’m tired of living with a spouse and two children on the razor’s edge of coverage from a byzantine industry.

    Still, that progressives believed the mandate was constitutional struck me as facile. Thanks, WRM, for framing this issue properly: stunning oversight fueled by a pathetic mix of hubris, desperation and partisanship.

  • Henry B

    Some critics of the healthcare bill act as if there were some simple solutions that the Obamacare authors willfully disregarded

    I can think of one; TORT REFORM!

  • AD

    “… what else did they get wrong?…”

    In 2000+ pgs, that is a bottomless pit of wrong.

  • MIner49er

    Let’s see. Dentists and veterinarians deliver the same kinds of services at high quality levels and affordable costs. How can they do it and human health care providers can’t?

    The only difference is that the narrow-tie, pencil-neck meddlers from employers, insurers, and government are not involved. The transactions are negotiated at the point-of-sale between informed consumers and providers.

  • Phantomorphan

    “Writing a bill that successfully improves American healthcare delivery while controlling costs, on the other hand, is hard. Very, very hard.”
    Really? Google Singapore + “health care” and you’ll find a description of a system that works well and isn’t busting the bank. It’s fairly similar to Switzerland’s system — again, not perfect but incentives-based, intelligent and affordable. The main thing we need to do is to introduce price competition. That’s what the socialists in Congress — and the one in the White House — disdained. Here in the Blue State Paradise of New York, an affordable high-deductible (“hospitalization”) policy is a pipedream. ObamaCare takes that concept nationwide, along with the obvious failing of RomneyCare — there’s a penalty for not buying insurance, but it’s too low. Thus ObamaCare’s huge expansion of Medicaid. That’s really what the lefties wanted all along — expand it enough and you’ve got a “single-payer” system with a committee of philospher-king progressives setting prices and rules.

  • Martin

    Wait… the patriot act IS constitutional! Wow, I never thought of it that way before.

  • Bonfire of the Idiocies

    Y, price competition! Just what is wrong with the politicians in Washington (amongst other places) that refuse to let people make their own decisions about what level of insurance they need and how much they can afford to pay? About the only “choice” Democrats seem to be able to concieve of is with regards to abortion. For everything, else, they want to make decisions for you. And to tell the truth, they STINK at it. I long for the good old days when congressfolk simply took graft and went on junkets overseas instead of hanging around Washington and screwing up everyone’s life.
    Someone should explain to these people they AREN’T smart, they’re just in Congress because they’re better liars than everyone else.

  • Dave H

    It’s not all that hard if you can get the utopian socialists out of the discussion.

    The presence of superfluous third parties in the marketplace is what has distorted its natural function of aligning price to value by causing it to operate inefficiently (primarily by reducing the number of buyers and transactions in the insurance mkt).

    We must end employer-provided health insurance. People feed themselves in a free market without relying on their boss to go out and buy their groceries for them, and what is a more basic human need than food?

    Employer-provided health insurance was a market created by the severe labor mkt distortions of WWII-era regulation and should never have been allowed to take hold. Unfortunatly, we now have reached the point where an outright ban is necessary.

    Also, it would be good to get even insurers out of the market for routine healthcare. People should pay their doctors themselves for checking out their sore knee or nagging cough. This would increase the number of buyers, sellers and transactions, thereby improving the efficiency of the market to more accurately align price to value. Insurance should be reserved for major and non-routine expenditures.

    But for those large “catasrophic” medical bills, a system of (yes, as a libertarian, I shudder, too) redistribution is necessary. The private insurance market is a redistribution system that redistributes from healthy people to unhealthy people. A system that makes that transfer (or at least a substantial portion of it) from rich people to poor people is probably better, and such a system would probably have to be run by the gov’t through the mechanism of taxation (although I’m open to pvt. mechanisms, a form of coercion – through the taxing power, not the commerce power – is probably needed to make it work).

    But I’m not advocating single payer for anything more than expenses above a fairly high “catastrophic” threshold (and I’m not certain that a private mkt COULDN’T do this).

    Also, gov’t needs to get out of the business of microregulating what type of plans insurers must offer. These regulations drive up prices without offering commensurate benefits. The market is perfectly capable of determining demand if allowed to operate efficiently.

    We don’t really know what a “free market” in healthcare looks like because there hasn’t been one in the lifetime of the Boomers or subsequent generations.

