Single-Payer And Pies-In-The-Sky

Vermont can’t keep moving towards single-payer, as even the folks in charge of Vermont have determined it’s not economically feasible.

The ACA isn’t single-payer, of course, but I’m guessing much support for Obamacare comes from similar pools of sentiment:  Those sympathetic to activist models of governance and the progressive coalitions held together for a time by this President, as well as those who stand to gain the most from the law: Some lawmakers, like-minds in California’s health-care system, many health-care bureaucrats with dogs in the hunt, direct recipients and the few ‘winning’ companies and contractors who will receive the money, prestige, and political power required to implement the law.

Megan McArdle foresaw the likely outcome Vermont back in April:

‘So this is going to be expensive. So expensive that I doubt Vermont is actually going to go forward with it.

This should be instructive for those who hope — or fear — that Obamacare has all been an elaborate preliminary to a nationwide single-payer system. It isn’t. The politics are impossible, and even if they weren’t, the financing would be unthinkable.’

From another piece of hers:

‘The problem is that Obamacare promised too much:  universal coverage, and no rationing, and lower costs.’

The problem as this blog sees it, is that you can end-up harming everyone more than helping in the long-run; over-promising and under-delivering ultimately to those you’re claiming to help and through taking away a lot of liberty, wealth and public trust in the process.

The moral case has never been sufficiently made to me that health care is a right.  Of course, there were serious cost problems with the jerry-rigged system we had going (where our health-care delivery system was used to dispense care inefficiently to save lives), but the solution we’ve legislated will now require much more government oversight of a limited resource, potentially increased politicization of the issues at stake, and the likely growth of a vast bureaucracy with its own inefficiencies, self-interested politics and inertia.  It’s as if we’ve backed into a forest of potentially unnecessary hazards without necessarily having the potential rewards to show for it.

Related On This Site:  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’

Richard Epstein At The Hoover Institution: ‘The Obamacare Quaqmire’

Richard Epstein At The Hoover Institution: ‘Watching Obamacare Unravel’

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’

Peter Suderman At Reason: ‘Obama Claims Repealing ObamaCare Would Benefit Insurers. In Fact, They Stand to Lose $1 Trillion ‘

Full post here.

You don’t get to single-payer overnight, you first pass an enormously complicated piece of legislation without the other party’s support, then you get private insurers on board, then perhaps you gradually restrict market activity with endless regulations, enormous and politically dependent bureaucracies, allowing access to fewer and fewer private insurers:

‘It’s not just health insurers. Most of the health system’s biggest and most powerful industries are betting on the law to boost their bottom line. The drug industry cut a deal with the White House to help finance the promotion of the health law. And following the debate, investors in the hospital industry got spooked.’

Health care costs are rising.  Our system is slapdash, and inefficient, tied to employment, and wasteful.  I think this solution is worse than the problem.

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’

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Megan McArdle At The Atlantic: ‘Health Insurers And Their Faustian Bargain’

Full post here.

‘The problem is that Obamacare promised too much:  universal coverage, and no rationing, and lower costs.’

The moral case has never been sufficiently made to me that health care is a right.  Of course, there were serious cost problems with the jerry-rigged system we had going (where our health-care delivery system was used to dispense care inefficiently to save lives), but the solution we’ve legislated will now require much more government oversight of a limited resource, potentially increased politicization of the issues at stake, and the likely growth of a vast bureaucracy with its own inefficiencies, self-interested politics and inertia.  It’s as if we’ve backed into a forest of potentially unnecessary hazards without necessarily having the potential rewards to show for it.

That there is such a deep divide in our politics bears considering, and so too does the fact that Obama spent a lot of political capital to get this done, but fiscally (and the risks to freedoms we all hold dear with the deficit we have) I’m skeptical that this is a good outcome.

Related On This Site:  A Few Health Care Links-03/18/2010From Youtube Via Althouse-’Paul Ryan: Hiding Spending Doesn’t Reduce Spending’From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?

The most knowledgable articles I’ve read that make the case for some government involvement are here:

Atul Gawande At The New Yorker: ‘The Cost Conundrum Persists’

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