Sorry, Liberals: Obamacare Won’t Lead to Single Payer

Whitehouse.govWhitehouse.govIf you spend any significant amount of time talking to conservative activists who oppose Obamacare, you’ll eventually hear some variant on the theory that Obamacare was never meant to work. Instead, it was meant to destroy the existing health care system, and in the process pave the way for liberals to step in with the comprehensive health care fix the far left has always really longed for: single payer. 

There’s often a hint of conspiracy surrounding the accusation, as if President Obama and the White House senior staff had hatched some meticulous plot to spend a year struggling to pass a health care law that they intended to fail in a series of carefully planned disasters sometime down the road, which would create the perfect opening for their true, secret goal.

I’ve always thought the notion was rather far fetched. Obamacare was a stalking horse for a modified version of Obamacare, not a single payer conspiracy scheme. But The New Republic’s Noam Scheiber suggests that conservative activists worried that Obamacare will lead to single payer might be at least partially onto something—maybe not in their belief that Obamacare was explicitly designed as a gateway to single payer, but in their worry that the health law will eventually lead to some sort of nationalized health system. And unlike those concerned conservative activists, Scheiber thinks this is a good thing.

The gist of Scheiber’s theory (delivered in response to a griping Michael Moore op-ed about the health law  in The New York Times) is that the law will create a unified, organized constituency for change. Private coverage in the exchanges will be too expensive for many, and dealing with private insurers will upset some beneficiaries. That will make existing government run health insurance options more attractive. “By pooling millions of people together in one institutional home—the exchanges where customers buy insurance under Obamacare—the Affordable Care Act is creating an organized constituency for additional reform,” he writes.

I don’t doubt that as Obamacare’s flaws continues to be exposed, liberals like Scheiber, as well as a some Democratic legislators and even presidential candidates, will push for a single payer overhaul. But I don't think it's likely to happen in the forseeable future.

For one thing, it assumes that irritation with Obamacare—a law designed and implemented exclusively by Democrats—will somehow generate public support for additional Democratic health legislation that is even more sweeping. But judging by the beating Democrats have taken at the polls over last few months, public frustrations with Obamacare will turn the electorate toward Republicans. Democrats won’t be given a second chance, with a mandate to do even more.

Scheiber’s theory also overlooks how tough passage of Obamacare was in the first place—and how much support the administration had to get from health industry stakeholders in order to eke out a legislative victory. Single payer would be even tougher. Moderate Democrats who were nervous about Obamacare the first time around would be even less likely to support single payer, especially given how the law cost Democrats at the voting booth. And there’s no way that doctors, insurers, hospitals, and other major health industry groups would play nice with a single-payer push. Quite the opposite: Even beyond the insurers, much of the industry would see single-payer as a de facto nationalization of the health system, and they would fight the transition with everything they could muster.

Finally, Scheiber’s argument rests on the odd idea that individuals with private coverage will become jealous of people with Medicare and Medicaid.

I might be willing to believe that some people would prefer Medicare to private coverage, but Medicaid isn’t going to become a consumer favorite any time soon. Here’s Scheiber:

There’s the likelihood that, one day soon, especially if Medicaid becomes more generous, the working-class person who makes 175% of the poverty level will look at his working-class neighbor making 130% of the poverty level and think, wow, his health insurance seems a lot better than my private Obamacare plan.

That’s some rather wishful thinking. For starters, Medicaid isn’t likely to become more generous: State budgets are already straining under the burden of Medicaid spending, and the federal budget squeeze means that it's more likely that the federal share of the program will be cut back. Meanwhile, it’s hard to imagine someone with private health insurance looking jealously at a program that has no statistically significant effect on physical health outcomes and that has even been found, in a couple of narrow instances, to produce health outcomes that are worse than no insurance at all.

Might Obamacare lead to a handful of state-level experiments with single-payer variants? Possibly, although that mostly means that very liberal states with heavily consolidated insurance markets will explicitly transform their insurance industries into public utilities. 

There’s a weird overlap between conservative fears and liberal hopes when it comes to single payer: Both seem to think that Obamacare makes a universal government-run system more likely. But both are wrong.

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  • Fist of Etiquette||

    Unless the Democrats some crazy how fall ass backwards into another congressional super majority full of members willing to be cannon fodder, no way.

  • Fist of Etiquette||

    Unless, of course, the HHS secretary declares single payer through the authority granted her by Obamacare provisions.

  • AlexInCT||

    ^^^^THIS^^^^

    These criminals think the law is to prevent other people from obstructing them from doing what they want. Otherwise our system of laws doesn't apply to them, because they mean well and hate profits, or some such nonsense.

  • albo||

    Once we get the benevolent executive branch dictator that some people on the Left want, Queen Hillary The First will make it so, not the HHS secretary.

  • some guy||

    Well, if they keep expanding Medicaid and keep narrowing the definition of "acceptable coverage" and keep putting the taxpayer on the hook for insurance company losses....

