Markets find ways to make things better and cheaper. Obamacare
forbids that.
Most
Americans -- even those who are legislators -- know very little about the
details of President Obama’s Affordable Care Act, so-called Obamacare. Next
year, when it goes into effect, we will learn the hard way.
Many people
lazily assume that the law will do roughly what it promises: give insurance to
the uninsured and lower the cost of health care by limiting spending on dubious
procedures.
Don’t count
on it.
Consider just the complexity: The act itself is more than 906 pages
long, and again and again in those 906 pages are the words, “the Secretary
shall promulgate regulations ...”
“Secretary”
refers to Secretary of Health and Human Services Kathleen Sebelius. Her minions
have been busy. They’ve already added 20,000 pages of rules. They form a stack
7 feet high, and more are to come.
Our old
health care system was already a bureaucratic and regulatory nightmare. It had
16,000 different codes for different ailments. Under our new, “improved”
system, there will be more than a 100,000.
Government
likes to think regulations can account for every possibility. Injured at a chicken
coop? The code for that will be Y9272. Fall at an art gallery? That means you
are a Y92250. There are three different codes for walking into a lamppost --
depending on how often you’ve walked into lampposts. This is supposed to give
government a more precise way to reimburse doctors for treating people and
alert us to surges in injuries that might inspire further regulation.
On
Government-Planned World, this makes sense. But it will be no more successful
than Soviet central planning.
Compare all
that to a tiny part of American medicine that is still free-market: Lasik eye
surgery.
Its quality
has improved, while costs dropped 25 percent. Lasik (and cosmetic surgery) are
specialties that provide a better consumer experience because they are a market.
Patients pay directly, so doctors innovate constantly to please them. Lasik
doctors even give patients their cellphone numbers.
President
Obama didn’t kill American free-market health care. It began dying during World
War II, when government imposed wage and price controls. At first, companies
said, “Great, stability!” But then they realized that they could not attract
better workers without raises. So companies got around the rules, as companies
do. They gave “benefits,” like health insurance.
Government then
distorted the market further by giving employer-based health insurance better
tax treatment than coverage you buy yourself.
But
employer-based insurance is nuts. Many workers feel locked into their jobs.
Company insurance largely destroyed the health care free market, since
employees rarely shop for the best service at the lowest price.
Now
Obamacare may kill what’s left of that market.
Maybe we
will soon be like Canada, where some people wait years for treatment. A
producer from my TV show went to a Canadian town where the town clerk pulls
names out of a box and then phones people to say: “Congratulations! You get to see a doctor this month!”
But there is
at least one area where Canada offers cutting-edge, life-saving technologies.
Unfortunately, to get this care, you have to meow or bark. Veterinary care is
still handled by the market. Providers innovate or go out of business.
Markets find
ways to make things better and cheaper. Obamacare often forbids that. For
example, it requires that every insurance policy cover
preventive care and “breastfeeding support.” It insists that mammograms and
colonoscopies be provided without any deductible.
It’s
tempting to believe that such rules prevent illness and save money, but there
is little evidence they will. Some people will undergo invasive procedures that
shorten lives instead of extending them. Some of us want those tests; some
don’t. Government controlled medicine means we all get
them and pay for them, regardless of whether we want them. Government control kills
consumer choice.
Lucky Lasik
and cosmetic surgery patients! Their treatments are better in part because
government doesn’t consider them important enough to subsidize and regulate. If
only government would neglect the rest of health care! Then we’d have better
service and better care at lower cost.
And we’d have choices.
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