    Plus tort reform.

  • Jack Davis

    Well, we’ll just have to wait for the Supremes to weigh in. In the meantime, here’s how I got screwed by Obamacare. Here is what Obama’s health-care reform law has done to me. Not FOR me; TO me.

    BEFORE Obamacare, that is up until December 31, 2010, the family deductible for my company-paid medical coverage was $300…and it had been $300 for years.

    AFTER Obamacare, that is on January 1, 2011, the family deductible for my company-paid medical coverage went up to $2,800. You can do the math. And because my company is self-insured, it was a take it or leave it situation.

    Obama LIED when he said that if I liked the plan I currently had, I’d be able to keep it. He was WRONG. Instead, my company canceled the plan I liked and in its place substituted the aforementioned high-deductible plan.

    Obama LIED when he said his plan would “bend the cost curve downward.” What he really meant was: “Bend over and face downward.”

    Thanks, Obama!

  • mnemos

    @VA Teacher – I like your summary. The problem is that the ability to “buy up” still “offends America’s sense of fairness and compassion.” For many the only acceptable minimal humane care is everything humanly possible. Oregon tried to do a universal coverage as you described, but got hung up on defining minimal humane care. It is the only way, though.

    And although I think the free lunch description is correct, unfortunately, at the national level we have one party for which “free lunch” is the basis of many of its policies.

  • Corlyss

    bien pensant

    With any luck at all, “They meant well” will be the epitaph of the criminal conspiracy masquerading as the Democratic party.

  • maxwello

    A lot of comments here seem to think competition would be a good thing to consider and that the free market would be the best way to find a viable solution. But I keep coming up against the necessary basis of market transactions, that being that both parties know the other can walk away if no deal is reached. Health care decisions don’t work that way. Patients can’t hold out indefinitely if they believe the service isn’t fairly priced. Providers can. Therefore, they control the transactions in a very non-market way. Add in the insurance industry, complicating the system, adding costs and making transparency impossible, and there is no way for the system to work efficiently. There may be ways to fix the system that don’t involve the government stepping in and taking control, but I have yet to hear a proposal that would work. People don’t choose to be sick. It’s not as thought the patient greedily decided to maximize their need for healthcare. And for anybody who argues that we need to squeeze more efficiency out of the industry, the most wasteful aspect of it right now is the middleman’s profit margin. Dividends, salaries for workers and executives, commissions to the Wall Street houses that invest Big Insurances holdings: none of these dollars make anybody healthier. And the knowledge that plan participants are only a liability for as long as they remain with the same employer, in an era when most people change jobs, voluntarily or not, every five years, means that there’s never an incentive to pay for a long-term solution, even when it would reduce lifetime spending on any one patient enormously. A single payer would have that incentive.

  • JKP

    Forget constitutionality, the individual mandate flat out doesn’t work. All it does is require people to purchase insurance; it doesn’t force insurance companies to reduce the price of their premiums. In theory, expanded coverage should in fact lower costs for insurance companies across the board (as doctors/hospitals shouldn’t need to charge patients higher fees to cover non-paying patients, and pass those costs on to insurance companies). In reality, insurance companies don’t have any incentive to reduce their prices, and therefore they are just pocketing the subsidy. It’s a terrible system for everyone, except the insurance companies (hence why they came out in favor of the plan).

  • don

    If, as I think, the individual mandate makes federal subjects out of citizens, what does that say for the fifty states relationships to their citizens? True, like the Swiss, one can always move, say from Mass. to, Nevada that doesn’t require purchasing goods and services at the state chartered “company store” as a condition of citizenship, or face a fine or imprisonment. But what happens when there is no escape, a modern neo-feudalism? After all, certain enumerated rights–free speech and due process and the right to not participate in commerce–were incorporated as requirements for the states.

  • ObamaCare was a total lie. It won’t cost less, it wasn’t necessary, we didn’t need to pass it before we read it…NO NO NO..

    ObamaCare is dead.