    If it looks like a duck and walks like a duck and quacks like a duck...

  • ||

    Fist wins the thread and "some guy" below comes in at a close second.

  • soflarider||

    That action just might be what it takes for people to take up their pitchforks and torches.

  • DenverJay||

    Sure, because if the systematic abuse of the 4th Amendment rights of EVERY SINGLE AMERICAN CITIZEN (not to mention the outright lies and extra-legal actions of the President) don't make Americans wake up and recall their revolutionary roots, well then, I'm sure that one more bailout to a favored industry will finally enrage the mob.

  • thom77||

    All of that stuff has some people pretty angry, but it's all too abstract for the masses.

    Instituting single-payer healthcare and nationalizing an entire industry through administrative fiat is the kind of outrage the average person can wrap their head around.

    If something like that ever happened, I'd absolutely be down for a full-on revolt.

  • Faceless Commenter||

    ^^^This.

    My phone might have been tapped. I don't know. But if my health insurance plan was replaced with some overpriced, underfeatured "upgrade" by Obama, I know.

  • Bryan C||

    Sure you know. But what are you gonna do about it?

  • ImanAzol||

    Nah. Never happen. The GOP would have to idiotically talk more about rape, abortion, worthless people and God to lose the momentum they have, and they're just not that stupid.

    ~~~~

    Shit.

  • DenverJay||

    Right! The Republicans would never blow the election by nominating a guy from liberal state, maybe one who has already enacted a version of Obamacare (last election), or one who thinks local disasters are Federal matters or who thinks NSA outrages are too subtle (next election if Christie is nominated).
    Nope, the Republicans make Machiavelli look like a chump, those clever, clever Republicans.

  • Bill||

    No, not for another 15 years maybe. But we'll probably also never get rid of it. So down the road (unless we are already bankrupt) people will forget that it used to be better and the bad healthcare will be blamed on libertarian free market ideas that somehow the opposing politicians left in there when they would not let the Dems have exactly what they wanted. And a lot of stupid people will vote the Dems back in and they will continue to fuck things up and then blame it on the free market. Because people really are that GD dumb.

  • Rasilio||

    The other thing they overlook is any attempt at single payer would be viewed as an Unconstitutional taking by every single private practice out there (and probably a good chunk of the larger corporate organizations as well).

    There is no way that the government can afford to compensate all of these individuals for the loss of their property and then you'd be left with a very large rich well educated group challenging your law in court and quite likely going on strike/emmigrating if they lose the challenge.

  • AlexInCT||

    You doubt their ability to use force to make these ungreatful bastards comply with their wishes? you have not paid enough attention to how the left thinks and works...

  • Rasilio||

    Lol actually yes.

    Because everyone wants a heart surgeon who thinks he is being treated like a slave.

    If it were almost any other industry they could probably get away with it but since a doctors value and capital is tied up inside his knowledge and skills it would be effectively impossible to compel them to participate in a system they didn't want to participate in.

  • AlexInCT||

    The USSR, China, North Korea, and Cuba say differently. It's not an accident that the leaders of these places always sought medical treatement outside their countries.....

    What people want and what the leaders want are two different things, as the disaster in the making right now clearly shows.

  • Rasilio||

    Yes, but in this case our leaders only get to remain leaders if they can keep the low information voters fat and happy and there is an opposition party who would be more than happy to use a couple of anecdotes of doctors letting patients die because their shift at the hospital is over in an election.

    America might be rapidly moving towards being a Police State but it ain't even in the same zip code as those places you mentioned

  • AlexInCT||

    Yet...

    But the conditions are ripe.

  • ||

    The USSR, China, North Korea, and Cuba say differently.

    You don't even need to go full authoritarian for examples. The UK's NHS is probably a better analogue.

  • Will Nonya||

    What will happen is that doctors will either leave their practice or leave the country, fewer Americans will go to medical school knowing that it leads to a life of indentured servitude and more doctors from other countries will be brought all of which will hasten the decline of the quality of healthcare in this country.

  • wareagle||

    on a recent flight, I lost count of the number of magazine ads from various Caribbean & Central American countries openly recruiting American doctors.

  • nova3930||

    Every Dr. I know, including the one I'm married to, is actively preparing to hang it up and go home if there's ever an attempt to force single payer on them.

    .Gov might be able to force doctors to take single payer, but they can't force them to get up and go to work every day.

  • Carolynp||

    My best friend and her husband left Canada for exactly this reason. Apparently they only get paid for a certain amount of work each year, so most doctors don't even work in December. They did the math and moved to greener pastures in the US. Right now they are scouting out Panama.

  • What's that smell?||

    they'll simply replace those "substandard" doctors with...Dr. Nick

    "Hello Everybody"

  • DenverJay||

    Hi, Dr. Nick!!!

  • SugarFree||

    I don't think so, because it will not be a taking so much as them starving private practices until they have to take Medicaid for all. With people being taxed to fuck and back, it will be hard for most individuals to pay out of pocket, especially for something they have "paid" for with taxes (which is why private school attendance is difficult without vouchers.)

