…isn’t just that it’s unconstitutional:
The key problem is the overall concept —- which begins from the premise that our system of health-care financing will only keep costs under control if the government becomes an even greater force in the health sector than it is now and proceeds to create a system that will cause premiums to rise rapidly in the individual market and create major dislocation in the employer market, driving people into vastly overregulated exchanges that would push premiums higher still, and then initiate a program of subsidies whose only real answer to the mounting costs of coverage will be to pay them with public dollars and so inflate them further. It aims to spend a trillion dollars on subsidies to large insurance companies and the expansion of an unreformed Medicaid system, to micromanage the insurance industry in ways likely to make it even less efficient, to cut Medicare benefits without using the money to shore up the program or reduce the deficit, and to raise taxes on employment, investment, and medical research. CBO does not expect it to make a real dent in the inflation of health-care costs or to avert the fiscal implosion of Medicare. Instead, it will double down on price controls and centralized administration and make a real reform of our system much more difficult.
But other than that, it’s great.
Before the government takes control of all health care, wouldn’t it be useful for it to prove it can properly manage the existing programs. What with the VA, Medicare and Medicaid having been in operation for decades, you’d think the government’s track record would suggest it doesn’t know how to manage health care, and you’d be right.
Imagine you have an inept handyman (say, a brother-in-law) that bungles every job he takes on. The workmanship is poor and the price is always far higher than estimated. If he weren’t a family member, you’d do everything possible to avoid using him for anything. Now, you’re getting ready to build a new house and he insists he can be the general constuction contractor in charge of everything. Would you give him the job given his track record?
Beyond health care, is there any segment of the economy that government runs better than the private sector?
Larry, there’s the areas of national interest that we don’t leave to private control, such as national defense, espionage, and law enforcement. I’m not hazarding a guess beyond that.
Those are generally the exclusive domain of government, not private industry (although private security firms and companies like the former Black Water stretch the rule somewhat). In cases where the government competes with private industry to do the same job, can you think of any examples where the government does the job better or more cost effectively? Off-hand, I can’t. Government ran colleges might be the exception on cost effectiveness as opposed to private universities (think State U verses Ivy League) but the state schools are subsidized and there is endless debate about the quality differences.
Any health care program that does not increase the number of doctors will not lower costs.