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TIM O'BRIEN - B&W_cropExpect the tempest over “ObamaCare” to continue brewing in tea parties across the country.  The one-party party in Washington, ostensibly to reduce the cost of health care services, ought to have been hosted by the Mad Hatter.

Now, reducing the cost of health care is a laudable goal — even in a country that already provides state-of-the-art service, the envy of the world, to 85% of its population.  However, amid all the sound and fury over the uninsured, pre-existing conditions, etc., the careful observer will note that nothing in the legislation will actually reduce the cost of health care.

Since it appears that virtually everyone in the Democratic Party at both ends of Pennsylvania Avenue slept through Econ 101, it is necessary to inform them of a fundamental of economics first articulated by Adam Smith just about the time our country was being born.

Here is that insight.  There are only two ways to bring down the cost of any good or service: increase supply or reduce demand.   That’s it.  There is no third option.

What we got instead from the Pelosi-Reid congressional committees (including, one might suspect, the March Hare and the dormouse) is mind-numbingly detailed legislation the goal of which is not to reduce but rather redistribute health care costs.

At the risk of belaboring the obvious, one does not reduce costs by merely handing someone else the bill.

Perhaps it would help to clarify by removing the question from the billion-here-billion-there surreality of government spending to a more mundane example.

Consider, for instance, a teenager importuning mom and dad to pick up the bill for his car insurance.  While this would certainly help junior’s cash flow, it should be apparent to even the most obtuse Obamaniac that there would be no net gain for the family budget.

Just so for transferring the cost of providing the remaining 15% of our citizens with health care.

The essence of the legislation is actually to subsidize insurance for poor and high-risk patients, raising the necessary revenue by:

  • Expanding  the pool of premium payers by conscripting those who are both better able to provide and less likely to consume resources.
  • Reducing existing insurance plans by cutting a half-trillion dollars from Medicare and taxing private ones that offer better than average benefits.  (Both of which must have been dreamed up by truly irony-impaired health care reformers as the well-known, founding maxim of the medical profession is “First, do no harm.”)
  • Fining individuals who fail to purchase, and businesses with fifty or more employees who fail to provide, coverage.
  • Compelling future taxpayers generally to cover the remainder.

Clearly, nothing here either increases the supply of, or reduces the demand for, health care services.

Indeed, adding tens of millions of new health care consumers — the costs for whom are to be borne by someone else — seems to be the whole point.  Since demand will inevitably skyrocket  that approach to bringing down costs is foreclosed with a vengeance.

And while I haven’t read the entire 2000-page bill (but then, who has?), neither does there appear to be much, if anything, in the legislation to increase supply.  Certainly, the planned “reconciliation” fix of putting a 2.3% excise tax on medical devices will have the opposite effect.

The plain fact is this “reform” is not about reducing the cost of health care.

Nor, it should be pointed out, is it about providing insurance, as that is a financial arrangement among a large group of people who collectively protect themselves against an individually bankrupting loss by pooling and subdividing the risk into affordable “premiums.”

This legislation does precisely the opposite — not only covering even the most routine health care services but also further disconnecting beneficiary from premium-payer.

“ObamaCare” is in fact simply a new welfare program.  Perhaps even one the American public supports.

But let’s not pretend that it is either “insurance” or a magical reconfiguration of spending that will somehow reduce costs.

Our country can no more increase national GDP by transferring money from one citizen to another than you can improve your family finances by taking the money for your son’s car insurance out of your daughter’s college fund.

Indeed, the cost of the expanded bureaucracy will swamp any small economies of scale that might be realized in expanding the consumer pool by the estimated 10%.

And that’s not even taking into account the inefficiencies that invariably attend any monopoly (which apologists in this instance prefer to euphemize as “single-payer”), unconstrained as it is by the opportunity for captive clientele to seek an alternative provider.

What we really have here is a classic example of the government “two-step” that has made it — rather than any productive segment of the economy — the premier growth industry in the country.

Step #1:  Manufacture a crisis. Chicken Little hysterics notwithstanding, there is no significant problem in either the quality or availability of health care in our country.  The overwhelming majority of Americans not only have health insurance, they are perfectly satisfied with the coverage it provides.  But imminent catastrophe is the stock-in-trade of the public sector.

Step #2: Propose extensive, new programs. Expanding the size and scope of the state, increasing spending, hiring, patronage and pork-barrel opportunities, rationalizing ever more intrusiveness and control.  That is the apotheosis of cradle-to-grave, caretaker government.

And in that, “ObamaCare” promises to be a smashing success.

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One Response to “Yeah, but what about reducing health care costs?”

  1. TimOBrien says:

    Well, a recent AP report indicates that, at least the state level, some thought is being given to actually reducing health care costs:

    Facing doctor shortage, 28 states may expand nurses’ role
    By Carla K. Johnson, The Associated Press

    CHICAGO — A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. more…

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