Obamacare Predictions: Part II

Read Part I. I’ll be away from the computer a large portion of today and will be slow in answering comments.

Your health care will degrade

Since the deficit will be almost impossibly high, taxes will not be able to be raised fast enough to pay for it. Thus, in the period of ten to twenty years out, politicians will be forced to cut government payouts.

This includes payouts from Social Security, Medicare, Medicaid, and Obamacare. Again, this is not something which is merely probable, but is certain. Demographics alone guarantee this.

Health care must eventually be “rationed,” in the same sense as it is in other countries with socialized medicine. In effect, those other countries will also suffer, because the States will no longer be available as a destination for superior care. Newfoundland and Labrador Premier Danny Williams will have to stay home next time he wants heart surgery.

Currently, few to none are denied care, regardless of their financial status. Poor people go to the emergency room for (expensive) routine care, for example. These costs are spread among those with money: already, in effect, people with insurance are already subsidizing those without.

That will continue to be so under Obamacare, where the subsidies are given a new name, but with the addition of two new layers of bureaucracy: one on the business and hospital side, and one on government. The cost savings of shifting people out of the emergency rooms and into offices will be ate up by paperwork. That must mean that service will degrade.

Be clear: poor people aren’t being granted new health, they are being granted a new name for what is already given.

Because this is true, I think predictions about doctor shortages are incorrect in one sense. Since everybody can already have care if they need it, there are, within some range, enough physicians to provide that care.

I mean, there will not be a flood of new patients, because these people are already there, somewhere in the system. What will instead happen is that these people will be redistributed in the system. We will see fewer ER visits for routine care, and more to general practitioners. There could be a doctor shortage in that sense, but that will quickly stabilize.

Doctors will receive less money for their services, and this will persuade some that would opt for that career to do something else. Any trend in availability will be gradual, however, because of the large inertia in the system.

Your liberty will be restricted

Health can mean, and will come to mean, anything which is related to human behavior. Absolutely everything you can think of, or say, or do can be plausibly related to health.

Since the government will be paying the bills, it will feel it has the right to proscribe or tax any behavior that would adversely affect your “health.”

Government especially will call for new sin taxes to pay for the deficit. This will lead to hypocrisy and lying of the highest order. I mean, politicians will know they are lying when they say, “We have to add this health tax on internet usage, because heavy internet use is associated with poor attention in school. We care about the mental health of our children!”

Enjoy the occasional soda pop? No, sir! That’s bad for you. “Waiter, where’s the salt shaker?” “I’m sorry sir. The law won’t allow us to add salt to our food.” Listen to talk radio? That’s bad for your stress level, I’m afraid. The “Fairness” Doctrine will help ease your suffering.

Too much CO2 in the air leads to adverse global warming, which leads to effects too numerous and too horrible to list. Yet the EPA will give it their best effort: it will take decades to do so. My most novel prediction: the number of miles driven per citizen will be limited, with inspections and fees paid for overages.

Favored political groups—“mascots” as economist Thomas Sowell calls them—women desiring abortions, people who want sex changes, drug addicts, and on and on and on, will find a way to squeeze money out of the government.

I have already speculated how homeopaths and other quack medics will seek protection. Perhaps many thought I was exaggerating. But Friday, Dennis Kucinich (D-Ohio) in an interview to explain his vote switch with Fox News reporter Neil Cavuto, said that he looks forward to a “whole new way of” medicine. To include, he said, “complementary and alternative” treatments. Just as I predicted.

All these moves will dramatically increase the Gross National Cynicism and increase the antagonism between special interest groups and citizens, further degrading public life.

Your sense of paternalism will increase

I saved the best for last.

Liberty used to be the most important part of life in the States. For those who are not natives, our heated emotion over this topic might seem strange. But recall that our country began with a provocation infinitely smaller; a trivial tax, which would have been far cheaper to pay for than any rebellion.

We saw it as a question of who would be allowed to decide our fate. We did not want to be dictated to from on high. We wanted to be left alone.

But no more. Increasingly, people see “government” as something other than themselves. They see “government” as an entity that somehow exists independently and can be called upon to fix all ills, even personal ones. Resources appear like magic.

People will not be as quick to think that they or their families can take care of themselves. They will more often go to the government and asked to be looked after.

And they will be.

Read Part I

Update For those who doubt the “every aspect of life” prediction: don’t forget this country once lost its mind with alcohol, even to the extent of modifying the Constitution. What happened before can happen again.

13 Comments

  1. Speaking as someone with experience providing medical care in emergency rooms on both US coasts and in the midwest, you are likely to be correct on virtually all predictions.

    Central governmental control of access to health care in the US will be a different animal than in Europe or Canada, due to the vastly different demographic makeup of the US population. As you say, it will become too easy for government to make every area of human action relevant to government health care oversight and regulation.

    As if the US private sector did not have enough problems already, diverting such huge amounts of additional (nonexistent) resources into the public sector will make recovery of private enterprise almost impossible. It is as if the Obama Pelosi government wants to create a large permanently unemployed class in the US, for some reason.

  2. “To include, he said, “complementary and alternative” treatments. Just as I predicted.”

    That has certainly happened in the UK’s NHS. Alternative therapies like acupuncture and even homoeopathy were offered from (I think) the late 1980s onwards.