  • Rene 591

    I really hate people who say they were paying 300 and now the blame obama. been having a deductible of 5k for years. its people that have low deductibles that are part of the problem. everyone should have to pay then you get the outrage against the medical and insurance industrial complex

  • guydreaux

    The healthcare bill, like most bills, was written by lobbyists- not by staffers,

  • jefjiljujenjon

    The only “individual mandate” that should be operable upon health care insurance is this — if you don’t buy insurance you must pay your own health care expenses. The epidemic of “uninsured” in this country is an unintended (maybe) result of the myriad of programs that allow people to receive healthcare for free. What is the incentive to forgo discretionary purchaases and buy health insurance when you know you will receive healthcare for “free” (and, as we all know, “free” means paid for by those idiots that actually buy health insurance). Until individuals are forced to live with the long-term negative consequences of poor decisions there is no real solution.

    Making the government compel the purchase of insurance is the wrong solution to the correctly identifited problem — insurance is short-term pain for long-term gain and most American’s won’t defer gratification.

  • wncchester

    “Health insurers also insisted on a mandate, as did the Democrats who controlled Congress.”

    Certainly so…health insurers and Fed. bureaucrats (who support Democrats) are the only ones who truly benefit from ObammaKare.

    The goal clearly was not to “reduce the cost of insurance”, it was to make us all pay for the increased costs of insurance – for reduced benefits – so the insurance companies would increase their contributions to the politicians who rammed it down our throats. And it’s working as planned already, gonna really work after next year unless this corrupt mess isn’t killed.

  • Dave H

    maxwello: health care is no different than any other necessity like food, shelter, work, clothing, transportation, communication, etc. (except when dealing with unusual, “catastrophic” health issues – people generally don’t develop a need for a $50,000 lunch.)

    Anything people buy is subject to market forces. Anything that costs money to produce can be produced cheaper for profit because the profit motive motivates a producer to reduce costs in a competitive market. This includes health care and other necessities.

    By “walk away”, we mean “walk away to a better deal elsewhere,” not necessarily “walk away and do without entirely.” In a more competitive market, there are more opportunities to “walk away to a better deal elsewhere.”

    A seller cannot stay in the market by refusing to deal. The profit motive compels him to sell something to somebody sometime, and if he doesn’t do it, the guy in the next booth over will. You seem to believe that sellers could have a perverse desire not to sell even at a price that exceeds their costs. Not in the real world. (On the other hand, if they can’t sell at a price that exceeds their costs, they don’t exist and neither does their product – and that also includes health care.)

    In a single payer system, there is no motivation to find a better deal elsewhere, you just ask the single payer to write a check regardless of the amount.

    Now, you might think the single-payer would have an incentive to reduce costs – but when that single payer is the gov’t, the profit motive doesn’t operate on it and therefore doesn’t compel downward pressure on costs (and also doesn’t spur innovation).

    Instead, rising costs are simply covered by rising revenues, otherwise known as taxes – the net result of which is to take productive dollars out of the economy and apply them to unnecessarily high prices (which means, to the extent the prices are unnecessarily high, applying them to unproductive costs), driving up prices even further while also suppressing economic growth generally. Prices will rise to meet the dollars available to pay them – which is why readily available grants and loans made college so expensive and why we had a housing bubble created by cheap credit.

    The idea that the profit motive simply raises prices unnecesarily is static thinking and simply wrong. The profit motive (1) creates the market (and therefore the product of that market) to begin with, (2) reduces costs, (3) spurs innovation and, (4) the weakest effect, causes price increases, usu. in response to market-wide cost increases such as regulation and taxes, but sometimes simply in response to fact that more dollars are inserted into the demand side of the market, which is what a gov’t run single-payer system tends to do.

    Eventually, due to the lack of effective downward pressure, prices rise beyond the ability of the single payer to pay them, and rationing is the inevitable result. The free market also rations, but it causes people to ration for themselves instead of imposing rationing on them through decisions made by others.

    Generally speaking, it is cheaper to die than stay alive. If you’re spending your own money, you get to make that choice. But if somebody else is spending that money, do you really trust them with that choice for your life?

  • Eurydice

    Evidently, writing an opinion piece about health care is very, very hard, too. Are there no Boomers who’ve been against Obamacare? – we know that there were. Were there no Boomers who had alternative ideas? – of course, there were. Of the 73% against the individual mandate, were there none who were Boomers? – statistically, one would think so. And are there no members of the Supreme Court who are Boomers? – a quick google says that there are. So, if Obamacare is struck down, how does that make an entire generation look like clowns rather than it just being the failure of a particular administration and a particular party? In any case, I would think you’d be grateful to those Boomers in the 73% as they refuse to participate in this part of The War On The Young.

