Well, as everyone knows by now, it passed. For better or worse, the U.S. has now joined the rest of the industrialized world in voting to allow the national government more-or-less run the health care sector. Will it have all the wonderful benefits progressives are insisting it will? Count me highly skeptical.
1.)I don't think it will have the magical effect on American life expectancy statistics that Nicholas Kristof of the New York Times anticipates. As Jonah Goldberg points out in this smart fisking, it appears that there are a number of factors that account for the (overstated) difference in life expectancy between the U.S. and other western democracies, and the presence of universal health coverage doesn't appear to be among the most important. If American life expectancies fail to leap upwards by five or more years as Kristof predicts, I expect him to acknowledge how wrong he was. On the other hand, maybe having health insurance will stop teenagers from dying in car crashes or gunfights and lowering the average American lifespan.
2.)I don't see any reason to expect it to control costs. It's economics 101 - you can't add a bunch of prohibitively expensive new beneficiaries to an insurance pool, and expect costs to go down for everyone. How anyone could be stupid enough to believe the Democrats when they claim this boggles my mind. Furthermore, given that accounting gimmicks can only produce savings on a balance sheet, not in the real world, I find the claim that this bill is going to be "deficit neutral" laughable on its face.
3.)I fully effect the bill to have deleterious effects on the rate of medical innovation and the willingness of doctors to continue practicing medicine. Since the bill actually taxes medical devices in addition to disincentivizing innovation, and does nothing to address the extraordinary cost of obtaining a medical license or the artificially restricted supply of practicing physicians, these effects will be even worse.
All this is leaves aside the, to be charitable shall we say, dubious, constitutionality of an act of Congress that will force private citizens to purchase a product from a private entity regardless of whether they want it or not. And the fact that the Democrats have just created a gigantic corporate-government nexus for waste, corruption and malfeasance that will give the military-industrial complex a run for its money on its worst day. While this legislation will have a few benefits - covering the uninsured and freeing individuals from healthcare-induced "job lock" - they are not remotely worth the astronomical costs we are going to pay, and could have been achieved with simpler, more market-friendly reforms. I hope to God I'm wrong, but I think that this legislation is going to be a colossally expensive failure.
I received an email from Barack Obama this morning thanking me for my support. I replied telling him to take me off his mailing list, because the candidate I voted for, the guy who seemed to understand how market economies and the Constitution and such actually work, and respect that those realities can't be changed by legislating them, is not the President I got, and I do not support the President I got. I will be voting for Republicans in the fall, for Senate and House. Hopefully Mr. Obama can be forced to lead from the center by the constraints of a divided government.
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