More on Obamacare

April 3, 2012

Mark Steyn, as usual, is must-read material:

Yet he was unintentionally making a far more basic point: A 2,700-page law is not a “law” by any civilized understanding of the term. . . . It’s not just that the legislators who legislate it don’t know what’s in it, nor that the citizens on the receiving end can never hope to understand it, but that even the nation’s most eminent judges acknowledge that it is beyond individual human comprehension. A 2,700-page law is, by definition, an affront to self-government.

Meanwhile Andrew McCarthy offers a great review of how far we’ve already fallen (before Obamacare) into unconstitutional statism.  Did you know that the custom of hospitals’ treating all emergency-room patients, regardless of ability to pay (or citizenship), is forced on them by a 1986 federal law?  In other words, America managed to go more than two hundred years without such a law.  Apparently its ostensible constitutionality weasels in not under the “commerce clause” generically, but by saying that it applies only to hospitals that accept payment from the federal entitlement program Medicare—i.e., “virtually all hospitals in the U.S.”  In other words, again, how far we’ve fallen.  As McCarthy discusses, each expansion of state power becomes a justification for the next.

Update (April 3rd, 2012): Also at National Review Online, a doctor discusses “Doctors, Patients, and the Future of Obamacare”:

As objectionable as the new wrinkles of Obamacare are — the individual mandate, IPAB, etc. — perhaps its worst feature is the way it takes the most harmful aspects of our current health-care system and expands them, rather than cutting them back. . . .

From a doctor’s perspective, insurance is a big problem, and government insurance is a bigger one.

Hat tip to Far-flung Fancies.

22 Responses to “More on Obamacare”

  1. Snoodickle Says:

    Click to access SiCKO_sickofactoids.pdf

    What is your solution to this unsustainable problem?

    • Well, if it’s an _unsustainable_ problem, we don’t need to worry about it. It won’t last long!

      The Affordable Care Act has little to do with giving us better health care. Most of the doctors I talk to about it are really concerned. They say it will mean worse health care for patients and doctors will quit. They say it changes the relationship among doctors, patients, insurance companies, and hospitals such that no patient will have an advocate anywhere in the system. They say it will make the problems with insurance even worse than they are now. (Even Chillingworth recently wrote a post about how much worse Obamacare is looking now than the folks who tried to sell it to us said it would look.)

      Just yesterday, I read yet another doctor writing about it. Check it out: he echoes concerns I’ve heard from doctors (yes, even liberal ones!) for the past couple years.

      • Thanks, now linked above.

      • Snoodickle Says:

        Again, what is the solution?

      • Wrong question. Serious recommendation: You should read Thomas Sowell’s The Vision of the Anointed. (Sowell says, among other things, There are no solutions, only trade-offs.)

        You haven’t disputed unassumingpseudonym’s argument that Obamacare does more harm than good. In other words, Obamacare makes things worse, not better. In other words, even the status quo is preferable to Obamacare. I don’t need to offer you any improvements on the status quo to argue against things that are not an improvement.

        That said, there are conservative alternative reform proposals; there have been all along. (McCain explicitly supported at least one of them.) They include repealing two past interferences from Congress that have made things worse (notice a pattern?): We should allow people to purchase health insurance freely across state lines again, and we should end the unequal tax treatment that has led to most people getting their insurance through their employer instead of directly.

      • Snoodickle Says:

        First, the individual mandate is a conservative reform. If it had been proposed by Bush or Reagan you would support it. Second, allowing people to purchase insurance across state lines is fine, but it will not lead to universal coverage. As to the effectiveness of Obamacare, it won’t even be fully implemented for another two or three years, so any argument on its effectiveness is pure speculation. Comments by some lazy doctor who doesn’t want to work hard for still better than decent pay do not persuade me. Obamacare’s major flaw is that it doesn’t go far enough. Single payer is the only viable solution to this problem. We are the only industrialized country without universal health care, which is a major part of the reason that we are not among the healthiest countries. If you want to argue that not everyone is entitled to health care, and that it’s okay if people die in the name of “liberty” (as I’ve said before, a confusing concept as you define it), we can have that debate, but sensible people will not side with you.

      • “First, the individual mandate is a conservative reform. If it had been proposed by Bush or Reagan you would support it.”

        I don’t know what you mean by “conservative”, but in any case, that’s not an argument.

        “Second, allowing people to purchase insurance across state lines is fine, but it will not lead to universal coverage.”

        Again, there are no solutions, only trade-offs. Saying that a proposed solution will not lead to a perfect world is not a sufficient argument against it. If this reform would be an improvement on the status quo, it should be implemented (it should already have been implemented).

        “As to the effectiveness of Obamacare, it won’t even be fully implemented for another two or three years, so any argument on its effectiveness is pure speculation.”

        So the arguments for Obamacare, based on projections that it would reduce costs and insure everyone, were totally valid, but the revised projections (including some from the same people who made the original projections) that it won’t insure everyone and will cost vastly more than predicted before are “pure speculation”? You can’t have it both ways.

