During the past few months Patch has become my primary source for local political news, news regarding the views and the electoral fortunes of our state, county and city politicos.
So, in looking over the comments posted in the aftermath of the late and unlamented election, I was attracted to the hundreds of reactions to, among other things, the unsurprising Obama sweep. As usual, much of the commentary came from what I call the "regulars," those individuals — most of them leftist fundamentalists — who, it seems, get their jollies by arguing with others about topics ranging from existence of God to the proper method of buttering one's breakfast toast. (The latter, of course, being a facetious example: I would not, however, be too surprised if some such trivial matter might some day generate a few hundred posts on Patch).
What really attracted my attention was the protracted argument about the merits and demerits of ObamaCare (aka the Patient Protection and Affordable Care Act [PPACA], a title reminiscent of Orwellian Newspeak). An aside: I did not read many of the hundreds of Obama encomimia (apologies for the "big" word: but it was the only one I could think of offhand). Most were the kind of political commentaries —including the traditional Bachmann bashing that turned up on another thread — that I think most people would find to be both annoying and stupid. But the PPACA exchange was, at times, somewhat worthwhile, worthy of further comment.
So, at the risk of being identified as one of the "regulars," I will venture a few comments of my own: my reactions to several of the points which surfaced during the ObamaCare discussion.
Foremost, there is the left's preoccupation with the rising costs of U.S. health care. Unfortunately, however, this concern serves as little more than a slogan, an ill considered rationale for embracing ObamaCare or, even, a reason for adopting a single payer health care system (something which we may have much sooner than some may think possible). What is lacking, of course, is any critical analysis of (or even any real awareness of) the forces and factors that have contributed to/driven health care costs during the last several decades. There are many such factors: fraud, malpractice litigation, "waste" (however that might be defined).
In my view such factors are, however, somewhat peripheral. The really signficant factors, rather, are advances in medical technology; the labor intensive nature of health care; the extensive training and rigorous standards required for those entering into and functioning within the health care system (and the relatively higher salaries involved); demographics (i.e. an aging population); increased patient demands/expectations, etc.
Consider, for example, the technological advances in health care during the past few years. Computerization, less invasive surgical procedures and so forth, innovations which have required extensive and costly investment, creativity and, of course, increased costs of care (although, whether in the long run or in the present, many of the advances may actually decrease (or have decreased) costs of care). Regrettably, it is here that the leftist nostrums, specifically the price control response to rising costs, threaten to do the most damage.
How? By inhibiting investment in medical technology, both of the "hard" and "soft" variety. (The real tragedy, obviously, is that we will probably never know what we might have missed: the advances that might have been but were strangled at birth because of externally/artifically imposed pricing policies). In this regard, like all good folks of a socialistic mind-set, leftists typically give priority to "equality," equality to be achieved, at least in part, by controlling the price paid by the consumer, health care in this instance. In a word, leftist ideology -- with its notions of price control-- does not mix well with a dynamic, market oriented economy.
And what of salaries? If we are to reward health care providers in a manner commensurate with their knowledge and skills and the demands placed upon them, we must pay them well (and often at a rate that typically exceeds rates of pay in many other sectors of the economy). Again, bureaucratically imposed price controls of the type implied in PPACA regime are quite likely to reduce the "quality" and quantity of health care providers. Interestingly, we see agitation on the part of nurses who seek less demanding workloads and higher salaries while at the same time bemoaning the high cost of health care. Foolishness anyone?
Moreover, leftists never seem to tire of telling us that insurance companies are evil inasmuch as they put "profits" before people. In this context we are fed a lot of class warfare nonsense about rich CEO's, about profiteering and the like. And we are also told that the government can do a much better job of coordinating health care while reducing costs.
Why? Because, among other things, it is claimed that government regulation and/or control of health care would eliminate the "profit" motive. Do people who make such claims, consider the fact of the large government bureaucracy required for administration and coordination of a government run (or highly regulated) health care system. Won't the salaries, benefits and sheer numbers of the bureaucrats involved more or less replace the insurance company "profits"? Arguably, government run health care and the attendant red tape will entail more overhead expense than a market oriented system.
Furthermore, government doesn't worry much about competition and the cost reduction incentives that competition provides. In this regard, consider the increased bureaucratic overhead associated with implementation and administration of PPACA. Or consider the extent to which regulatory costs (as in Medicare) have already contributed to rising health care costs. (Hopefully, however, the competitive elements of PPACA, health care exchanges in particular, will blunt the non-competitive aspects of the new "system".)
Although there is much more to said about government regulated health care (as in PPACA) or as in the single payer system (the dream of the "hard" left, a dream/nightmare which is likely to be reified in the next ten years or so), I must stop. But with one final comment: the PPACA is demonstrably oppressive, unjust simply because of its jerrybuilt complexity.
Forget the foregoing critique and reflect, for a moment, just on the effect of a confusing two thousand plus piece of legislation and the thousands of pages of regulations which will be required to implement it. It will be difficult to know whether or not one is complying with the law or not, it will require enormous amounts of paperwork and it will be psychologically and physically wearing.
But the leftists wanted it, got it and left the rest of us to live with it. Some gift!