    However there are moves afoot to limit or stop this

    http://www.guardian.co.uk/science/blog/2010/mar/12/mps-and-evidence-for-homeopathy

    Progressive movements have always attracted cranks and sandal wearers. Lenin famously refused to use “Bolshevik doctors” because of their preference for alternate medicine. And Orwell observed “Socialism, ” attracts “with magnetic force every fruit-juice drinker, nudist, sandal-wearer, sex-maniac, Quaker, ‘Nature Cure’ quack, pacifist and feminist in England.”

  3. All your predictions are worthless – they will happen whether or not HCR is passed. The cost pressures are already there and will impact health care in this country regardless of any legislation. Unfortunately, because of Tom Harkin, the US is already wasting money on a National Center for Complementary and Alternative Medicine (NCCAM):
    http://nccam.nih.gov/

    My biggest complaint with Obamacare is that it is directed at insurance companies. They have little to do with the amount wasted on health care in this country. It is the providers – doctors and hospitals. I want someone between patients and doctors. Otherwise, there is no incentive to reduce cost.

    The only solution is to make individuals responsible for their health care. Health care should not be tied to employment – that is the result of government policy. The elderly should not be a protected class. I won’t hold my breath for that kind of reform until the cost pressures blow up the entire system.

  4. Your predictions are so fun that I intend to take better care of myself from here on so I can observe them first-hand. The one prediction I am not so sure about is the one about decreased visits to the ER. The ER is the only service open during the hours that many folks actually stir.

  5. Best to ban tea parties too as they cause too much stress for our representatives.

    Just this week I got my alumni magazine, Oregon Quarterly (U of O), which had an article called “At the Zoo” by Robert Leo Heilman. This magazine keeps me informed on the latest liberal/progressive thinking. He hit right on your comment about talk radio causing trouble and stress. Quote:

    “Those who profit from the subversion of reason, who inflame smoldering anger for personal or ideological gain, who appeal to the worst in human nature – to our anger, distrust, resentment, and greed – are much more dangerous to the domestic tranquility of this nation than the majority of common criminals.”

    Wow!

    Also, there was also a short note on a David Letterman interview with M. A. Sanjayan (The Nature Conservancy) about how global warming alarmists are too “doom and gloom.” Perhaps they will need to lighten their attitude when the bill goes through to help reduce the stress.

    You can check it out at oregonquarterly.com

  6. As always. Spot on. Just look across the water aas us. t us. In the UK this is dragging us down. Where were we in the economic tables and now look at us. Almost a third work country. Well crack on — can’t wait to see you in the same straights as us. God Bless America.

  7. The more health care is seen as a free good, the more of it will be consumed. Charity care has a way of limiting misuse – an undoubtedly some underuse in certain cases. I do see increase demand for physician services and no decline in ER services. For our PPO plan, it was not until we significantly upped the co-pay on emergency room care ($150) that we really saw a significant drop in the use of this “convenient” form of medical treatment. Because the whole program is designed to avoid the use price as a mechanism for managing behavior and rationing treatment, demand for treatment regardless of cost will increase.
    One early indicator will be in the use of ambulances and emergency services. I suspect that since this will now be covered there will be increased usage.

  8. Although I think your analysis is correct, I think it underestimates cost because one of your premises is false. I argue that emergency room care is not more expensive; its cost is mostly accounting tricks for tax or regulation purposes. This is done by mostly shifting fixed and overhead costs onto the emergency room balance sheet. Please see this article;

    http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/

    My guess is the rest of your argument is correct just underestimates the negative affects on the system. The pressure to cut costs will quickly put downward pressure on salaries of doctors and the actual providers.

    An interesting aside, a friends grandmother in France needed eye surgery or she was going to go blind. At the hospital, where doctors now get paid less than plumbers, the eye surgeon wanted a cash kickback to perform the surgery. Confounded she drove to Paris to see another doctor who wanted the same kick back. It seems the doctors had decided their services were more valuable than the govt.. was willing to pay. Of course she paid and got the surgery. I mention this because I think the governments reaction to the perverse incentives in this bill will lead to a health system similar to France’s system.

  9. Ignacious,

    Interesting antecdote. Illustrates (true or not) that the market rules. Prohibition creates black markets, price controls gray markets.

    Al Fin,

    I think you’re partly on track, but partly off. Doctors need to make whatever the market can bear. It’s insurance that insulates consumers from suppliers (patients & doctors). I think you’re dead on that individuals should buy insurance, not employers.

    A sensible insurance plan would have a high deductable so that patients paid cash for all routine services, the insurance would be for the unexpected catastrophe – it makes no sense to pay insurance to pay the doctor for what you were gonna get no matter what.

    Once created a real (we don’t have one now) health care market would select the most efficient (cheapest) forms of insurance. Since patients would be paying directly for much of their care, the market would also select the most efficient providers.

  10. Barack Obama in addition to the rest of his liberal cronies should really be embarrassed with them selves. This is an absolute outrage. I seemed to be under the impression that when the us president will take office he is required to make an oath to uphold and also defend the constitution of our great country. Nowhere inside the Constitution does it provide the government the authority to enact or enforce legislation like the healthcare reform bill. I believe that these power mongers are going to be in for a total surprise come November. Great job on the demise of your political careers.

  11. This legislation and it’s myriad unintended consequences will be truly the greatest threat to Liberty and the economy for the next 100 yrs if left to stand. As correctly pointed out, everything will fall under the rubric of “public health” and be either taxed or regulated. My biggest fear is that we , the people, will do nothing other than gripe. Everyone seems to feel that those who voted for this abomination must go, but in reality, when it comes to our own incumbents, we are much less enthusiastic. Hopefully the anger will not wane prior to November and we can start to vote these bums out.

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