    Crummy public health care vs "double cost" private care is going to force more and more doctors to take single payer to stay float. See, it's not a "taking" because they "chose" to take what the government offered them.

  • Rasilio||

    Actually no, single payer by definition means that all doctors MUST accept the government insurance program and it's reimbursments and terms and conditions.

    If there is a private health market which does not accept the government insurance then it by definition is not single payer.

  • SugarFree||

    OK, I see. My scenario still sounds like a step along the way that avoids takings (to a statist polluted SCOTUS.)

  • Rasilio||

    Yes, I could see a system in which there is truely crappy Medicare for all and that everyone is required to purchase and then for those who can afford it a small cadre of private clinics and concierge doctors for the super rich.

    You'll also probably start to see a thriving medical tourism industry take off and become the dominant form of surgical care for the upper middle class and maybe even occasionally the middle class.

    Everyone else, basically gets the VA system.

  • Will Nonya||

    The only thing worse than the VA system is the care provided to active duty servicemen.

  • Michael S. Langston||

    Disagree and I've had personal, serious, and long term experience with both.

  • Will Nonya||

    I speak from experience.

    My experience with active duty medicine was miserable and I was on flight status. My wife had it slightly better as long as she didn't mind waiting (sometimes weeks) but many of my friends paid a much higher price for their negligence.

    I've seen people have MS misdiagnosed as shin splints for more than 2 years, i've seen a friend given sudaphed for sinus issues until it got to the point where it abscessed his skull requiring a horrific surgery to save his life and ending his military career.

    In the Army if you cant get past an aide station you're not getting any level of medical care that doesn't involve motrin or sudaphed.

    Most of my VA experience consisted of come back next month and see if we can get you in. I'm lucky enough now to have pretty good coverage through work so I bypass the VA. Of course there's my wife's grand father, a Korean war vet, who received the old sorry but we gave you the wrong surgery routine and 4 months later the told him they couldn't prescribe him enough medicine to make it through the month so try only taking it every other day and see if you can manage.

    Military care is great if you're wounded and might make a great news story but miserable otherwise.

  • Andrew P||

    Military care is really designed for fixing the wounded and keeping the soldiers fighting. Everything else is just maintenance.

  • Carolynp||

    So, this is an area I'm not fluent in, doesn't this mean Canada and UK aren't single payer? I know Canada has plenty of private clinics, not sure about UK.

  • ImanAzol||

    They do not have the same system. And neither works very well. Eventually, they ran out of rich peoples' money.

  • Carolynp||

    Go figure.

  • Jefferson's Ghost||

    Monopsony sucks hth gth

  • nova3930||

    That assumes Drs are planning on staying in business. Many are specifically planning on quitting in that eventuality.

  • Jam||

    it's called incrementalism, the state nationalized banking, home loans, schooling, national security, etc, in steps - not leaps.

  • Will Nonya||

    I'm pretty sure that national security was nationalized with the constitution but I assume you're referring to nationalizing security with f-ups like the TSA.

  • Brian D||

    If the government fucks something up, it's obviously because they don't have enough control over it.

    /derp

  • Will Nonya||

    you mean money don't you?

    they have all the control with none of the responsibility but they always need more money...

  • ||

    The midterms this year are going to be very telling.

  • NoVAHockey||

    for the senate: To win the majority, Republicans need a net gain of six seats. Democrats are defending 21 of these seats, including six in states that GOP presidential nominee Mitt Romney won easily in 2012. That's hard to fuck up. even for the GOP.

    in the House 233 Republicans, 200 Democrats, and two vacancies (one Republican and one Democratic). Democrats need a net gain of 17 seats to reach a majority in 2014. adn from what i can tell, the Ds are going to use "income inequality" and "obamacare is awesome."

  • NoVAHockey||

    crap. meant to cite cook political

  • Fist of Etiquette||

    The only people who come out for the mid-terms are people who pay attention and/or have a beef. That's not good for Democrats this time around no matter how you slice it. Class warfare ain't gonna do it without a president in the mix.

  • BakedPenguin||

    Yep. Mid-terms have far fewer low-info voters. Not good for Team blue.

    And it will probably be much, much worse if tens of millions lose their job-sponsored health insurance in the run up to October 2014.

  • Andrew P||

    You would think midterms would have low Dem turnout, but that was wrong in last year's VA contest. An odd year election, normally worse than midterms, but the Black turnout was nearly as high as a percentage of the electorate as it was in 2012. Saturation levels of advertising and personal contact by The Machine work wonders for turnout.

  • Spoonman.||

    Okay, I didn't realize this before: to hold on to the majority, the Democrats need to keep Montana, South Dakota, West Virginia (all with their incumbents retiring), Arkansas, Louisiana, North Carolina, New Hampshire, and Alaska, or keep some of those and gain something like Georgia, Kentucky, or Maine.

    Why the hell did they fuck with filibusters?

