Obamacare: How Bad Is It?

Cornell law prof William Jacobson's unhappy:

• Yes, it is that bad. The Democrats are about to put in place the legislative, regulatory and bureaucratic infrastructure for a complete government takeover of health care. Just read the comments from the supporters and you will see a common theme -- this is just the beginning. They know it, we know it, and Ben Nelson knows it but doesn't care because he scored some pork for his home state, just like Mary Landrieu


• This is the worst of Washington. Payoffs, lies, deceit, and deception. Oddly enough, I've come to have more respect for the left-wing advocates of single-payer than the so-called moderates who will sell their principles for money. At least the left-wing has principles, even if I disagree with those principles. The moderates like Nelson and Landrieu have no principles, at least none that cannot be sold.

James Joyner says the bill is "pretty bad — historically bad, even — if you’re a believer in limited government and pretty good if you believe in more government control."

As I have argued before, I think passage of the bill will put us on a slippery slope to some form of European or Canadian-style single payer plan. See, e.g., Obamacare: On a Slippery Slope to Where?, in which I argued that:

Slippery slope arguments are often derided as inherently fallacious. As my friend and colleague Eugene Volokh has pointed out, however, there are a number of situations in which slippery slope arguments are perfectly valid. Sometimes the first step down a slope reduces the costs of taking the second step, which reduces the cost of taking a third, and so on. Alternatively, sometimes a seemingly desirable first step creates a situation in which not taking the second step is too costly. A different type of slippery slope exists where the first step changes attitudes, making a second step seem less objectionable. A related phenomenon is suggested by the parable of the boiled frog: A frog put in cold water can be boiled because it becomes desensitized to gradual changes in termperature.

Obamacare potentially entails both types of slippery slopes. As we take the first step down whatever road Obamacare puts us on, it may become too costly not to take a further step designed to control health care costs. A first step down this road may also start a process by which people become desensitized to the growth of government control.

Obamacare also could trigger what Volokh calls a "political power slippery slope." Sometimes an initial change shifts the political balance of power in favor of proponents of taking the second step. Obamacare will create new special interests favoring government intervention as well as creating a new dependent class that acts as a constituency for ever increasing benefits. As Volokh observes: "People who become users of a valuable government service become a constituency for political decisions that preserve and expand this service."

In addition, however, Obamacare also illustrates yet another situation in which slippery slope arguments are valid; namely, the case in which the proponents of taking the first step intend to keep pushing us down the slope.

In my post From the Trojan Horse's Mouth: They Plan on a Slippery Slope, I revisit that last point, quoting some left-liberal pundits who openly admit that they see Obamacare as a Trojan Horse for single payer.

So, yes, it's very very bad.

Comments

[Allan]

Maybe you are correct. Maybe not.

The question is whether, for the country as a whole, the European or the Canadian system would be better than we have now. More to the point, the argument has been that our health care system is broken and needs to be fixed. Conservatives and libertareans have not come up with a solution. Now we might have one.

As a result, perhaps the costs of emergency health care will go down (as more people get preventive care). Perhaps the workforce will be healthier (benefitting the economy). Maybe malpractice costs will go down (as individuals will no longer have to foot the bill when their physicians make a mistake). Worker's comp insurance may go down (as employers might not have to foot the full bill for injuries).

Republicans had the reins for a number of years and they effectively did nothing to address health care for the poor. Indeed, the only thing that the Republican administrations did was lower taxes and regulations. But that did not help the economy. Combine the economic failures with a devistating recession and an ill-conceived two front war, and what do you expect?

[Werner Patels]

Unfortunately, this "reform" will do very little to improve health care per se. Frankly, though, American health care doesn't need fixing; access and affordability are the real issues here.

No country's healthcare system is perfect -- Canada's certainly isn't -- but I don't like starting reforms based on lies (e.g., 40 million uninsured Americans - an inflated number that also includes illegal immigrants; the real number is closer to 5-10 million, and many of those actually choose to go without insurance and pay out of pocket instead).