  • valwayne

    If the Constitution allows the Congress and President to force Americans to spend their hard earned money to buy something just because they are alive than we cease to be a free nation and become slaves of the federal Government. If the Federal Government can order us to buy insurance they can order us to buy apples, or cars, or anything, at which point we have no control over our money which means no control over our very lives. The Supreme Court will surely see that the Contitution does not, and was never meant, to make the Federal Government the Slave Holder of ever living American.

  • Doug Schexnayder

    What should a bill that
    socialized medicine (worldwide failure we all should now), required locking out the opposing Party to pass it,
    blocked voters from viewing it,
    added over 100 unelected boards and panels,
    heaped on new taxes or fees
    then lied about its cost and rationing intentions…have any acceptance by those it forced itself upon?
    BTW, its such a wonderful bill that federal workers, including the royal congress are EXEMPT! What does that tell thinkers voters?

  • Cheryl Ansell

    Simply put…Obamacare has two reasons for existing, one: government control over health care to try and hide the unmitigated failure of medicare and medicaid….two: this is another give away to unions, specifically nurses and Service Employees (as in SEIU) members who have “work” taxes taken out in the form of union dues to support the greed and avarice of union leaders and democrat politicians

  • Harold

    Rather than force healthy young men to buy health insurance, we should adjust the bankruptcy code to provide that, if you have failed to maintain medical insurance, you womn’t be able to bankrupt out of the consequences.

  • Bryan

    @maxwello

    One simple step prepares the ground for reducing the present system’s cost and power over the patient – tort reform. The healthcare bar has by itself reduced the number of providers (doctors and other HC professionals) by creating huge disincentives for the practice of medicine. A larger population of doctors, combined with the participation of patients who can choose care based on price will, over time, necessarily lead to lower costs and better care. Also consider this – the middlemen may lose a lot of power if the doctors don’t need them as a shield against liability.

  • Marty

    EVERYTHING emanating from the Obama Admin, from Pelosi, and only slightly less from Reid, is of a piece, that the government should set pretty tight rules and bounds on what you can do with in aspects of your life except sexual, where you get total freedom. Everything else is to be tightly defined, regulated, taxed, subsidized, and controlled for someone’s idea of the greater good and greater equality, tho what exactly that means and how much is enough will never be defined.

    In that view, the health care law, the auto bailouts, green subsidies and Michelle Obama’s crusade to tell you what you can (and cannot) eat is entirely consistent. Tell everyone what they can and can’t do, and make sure hardly anyone has enough after-tax income to do anything else. Lots of regulation, lots of prohibitions, and social engineering through the tax code and subsidy programs.

    And, of course, some previous commenters were correct that the health care bill was set up to eventually force single-payer with, again, tightly controlled available services that embody some bureaucratic idea of the health care you statistically should need if only you were as intelligent as your betters in HHS, completely ignoring you as an individual–Medicare/Medicaid for all, but with services continually being redefined as not cost-effective (mammograms and PSA tests are just the start) and therefore not covered; if you can find a doctor willing to treat you for what the govt pays, of course.

    All at a cost of hundreds of billions of dollars a year more than previously, to address an “uninsured” problem that was/is a small fraction of what is claimed.

    “Train wreck” hardly does justice to this evolving catastrophe.

  • lefty

    I am alifelong Blue-Doggisg Democrat. I am also a lawyer. there is no doubt in my mind that the Individual mandate is unconstitutional and that much of the Bill, if not the entire Bill, will fall with it as be thE IM is the critical funding mechanism.

    Congress could constitutionally pass a single-payer plan or a public option. But it cannot constitutionally require people to buy something.

    Somebody up top raised the Chicken Case. The Supes didn’t say that the guy could not raise crops for consumption. It said that he could not do so without paying attention to the applicable Ag Regs.

  • Michael Wells

    I’m not going to address the contents of this article. I’m instead going to address the rather obnoxious tenor of the remarks left by commenters here. Look, all of you free market idealists need to get over yourselves. Healthcare in the United States in the free market paradigm is a failure by almost any barometer. 1. We insure a much smaller proportion of our nation’s citizenry than other countries do, at a much greater cost. That doesn’t sound like success to me. 2. Health care systems in nations as diverse as France, Germany, Sweden, Canada, and Singapore all spend less than we do, for comparable outcomes. That is NOT a reasonable barometer of success. And lastly, 3. though our healthcare system has been at the forefront of generating new medical technologies, our system is NOT good at making sure those technologies reach the human beings who need them, rather, they go to those who can afford them. The current system is inhumanely Kafkaesque, where working men and women can have their lives completely destroyed with one emergency room visit, or one cancer diagnosis, at no fault of their own. Burying our heads in the ideological sand doesn’t change the fact that our system is broken.