        “Comments by some lazy doctor who doesn’t want to work hard for still better than decent pay do not persuade me.”

        That’s ad hominem. It’s not an argument.

        You may be surprised to learn that calling people “lazy” doesn’t persuade them to take on extra work for no extra pay just because the government wants them to.

      • Snoodickle Says:

        What about single payer? The healthiest countries in the world use it, why should we be the only industrialized nation without universal health care. Make that argument.

      • Snoodickle, you sound confused about what problem you are trying to solve in the first place. That list of “facts” you linked too is clearly propaganda and confuses the issues. If you don’t believe that, take a look at the second item, which cites false information alongside current information to make it seem worse to you. Don’t give in.

        Do you really care primarily about the health of Americans? Those answers are easy and have nothing to do with insurance. We have bad health because of diet and lifestyle choices. Europeans don’t live on bacon and french fries. Even your own list says that American health problems are things like diabetes, heart disease, and lung disease! Anyone working in preventative medicine will tell you that all the biggest factors in our health are the choices we make in our own homes. With respect to lung disease specifically, a pulmonolgist I know used to say “lung cancer is the most preventable, and the most deadly, form of cancer.” That is to say: not getting it is up to us, and once we get it, not even the most amazing health care system has a good chance of curing us. (but we’ll take the treatment anyway and it will be expensive, which contributes to the high “cost” of heathcare in the US.)

        A lot of the comparative-health-system talk is comparing apples to oranges. All those European systems we cite are actually very different from one another. And frankly, I’m not persuaded by recitations of misinformed talking points.

        Also, I think calling doctors lazy and overpaid is probably one of the most laughable insults I’ve ever read. You must not know very many doctors, or have a good understanding of what they do, or of what it takes to become one. Actually, the last doctor I talked to about Obamacare draws a yearly salary of $20,000. You may be thinking of anesthesiologists when you say doctors are overpaid. They do quite well. But the anesthesiologist’s job is to be there with a patient during a whole surgery, keeping the patient alive. It’s hard, and there is a life at stake every single time he comes in to work. How much money would you ask if it were your job? How often in your current work does the smallest mistake mean watching someone dye before your eyes?

        On the other hand, I have met lazy doctors. But only in countries with socialized medicine (hmmm!). When a doctor answers to the government instead of his patient, his incentives change. He isn’t working for the best outcome for his patient. There’s no way around that. I’ve lived in those systems. I don’t want to again.

      • haha! Should be “die” not “dye”! What a goof!

      • Snoodickle Says:

        What is your proposal again?

      • My proposal is scrapping Obamacare in favor of a more accurate analysis of what, exactly, the problems are and what is causing them. Also, eating healthy. I’m not going to re-type all my comments. I notice that although you keep asking us for our solutions (which we’ve given you), you have yet to provide one. Unless your proposal is Obamacare, in which case, you have yet to counter any of our criticisms of it. Read our comments, and therein you will find our proposed solutions. I can’t do your thinking for you.

      • Snoodickle Says:

        Here’s my proposal – do away with for-profit insurance companies, which admittedly Obamacare does not do. Even a simpleton can understand that allowing a health insurance company to profit from its insureds creates an inherent and unresolvable conflict of interest. This is why single payer works so much better, or multi-payer that relies on not-for-profit funds. Any objections?

      • Snoodickle Says:

        P.S. – I just read your comments and you haven’t proposed a single solution other than “eating healthy.” Ha!

      • I think it’s already clear who won here, but since I just happened to read something very much on topic, I want to pass it on:

        In the UK’s single-payer system (that’s Snoodickle’s ideal, right?), a woman was banned from the doctors’ office she had been going to for 30 years, supposedly because she was driving too far to it and making too big a “carbon footprint”.

        It was a one-mile drive.

        The only problem with giving the government control over any given thing is that then the government will have control over it.

      • Snoodickle Says:

        For someone who knows little to nothing about winning, you seem to be the authority on such things. I do favor single payer over our current system, but my ideal system would rely on multi-payer nonprofits that are more localized. Any system that removes the conflict of interest present in the insurance business is a plus though. On that note, and since you answering for assumingpseudophredine, are you disputing that for-profit insurance creates a conflict of interest that is harmful to the insureds?

      • Snoodickle Says:

        I’ll take that as a concession of my point. I win!

  2. Tevyeh Says:

    To digress ever-so-slightly from the post, I wanted to make my official prediction of the outcome of this case (I’ve made this prediciton before, but never publicly and never online, and this is as good a place as any):

    After a lengthy discussion of the Constitutional difficulties inherent in a Federal mandate compelling citizens to purchase something, the Court will find that the individual mandate is Constitutional. However, the opinion will emphatically state that this holding does not give the federal government a blank check to compel just any action on the part of the citizenry. They will decline to define the boundaries of the federal government’s power to compel individual economic activities, invoking the magic words “We Need Not.”

    I hope I’m wrong, but if not I eagerly look forward to reading Scalia’s dissent.

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