The exchanges are a bureaucratic mess, and will not likely be functioning soon:
‘At this point, the total administrative burden on the federal government has massively increased. Yet neither the federal government nor the states have the human or financial resources to discharge these tasks in a timely fashion, making it highly unlikely that these exchanges will be up and running by January 1, 2014. To achieve that goal, the various private participants on the exchanges must design and post their policies by October 1, 2013.’
He finishes with:
‘As I have noted before, there is only one type of reform that can make progress in meeting the three goals of a sensible health care system: cost reduction, quality improvements, and public access. That reform requires massive deregulation of the many market impediments that are already in place. Lower the costs, drop the excessive mandates, and thin out administrative costs, and people will flock back to the system voluntarily.’
More broadly, If you haven’t noticed, many progressives have a problem with that ‘voluntary’ part. Individuals usually end up as pawns on a chessboard of ideals. I suspect many progressives are so caught up in the oppressor/victim mentality, are so busy responding to the endless injustices of life (someone else is always to blame), and are so concentrated on deriving rights from the top-down and from abstract principles, that they completely ignore human nature. Solidarity!
Perhaps as with Obamacare’s exchanges, they haven’t thought that far ahead. The trick was to ram it through and worry about the details later. It’s now getting to be later.
In my experience, such idealism will always fail to recognize just how such regulations, taxes, and laws stagnate the economy and the reasons that people work and pursue their aims. The private sector will have the life sucked out of it, and everyday people will have to run through mazes of red tape. This twists the incentives beyond recognition. The earthly kingdom set-up on the road to such ideals consistently fails, calcifying either into an unresponsive, bureaucratic mess that can’t respond to new challenges, or worse, the same mess controlled by worse and worse people and desires, until it really starts getting nasty.
The ideals, of course, are just that, even if they’ve settled into mainstream thinking in the U.S. Political parties who work in the trenches to protect me from such idealism are welcome. What’s important usually happens far away from politics.
My two cents.
Related On This Site: From The New England Journal Of Medicine Via CATO: ‘The Constitutionality of the Individual Mandate’From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?… From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”…Sally Pipes At Forbes: ‘A Plan That Leads Health Care To Nowhere’…From AEI: ‘Study: ‘Obama Healthcare Reform Raising Costs, Forcing Workers Out Of Existing Plans’
Covering the law and economics from a libertarian perspective: Richard Epstein At The Hoover Institution Journal: ‘Three Cheers for Income Inequality’…Richard Epstein At The Hoover Institution: ‘Death By Wealth Tax’…Richard Epstein At The Hoover Institution: ‘The Obamacare Quaqmire’