  • ClingClankKbang

    @kenny
    “See what too much drugs, sex, amnd rock ‘n roll will do to you.”

    Apparently one effect is to take away the ability to spell conjunctions.

    @lord garth:

    “The obamacare bill was not Obama’s bill. It was developed by Congress, principally by staffers of Pelosi, Reid and some others.”

    What was it that kept obama from having any input in said bill, outside of his other more pressing concerns like filling out ncaa brackets and throwing wednesday night white house parties? And if there was something objectionable in this bill that “was not” his, why didn’t he veto the bill and ask for something more to his liking?

    “the overwhelming consensus is that a national single payer health care system would be constitutional.”

    Interesting- the overwhelming consensus in my house is that it would be constitutional for the government to send over a parcel containing 10 million dollars on the basis of my congenial and pleasing personality.

    Notwithstanding the mysterious composition of your “overwhelming consensus”, the only consensus that matters at this point is the one arrived at by those people wearing the robes in the Supreme Court building.

    Overall, good first effort on the astroturfing for President Turtlehead. Tighten up your work, and you can be quite an asset for Axelrod in the coming months.

  • richard40

    “the overwhelming consensus is that a national single payer health care system would be constitutional.” Lord Garth.

    Single payer probably is constitutional, it is also incredibly stupid.

  • maulerman

    @ Michael Wells

    You urge that health care in the US is a failure under “almost any barometer”, but then go on to provide three examples which establish exactly the barometer you believe is applicable; i.e., that everyone should get the same health care regardless of the ability to pay for that care. That barometer is fairly muddled. While the attached link references an older article, it provides a more nuanced view of the right to health care regardless of ability to pay for that care and the role of individual responsibility.

    http://content.healthaffairs.org/content/18/1/180.full.pdf

    Ultimately, when it comes to health care, one has to determine whether the role of the government should be a safety net or a guarantor. Prior to Obamacare, government was the safety net. Obamacare clearly chose to change the role to the guarantor. Unfortunately, part of the price tag for acting as guarantor was an erosion of individual freedoms. It should not be any surprise that when individual freedoms are attacked, that people respond vociferously.

  • earlgrey133

    This reminds me of all those articles I clung too before Obamacare passed, saying it will never pass. Already been burned, and I am not going to buy into the nonsense that the Supremes even care about the original intents of the Constitution.

  • dg forbes

    @VA teacher:
    In Britain, ‘buying up’ is ideological anathema against the principle of fairness. There was an instance recently where cancer patients were warned that if they privately bought a drug not available from the NHS because of it’s cost, they would be denied all further NHS treatment for their condition. They would then have to buy life saving treatment privately for which they probably had not insured. This kind of regulation is necessary because of the cost/benefit analyses used by the government; if a treatment is deemed too expensive for NHS budgets, patients are denied it. People remain free to buy treatment outside the NHS from their own resources.
    Under the British system, NHS treatment is free at the point of delivery. In France, the government pays 70 per cent of medical bills and most people buy private insurance for the remaining 30 per cent. Both systems are heavily underwritten by taxpayers because costs are not covered by what employees pay in from their monthly pay cheques.
    I think Europeans generally are happy with the system whereby they pay health contributions throughout their working lives. Even if they require minimal care until their mid-50s, barring unforeseable accidents, they know that they are likely to become increasing users of health care as they age.
    If I were an American, it would look logical to me to take the risk of paying medical bills on the go for most of my life knowing that this would average out cheaper than paying insurance. But then I would stand a good chance of being a health cost later to which I had not contributed.
    It seems to me that as health costs continue to rise at a rate far ahead of inflation and ever more costly treatments are invented, a working life-long single payer system will become inevitable in the United States to spread the burden.

  • I’d like to appreciate your attempts you have produced on paper this specific report. I hope a equivalent very best item of your stuff down the road at the same time.

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