Wednesday, March 8, 2017

- Why I Don't Obama-Care

Mark Steyn frequently quoted the truism, that once Federally provided healthcare becomes encoded into law, it's place as an entitlement will be permanent. This is the main reason I can't manage any enthusiasm to examine the Obamacare replacement offered up by congress, except at the absolute highest levels.

Is it "better" than Obamacare? It probably isn't better for the thousands of Federal employees and the SEIU, who are probably looking at the demise of thousands of federal jobs; each one wrapped in the opaqueness of Obama's behemoth law. But for the rest of us, you don't even have to read it to know it's an improvement, you only have to weigh it. It's roughly 60 pages, and you simply cannot get the same degree of micro-managed idiocy into a 60 page law, that you can in a law whose length ran to 20,000 pages.

In as much as this indicates a differing perspective on how to govern, that's probably a good thing. We'll hear all the usual hyperbole of course, from both the left and right. No effort of the government to 'control' the distribution of a scarce resource like 'healthcare services' is ever going to be perfect. and I'm sure we're all about to hear all the myriad of ways that this new effort fails as well.

And whatever it does or doesn't command the rest of us to do, it's still going to be massively expensive. We are remarkably illiterate when it comes to the law of supply and demand, and as a culture we still imagine that things can be made 'free' by the government. Since this will neither increase the supply of nurses, doctors, drugs, and devices in anything but the longest term (by failing to drive them into other fields), and will exclude basically no one from access to 'free healthcare', that unshakable rule still apply. Supply stays static, demand rises, so too must cost.

But if it gives even one tiny choice to consumers, then in my view it is a 'better' bill and will over time, lead to a more satisfactory result. The problem there though is the bar for that metric is very, very low. and it can still be a really awful law while being twice as effective as Obamacare. Better is easy, good is hard.

And none of this will stop the NYTimes and WaPo from running heart tugging stories and 'human interest' profiles, of any sympathetic creature they can find who has been in some small way negatively affected by the new law. Lucky for us we've all become pretty hardened to that, and no one cares much what they say anymore.

So I don't care much about deep diving the new law's details. It's politics not healthcare. It's interest groups competing, not doctors, hospitals and Insurance companies. I'll only add this one thing.

Lasics surgery isn't covered by insurance, and is therefore mostly deregulated. And in the past few years it's price has consistently fallen and the quality of it has consistently improved. So too with veterinary care. It's better, and cheaper, because it is mostly unregulated. That's what the market does. It squeezes margins, adds efficiencies, and lowers costs. That's the right way to put the best incentives in place for the rest of the medical industry as well, if we would just have the courage to do it. There's the whole debate in a nutshell. But courage isn't somehting Americans are known for these days.

1 comment:

MikeCLT said...

The healthcare reform I would like to see is for the GOP to override state medical malpractice liability laws and replace it with the type of liability fund the feds created for vaccines. Doctors claim that they have to run all these unnecessary tests or else they will be sued if they miss something. A friend who is a doctor claims that this inflates medical costs by 25%-30%.

Let's see if this is true. It would also have the added benefit of cutting funding for the Democrats by hitting the trial lawyers.

I don't see the government getting out of health care though. As Derb says, we are too far down the road to socialized medical care.