  • Marshall Gill||

    Why the hell did they fuck with filibusters?

    While it is true that the GOP is the stupid party, they don't have a monopoly on it.

  • Carolynp||

    Heh, this. ^^^

  • Carolynp||

    If the GOP wants to impress this cynical old libertarian, the first thing they ought to do is reinstate the filibuster.

  • nova3930||

    The howls of outrage from the nitwit left are going to be glorious when Ginsburg kicks the bucket under the likely Republican next president at which point they'll swiftly install someone far to the right of Scalia and Thomas...

  • ||

    If we have a Republican president before Kagan kicks the bucket I'd be astonished. It sure as fuck ain't gonna happen in 2016.

  • Carolynp||

    I think it's quite possible, actually. this is the first time they may run someone I'd consider contributing to. Say a Rand Paul/Rubio ticket? We have a really good chance of a "libertarian" Republican. I know they don't make the litmus test of extremist libertarians, but every step toward smaller government is a hard won victory to me.

  • Andrew P||

    That is precisely why they abolished the filibuster. They need to ram through all Obama appointees this year, before the Senate flips. Reid expects it to flip.

    And the Democrats won't need a filibuster in Obama's final 2 years, because they have Obama's veto. So they can just sit back and do nothing.

  • Rasilio||

    "That's hard to fuck up. even for the GOP."

    Never underestimate the GOP's ability to screw things up

  • some guy||

    It will be fun to watch Obama become the "obstructionist" if the GOP takes both chambers.

  • DenverJay||

    Nope, the labels are applied by the media, so the GOP are always the bad guys.

  • C. S. P. Schofield||

    "Obamacare; it's better than the Bureau of Indian Affairs …. but not much"

  • ||

    Paging Fauxcohantas.

  • ImanAzol||

    The GOP will open their Christard yaps about abortion and "legitimate rape" and lose.

  • Andrew P||

    So, how did the Democrats manage to elect a Senator in ND last year - their candidate ran 20 points ahead of Obama and narrowly won.

  • John||

    Yes they will be. I think it is going to be a blood bath. The Democrats are trying to run on the minimum wage in hopes people will forget that Obama fucked up their health insurance. I don't see that going well, especially since every single Democrat in both Houses has voted multiple times to keep Obamacare. I can't see that working too well.

  • Pro Libertate||

    Normally, I'm not thrilled with too strong of a majority by either party, but for the time being, I'd be happy if the GOP got veto-proof majorities in both houses. But only if they decided to gut some things, starting with the stupid Obamacare law.

  • John||

    The Democrats have gone insane. Only a soul crushing electoral defeat will bring them back to reality. The Republicans got smashed in 06 and 08 and are a better party for the experience. The same thing needs to happen the Democrats. Losing big is the only thing they will understand. And they need to lose in some blue states where they think they never will again.

  • Pro Libertate||

    I just hope the new Republicans are really interested in reining in the insanity and not doing what they did last time in power.

  • Spoonman.||

    The problem is, when the Republicans deservedly got that experience, we got Obamacare. The GOP will come up with something equally insane, I'm sure.

  • some guy||

    What could they do that is equally insane, though? Nothing is as bad as a large social program. The GOP could outlaws abortions and homosexuality and still not hurt as many people as Obamacare has. The GOP could start another war in the middle east and still not hurt as many people as Obamacare has.

  • Carolynp||

    Yikes.

  • DarrenM||

    Most things Republicans come up with are easily reversed. Not so with Democrats.

  • Carolynp||

    This.^^^

  • Andrew P||

    Veto proof in both houses is not mathematically possible. There aren't enough Senate seats up.

  • 10percenter||

    I don't think it is far fetched. Didn't Harry Reid admit as much at some point?

  • some guy||

    If you spend any significant amount of time talking to conservative activists who oppose Obamacare...

    Come on, Peter. You know we all spend a significant amount of time talking to John. It's hardly avoidable.

  • Fluffy||

    I agree with John.

    I foresee a Blue Bloodbath.

    The people helped by the Medicaid expansion were already voting Democrat. The people fucked by the exchanges came from all across the spectrum. That means the ACA moves large numbers of Blue voters to Red.

    Add that on top of the natural tendency of mid-terms to move against the Presidential incumbent and these guys are toast.

    I foresee such a good year that I am getting the last of my hate rants out of my system now so I can go on to a year of good behavior. There is no point to our fighting among ourselves when there is such a feast of salty ham tears in the offing.

  • NoVAHockey||

    I'm watching PAC decisions. if it's little more than token contributions for those at-risk Dems, they're done.

  • Carolynp||

    Not sure about this. Freakonomics suggests there is no real correlation between wins and donation amounts, and liberals are tightwads anyway. Most of their big backers put their bucks behind the liberals in Colorado. I'm guessing the unions are going to have to give some quid pro quo for that exemption they got. I'm hoping you're right, but I'd like to see the data anyway.

