‘For Obamacare’s critics, of course, allowing the exchanges to collapse under their own weight might be politically preferable to passing a bill that can then be blamed for the inevitable denouement. Republicans are now discovering the unhappy truth first learned by the Obama administration: Talking about what you’d like to do with America’s convoluted health-care system is a lot easier and more enjoyable than actually doing it.’
Richard Epstein revisits some of his original predictions, and explains his reasoning as to why the exchanges would inevitably collapse.
In order to implement the ACA, you first must control markets, making deals with the insurance companies to get them in by offering taxpayer (other people’s) money and promising them captive consumers and competitive advantages. This will centralize and bureaucratize the health-care industry and naturally continue many of the market distortions in place. Then you must force younger, healthier people into involuntary arrangements which often work against many of their interests.
Political influence and populist sentiment are the main levers in pursuit of your vision of a better society.
Of course, if much of your identity is dependent upon a political ideology and moral belief system which promises equality and fairness through redistribution of the ‘fixed economic pie’, then these details are post-hoc…your fight is righteous and your enemies the cause of most if not all failures of policy design.
Previously: Charlie Martin here:
‘Whatever solution we look for though, the really important point is this: the whole basis of Obamacare, the notion that we can have more people, getting more benefits, and pay less, is just impossible. The arithmetic doesn’t work. And if you think that’s “unfair,” I’m sorry.’
Avik Roy At Forbes: ‘Democrats’ New Argument: It’s A Good Thing That Obamacare Doubles Individual Health Insurance Premiums’…Megan McArdle At Bloomberg: ‘Health-Care Costs Are Driven By Technology, Not Presidents’