In response to a friend who could not see any downside to ObamaCare, I have to say that anyone who says they can’t see the down side of a major piece of legislation, forged in compromise between the various factions of one party with a handful of defectors from the opposing party, hasn’t looked at the law or the facts. Even when Congress acts in ways I approve of , I know that there is a downside, and that a significant portion of the citizenry strenuously objects.
The foundational concept of economics is scarcity. There are simply never enough resources to do everything. Even the wealthiest persons and the wealthiest societies must prioritize where to spend their resources. For example, Even Bill Gates cannot maintain his lifestyle and feed everyone in Africa, even his resources are not enough to do both. How we organize our society to use resources defines our economy.
Modern economies exist along a continuum, stretching from capitalism through socialism to communism. Neither pure capitalism, where a laissez faire market makes decisions with no governmental interference nor pure communism where no markets operate and the government makes all economic choices, actually exist.
America has primarily had a democratic capitalist economy throughout history, with growing government regulation of markets since around 1900. Europe, on average, has a stronger socialist tradition and has markedly more government decisions made in the economic sphere, while still retaining quite a bit of a capitalist market.
In Europe over the last few decades the government has essentially taken control of the healthcare industry and removed the market’s ability to make decisions based on supply and demand, and the government allocates the resources. In America government interference in the health care market has been slower but growing.
In the last century, medical technology has improved exponentially. Diseases, disorders and injuries that were once life threatening are now routinely cured. In western civilization, infant mortality has virtually vanished and average life spans have almost doubled. The technological means to treat illness and injury have created a longer lived populace. No one has yet found a way to pay for all of this.
Health care is now said to occupy 18% of the US economy. A few more cancers subdued with new treatments and that percentage will grow. Larger, and aging populations along with better treatments mean more and more people demanding health care. Eventually, if technology advances enough, economic demand for health care will become completely unsustainable. More 90 year olds, 25 years retired, demanding their latest cancer be cured, their lives prolonged, will subsume the economy.
Conservatives believe that the best way to solve the problem is through the market. Let an open market system value health care and it should make efficient decisions about how to allocate resources. Market economics also allows for the best re-investment in R&D, which is why the US’s much criticized health care system still counts as the most technically advanced.
According to liberals, the market is not fair. It is, by their narrative, essentially unjust because the wealthy do better than the poor. Even with America’s evolving system of insurances and HMOs, poor folk are can be priced out of newer and more expensive treatments.
For conservatives, the issue is complex but the principles are simple. While the market may make decisions that seem unfair to certain observers, it makes them efficiently and facelessly. If the insurance market was more de-regulated, allowed to cross state lines, used only as insurance, and not as a complete health care funding apparatus, costs would become more generally affordable.
ObamaCare means to further regulate the market. But Hayek and history have shown that when governments attempt to supplant markets several negatives accrue. First the government becomes more powerful. No more does the market decide that nonagenarians who still have wealth can be treated for melanoma. Now a bureaucrat decides that no melanoma patients over 93.25 years will be funded for melanoma treatments. Second, the government is never as efficient as the market at making decisions, so it will use resources far less efficiently. Ultimately inefficiency will create even more unfairness than the market.
ObamaCare’s mandate/tax provision means that the government is now essentially telling everyone how much they are required to spend on Health Care. The act also defines what everyone must receive as part of their health care plan. Hence, the religious community’s objections to cover abortion and abortifacients.
So the conservatives see downsides in inefficiency, in growth of government power, in loss of freedom of choice.
I’m sure there are positives, especially for those who believe in a different philosophy of government. I simply don’t believe they outweigh the negatives. It seems either extremely biased or extremely uninformed to deny any downside to ObamaCare.