  • Andrew P||

    Why do you think Obama Democrats are such corporatists? They know that Business is the source of the big bucks - and Business expects a large return on investment for their "contributions". The VA Governor's race shows what happens when Business cuts a candidate off from the money spigot. It was done deliberately by the Big Business interests to show both parties (but especially the GOP) that they can't win without business cash.

  • The Last American Hero||

    You should check out Scott Trende's work. He does a really good job at looking at how races break down beyond "everyone's mad at team blue, so they're screwed." He looks at individual district politics and trends, who lives there and who votes there. I think at last check he indicated either Team winning the Senate by a seat or so.

  • Tony||

    Name one good thing Republicans have done at the national level in the last 40 years.

  • Jerryskids||

    Nixon resigned and paved the way for Jimmah. That was a good thing, no?

  • wareagle||

    I can name several horrible things the Dems have done. Repubs supported Civil Rights by a greater % than Dems, and no one thinks the jackass party in remembering the collapse of the Soviets.

  • Mike M.||

    About one of the only good things George W. Bush and the republicans did was they cut my taxes.

    But it was a really big good thing, because my money staying in my pocket is a hundred times better than my money going into the pockets of scumbags like you.

  • Tony||

    But let me guess, you piss your pants over the national deficit that policy largely caused, don't you?

  • Rasilio||

    Hey moron, even if you took the most wildly inflated assumptions of the revenue cost of those tax cuts you're only getting to something like $4 trillion, less than 1/4 of the entire Federal Debt.

    You'll probably never be able to wrap your mind around the fact that there is absolutely no evidence that those "tax cuts" ever actually reduced tax receipts by even a single penny.

    Hell even the most hard core Keynesian will admit that if you cut taxes but keep government spending steady (which is what they did) you will create economic growth, the question is whether the additional taxes collected on that growth were enough to offset the reduced rates

  • ImanAzol||

    Bush caused 0bama to increase the debt from $9 trillion to $17 trillion?

    Man, he's awesome. Maybe we should re-elect him if he has so much power. He's like a god.

  • Carolynp||

    ^^^Still chuckling. Point, you.

  • ||

    Lower tax rates =/= lower taxes. Common and dishonest conflation by redistributionists.

  • ||

    Ended the draft.

  • The Knarf Yenrab||

    /drops the mike, walks offstage

  • Rasilio||

    Easy, forced Clinton to actually come to the bargaining table and crafted a sensible reform for the welfare system that was actually successful.

  • Sevo||

    One of the few good Bush initiatives was to privatize S/S.
    Of course proggy ignoramuses like our resident turd broke out in assholes and shit themselves to death at the thought of it.

  • The Knuckle||

    This^^^^

  • C. S. P. Schofield||

    Annoyed you.

  • OneOut||

    That's not the right question.

    The question should be, who has been the lessor of two evils in the last 40 years.

  • ||

    I'm thinking you meant lesser, but that typo is gold.

  • RightNut||

    Suderman is assuming Democrats will push for single payer this year, or maybe after the next election. It's much more likely that they will wait a decade or longer to try and push for single payer. In other words Democrats are playing a long game in the push for socialized medicine. President Obama has himself said that he expects a sort of quasi-private insurance reform to exist for awhile before full on socialization.

  • some guy||

    Well, we've always known the Democrats were going to push for single payer eventually. Even if Obamacare had never passed or had been shot down by SCOTUS we knew single payer was going to come up within a generation.

  • Paul.||

    There’s often a hint of conspiracy surrounding the accusation, as if President Obama and the White House senior staff had hatched some meticulous plot to spend a year struggling to pass a health care law that they intended to fail

    It's not about intentions, it's about results. Obama and his minions truly believed Obamacare would work (although one has to question the intelligence of anyone who looked at the law and continued to think as such), but its failure will demand the same fix every failure in government has ushered in ever ever forever and ever amen: More government, and what better more-government than single payer?

  • SusanM||

    I wanted to believe otherwise, but The Big O really lives the hype surrounding him. It's impossible for him to think anything else but "if everyone would just agree with me everything would work".

  • Andrew P||

    Yes, he believes his own propaganda. He believes in his own greatness. Why shouldn't he? He had the luckiest, most greased path to the top of anyone anywhere.

  • Paul.||

    will somehow generate public support for additional Democratic health legislation that is even more sweeping

    Guaranteed work.

    Social security for all.

    Everything is owned by everyone.

    The era of Free Stuff(tm) is here.

  • Carolynp||

    And, it's so unfair! You have to work, while a do nothing like Romney doesn't, have you seen his black grandchild? It's really amusing how seriously racist Democrats are, and how effectively they deflect. Hats off to that.

  • James Ard||

    Suderman assumes policy makers are smart. In their own words they've admitted their long term goal is single payer. And thinking a Democrat politician will believe government screwing stuff up is not a good reason for more government is delusional.

