Cato's Silly Premature Obituary for Obamacare

 

       The operative word here is "may" and it would be far more accurate to say "some Americans." In fact, there's tremendous flux right now in the health insurance market. Tanner cites a study that found that 40 percent of doctors "are uncertain" whether they will be included in networks of plans being sold through the new health exchanges. Those doctors will probably have a better fix on things a few months or a year from now, at which point consumer choices will be much clearer. Anyway, Tanner's main point is that if you change to a plan that doesn't cover your doctor, you'll have to go out network to see that doctor. That point is well taken and surely disconcerting to those people affected. But a lot of Americans, like myself, actually don't have strong allegiance to "their current doctor" because they don't go to the doctor very often. One of my few longstanding relationships with a doctor is with my eye doctor. I like him just fine, but wouldn't especially care if I had to shift to a different eye doctor -- especially if that inconvenience were part of a big national effort to make sure that every American could have any doctor at all. As the Times noted in 2012, writing about government data: "People lacking insurance were far less likely to go to doctors. Just 24 percent of the uninsured went to a doctor at least once in 2010, compared with 72 percent of the general population of working age adults, the report found." Now that's an urgent and serious  problem, more so than some people not wanting to switch doctors. 

       

       This is likely true in the short run, as people are forced to buy better health insurance policies and other changes, but what about the long run? What if Obamacare succeeds in slowing the murderous rise in premiums, as some suggest it is already doing -- so that we're all paying less five years from now than would otherwise have been the case? That's definitely a scenario that's worth considering here, and Tanner himself acknowledges about future premiums that "there is no way to know what will happen. . . . " Exactly my point with the ACA still in the maternity wing -- or the incubator, really. Anyway, the first part of the sentence is key. Nearly every big national reform of anything ever has resulted in winners and losers, and probably the better question to ask is whether the gain to losers offsets the pain for the winners. Tanner never asks that question. 

 

      Tanner makes some good, although familiar, points about how the law's real ten-year costs were obscured by its slow phase in. But here again, we need to wait and see what the "final" cost is of a law is that could be on the books for decades and will certainly be amended by future political leaders. If some of the many cost containment experiments that are part of Obamacare bear fruit, and this nation finally gets healthcare costs under control -- with huge implications for future Medicare outlays -- we may later look back on passage of the ACA as a historic turning point when the United States began to steer away from the shoals of healthcare-induced national bankruptcy. Better yet, if the law becomes a stepping stone to genuine government domination of the healthcare marketplace -- which is the only proven way worldwide to contain healthcare costs -- than the right prediction now would be that "the law's cost savings were wildly underestimated."

 

      No kidding. But what do you expect when legislators in two dozen states would rather placate the far right than expand Medicaid to cover millions of poor people and bring thousands of healthcare jobs to their states. I predict, along with others, that many of those states will eventually come around when Tea Party strength has waned and business and healthcare interests are more fully heard. As for all the people not signing up, let's talk in a few years. Or just look at Massachusetts now, where 98 percent people are covered eight years after Romneycare was enacted. 

 

      Tanner's argument here is very much in the here and now, citing a blizzard of facts that are vigorously contested by the law's advocates. Whatever. Again, it's more interesting to think long term: In fact, the law could lead to major economic benefits by helping the United States control healthcare costs in coming decades and compete more effectively with industrial powers that spend half as much national wealth on healthcare as we do. Indeed, many of the advanced world's most economically free and and dynamic economies, by Cato's analysis, are also countries where government dominates the healthcare marketplace and some form of universal coverage has long been in place. As I have argued earlier, "If CATO Read Its Own Study on Global Economic Freedom, It Would Stop Bashing Obamacare." I've also pointed out here that universal coverage is the key to a dynamic economy because it makes it easier for entrepreneurs to quit their day jobs and start new businesses.