  • The Late P Brooks||

    you’ll eventually hear some variant on the theory that Obamacare was never meant to work. Instead, it was meant to destroy the existing health care system, and in the process pave the way for liberals to step in with the comprehensive health care fix the far left has always really longed for: single payer.

    I just assume(d) it was doomed to failure by the inescapable fact of being a gigantic clusterfuck haphazardly lashed together by a bunch of imbeciles who had no idea what they were doing.

  • Bryan C||

    +1

  • Faceless Commenter||

    That's more like it. The whole notion of "This law will self-destruct in five elections" is unnecessarily complex and deliberate.

  • Carolynp||

    I could easily see taking the teeth out of it in 2015. Repubs take the Senate. Repubs start calling it a "high risk pool", which, btw, it is. Repubs negate the individ and employer mandate as well as various heinous government goodies. Begin pulling the rug out from under states that expanded Medicaid stupidly. Poof! ACA equals a large meaningless document.

  • Tony||

    And laissez-faire capitalism will never deliver universal access to healthcare. No theory of the remotest seriousness claims it can. Anyone who refuses to allow for a system that works because it conflicts with their political ideology needs to grow the fuck up. In almost all cases, it's the ideology that's flawed, not empirical reality.

  • RightNut||

    laissez-faire capitalism will never deliver universal access to healthcare.

    And neither will socialized medicine bub.

    Anyone who refuses to allow for a system that works because it conflicts with their political ideology needs to grow the fuck up. In almost all cases, it's the ideology that's flawed, not empirical reality.

    Project much? That sounds a lot like your theories about government schools, healthcare, economics, ect.

  • Calidissident||

    Don't you know that a government insurance card guarantees access to quality care?

  • wareagle||

    socialism doesn't work. It never does. Ever. The single greatest cure to poverty has been free-market capitalism.

  • Tony||

    That's just false. Laissez-faire capitalism always leads to wealth stratification and widespread misery. The best systems humans have come up with have been mixed economies with room for both capitalism and social safety nets.

  • RightNut||

    Laissez-faire capitalism always leads to wealth stratification and widespread misery.

    Where and when did this magical land exist exactly?

  • Tony||

    It wasn't magical but 19th and 20th century US came pretty close to a laissez-faire system at times, with predictable results.

  • RightNut||

    massive wealth creation and the creation of the most prosperous society in history?

  • Sevo||

    ..."with predictable results."
    Yes, fewer people went hungry than at any prior time.
    Of course proggies hate that. If it weren't for the poor, proggy turds would have to make some (as they commonly do).

  • OneOut||

    And 20th century socialism ( wealth redistributionist ) only killed about 250 million people.

    Do you compare life in 20th century Russia favorably with life in 20th century America ?

    Do you propose that wealth stratification based on political ideology, (party membership) more merit based than capitalism ?

  • ||

    Yeah, aside from socialized rail transportation, Indian displacement, the first immigration restrictions, the introduction of the income tax, the federal reserve system, corporate cronyism up to and including Teapot Dome, why the 19th and early 20th centuries were practically a laissez-faire utopia.

  • Don'tTreadOnMe||

    …and supported the establishment of hundreds of charity hospitals throughout the United States. Fuck you….

  • Brian||

    Tony:

    It wasn't magical but 19th and 20th century US came pretty close to a laissez-faire system at times, with predictable results.

    Right. With explosive GDP growth, personal income, standards of living, and deflation, all at the same time.

    God forbid that happens again.

  • DarrenM||

    Laissez-faire capitalism

    Perhaps you'd like to argue against the Tooth Fairy, too.

  • Will Nonya||

    I get annoyed with the flawed vocabulary of the politician. Every American has access to healthcare and it's due to capitalism.

    That's a different thing than saying every American has the resources to pay for someone to provide these services or that they would choose to allocate their resources to this cause.

    Healthcare is a fantastic thing to have when you need it and a horrific thing to need when you cant but it isn't a right. Any ideology that professes that it is or allows governments to confiscate the services of those with the applicable skills just because it can is flawed.

  • FYTW||

    ^^ This.

    Let's simplify. In the real world today, anybody in the country can walk into a doctor's office and exchange greenbacks for treatment.

    Tony's complaint is that some people can't afford the doctor's asking price.

    Those people have been "denied access" to healthcare in approximately the same way I've been "denied access" to Candice Swanepoel's filthy bits: it's something they were never entitled to in the first place. Can't afford it? Tough fucking shit.

  • Tony||

    I do not attempt to obfuscate my belief that healthcare should be considered a basic human right (like education, potable water, due process, etc.). The entire civilized world agrees with me, a faction of antigovernment radicals in the US agrees with you. There is no truth or fiction here, there are simply competing rights claims. May I win and you lose.

  • FYTW||

    May you fuck off and die in screaming agony, you worthless collectivist toad.

  • kbolino||

    How can things be rights which did not exist for most of the history of mankind?

  • Tony||

    Like due process? Like guns?

  • kbolino||

    Guns aren't a right. No one is required to supply you with a gun. You have the right to keep and use what is yours, which was specifically called out for firearms because the Founders knew that governments are especially prone to confiscate them.

    Due process isn't a right, either. It's a limitation on the government designed to protect your actual rights as much as possible while still allowing the government some power to prosecute and punish crimes.

  • Tony||

    Usually absent from this never-ending and pointless semantic debate is the fact that not once does the US Constitution or any of its underpinning theories of governance declare "Thou shalt not have positive rights."

  • kbolino||

    You have a point, although accidentally.

    The government itself is nothing but a provider of positive rights. Even when it steps in to enforce a negative right, the enforcement itself is a positive act. However, our government is based around the idea of trying to provide a small list of enumerated positive rights (see Article I) while respecting as much as possible the innate negative rights of the people it governs (see Amendments I-X et al.).

    In other words, we the people may do all that which is not forbidden, but the government may only do that which it is permitted to do.

    Providing health care, insurance coverage, or any other such service is not among the things the Federal government may do.

  • Don'tTreadOnMe||

    But does anyway, over and over and over again. SCOTUS doesn't seem to understand the document.

  • Will Nonya||

    And may you avoid the suffering caused by socialized medicine around the world.

  • Paul.||

    Education and potable water are not rights. It's certainly egalitarian to provide, and could be argued that if provided, they have many secondary benefits-- ie, it's in a government's interest to make sure as many people have access to them as possible, especially the potable water.

    But that which must be provided to you is not a right.

    Explain to me, that in a group of say, 100 lone survivors in a geographical space, who is going to provide the free education or healthcare, and at what cost to his or her civil rights will it be made to happen?

  • Tony||

    So is due process not a right then? Without question it requires taxpayer funded institutions to realize. Traditionally it even requires conscripting people for jury duty! If that's not a positive right then nothing is.

    You're so obsessed with the definition of the word "right" that you're losing the point of the conversation.

  • kbolino||

    If the government did not exist, we would not need due process to limit it.

    The positive right here is actually safety. The government has the power to prosecute and punish crimes, ostensibly for our "benefit", and due process is a limitation on that power designed to remind the government of its actual purpose, and failing that, to give individuals some recourse should the government violate their rights.

  • ||

    So is due process not a right then?

    I like that you've repeated this question 4 times, despite the fact that it was answered in full after the first.

  • DarrenM||

    So is due process not a right then?

    So if the government passed a law declaring due process was not a right, would you agree that it would no longer a right?

  • ||

    there are simply competing rights claims.

    Nope. You don't have the right to steal, regardless of the nobility of the purpose of the theft. We have competing concepts of what constitutes a "right", where your concept of rights is "whatever a majority of the people who have access to the guns want".

  • Tony||

    It's as much a right as we decide to make it. That we're the last industrialized country to recognize this right is a not uninteresting empirical fact all by itself.

  • Will Nonya||

    That's the key fallacy right there, simply declaring something a right doesn't make it so.

    It's difficult to argue with your empirical fact though. It's clear that we're the last industrialized country to resist trading our principles for a warm fuzzy feeling and a high five from our socialist peers.

  • Tony||

    simply declaring something a right doesn't make it so.

    Depends on who's doing the declaring. If you're Congress or the Supreme Court, then it does make it so.

  • kbolino||

    No, it does not. It still only matters if people care to follow it, which makes it no more real than anything else in your head. Intangibles like belief and trust do not become tangible simply because they are important. How far those intangibles differ from reality has proven to be the deciding factor throughout human history.

  • The Knuckle||

    If SCOTUS decided we all have a right to a spaceship, do you believe you would ever receive said spaceship?

  • kbolino||

    If all that matters is what it's in your head, then simply believe that all of your needs have been met and they will be.

  • OneOut||

    What he said.

    Just deem them met Tony and they shall be so.

  • Carolynp||

    "It's as much a right as we decide to make it." Behold the liberal tendency to demand violence to uphold mob mentality. If you have a gun, and you decide to rape someone, that's as much a right as you decide to make it, also. Thanks for the illustration of how large governance always ends in demands for violence.

  • DarrenM||

    It's as much a right as we decide to make it.

    Keep it simple. "Might makes right". That's really all you are saying.

  • kbolino||

    And laissez-faire capitalism will never deliver universal access to healthcare.

    It already has. Absent all of the government interference, you have access to all the healthcare anyone is able to provide. The problem is that you don't want to pay for it, which obviously means it's not worth anything to you, so why do you want it so badly?

  • Tony||

    I can't afford a yacht but that doesn't mean it is worth nothing to me. Look dude to be a libertarian you have to not understand anything beyond Econ 101... but you have to at least get that far.

  • kbolino||

    Your economics 101 course lacked several fundamental concepts. If I were you I'd get my money back, but I'm guessing you didn't pay for it.

    There is not an infinite supply of doctors and nurses. Not everyone wants to be a doctor or a nurse. Doctors and nurses can save your life. So there is value to the services they provide. If you think you should get it for free, then you think there is no value. So then why should they do it for you?

  • Tony||

    I don't think I should get it for free. I think I should get it at the cheaper price that is made available when the insurance risk pool is made larger.

  • kbolino||

    The (non-elderly) insurance risk pool was at its largest before the HMO Act of 1973. That act, and every subsequent one dealing with health insurance, has forced insurers to divvy up the insured into different pools to better manage their risk within the context of the regulatory framework. The cheaper price is only available to you if people are free to manage their money in the manner they deem most prudent for themselves.

  • Will Nonya||

    Risk pools are oddly enough about managing risks yet the ACA addresses this by removing reasonable risk management tools like preexisting conditions, gender based healthcare requirements and limiting the age dependents can remain listed as children.

  • Ann N||

    removing gender based healthcare requirements

    yet car insurance is allowed to discriminate based on gender. this is something i will never understand. is the world really this retarded and hypocritical?

  • Carolynp||

    In the 90's Hawaii made it illegal for insurers to "discriminate" (which means charge more for the annoying tendency of younger men to drive recklessly), this caused everyone's policies to go up except teenage boys. Yay fairness.

  • Carolynp||

    In the 90's Hawaii made it illegal for insurers to "discriminate" (which means charge more for the annoying tendency of younger men to drive recklessly), this caused everyone's policies to go up except teenage boys. Yay fairness.

  • Don'tTreadOnMe||

    You think your healthcare costs are gonna go down now? You are stupid. Dumber than the 20 somethings who aren't willing to give up buying import beer rather than PBR to pay for Ocare. Really?? Fuck you for wanting to enslave them to reduce your medical bills. Asshole.

  • Brian||

    Tony:

    I don't think I should get it for free. I think I should get it at the cheaper price that is made available when the insurance risk pool is made larger.

    And the risk pool just isn't quite large enough until everyone is forced into one big pool, creating a monopoly.

    Usually progressives tell us that monopolies are bad. Except when they're the government, in which case, they're totally awesome.

  • Will Nonya||

    OK, say you were a yacht builder. You were successful in your field then one day some yahoo in government decided that everyone had a right to own a yacht. I mean everyone in Europe had one so it's obviously a right.

    So the government decided it would make yachts "affordable" by heavily regulating your industry, mandating several expensive features and required you to accept government defined rates. Rates which practically guarantee a loss because any profit you made was unethical anyway, you could only be profitable by ripping people off rather than reaping the value of your experience and skill. It is a right after all.

  • Tony||

    I long for a future in which we're debating whether there is a basic human right to own yachts. Why not? Scarcity is what makes economics necessary, but there is no inherent virtue to goods or services being scarce. But, first, let's get to acknowledging that the healthcare question has long been answered already.

  • kbolino||

    Scarcity is not a virtue, but pretending it does not exist is absolutely a vice.

  • Will Nonya||

    It only matters if it's yachts, healthcare or knurled flange brackets when you're working to avoid the point.

  • fish||

    It only matters if it's yachts, healthcare or knurled flange brackets when you're working to avoid the point.

    You must be new here...the undergrad fellator has made a career out of "avoiding the point".

  • Will Nonya||

    Fish, I've been around long enough to spot Tony's tactics but that's no reason not to call him on them.

  • OneOut||

    "But, first, let's get to acknowledging that the healthcare question has long been answered already."

    Hey, that's just like man made global warming. Al Gore said the debate is over.

  • Don'tTreadOnMe||

    You have no idea what you are talking about. We would all like to believe that any person can have access to basic healthcare…..and there are means to achieve that. But the fact of the matter is that there are many levels of services available that if the highest level is provided to everyone irrespective of cost and ability to pay it will destroy our country economically. So, if you want healthcare to be a 'basic human right' and design a healthcare system around that principle, be ready to accept either shitty care for yourself or economic implosion. Which nets the same result. Get off your fucking cloud.

  • Gilbert Martin||

    "Anyone who refuses to allow for a system that works because it conflicts with their political ideology needs to grow the fuck up"

    Sorry but you don't get to define the parameters of "what works" or what the objectives of government action should be.

    It is after all, merely an ideologoical belief that your inablilty to get medical treatment is anyone else's problem to begin with.

    I know it's certainly not mine, since there isn't so much as a single thing you've ever done in your life that's ever had anything whatsoever to do with me having anything I've got.

  • Tony||

    It is after all, merely an ideologoical belief that your inablilty to get medical treatment is anyone else's problem to begin with.

    That's at least valid in that it's not an empirical claim contradicted by a world of evidence. But it is, relative to modern standards of civilization, a bit on the sociopathic side of moral opinions. Unless you're an anarchist you obviously do expect me to pay for some of your upkeep, so it's just a question of priorities but not of clear-cut moral truths.

  • Will Nonya||

    That's a pretty good point. So which priorities of government spending would you cut in order to pay for healthcare?

  • Tony||

    Defense could use a good plundering, but it's a bit more complicated in a macroeconomic sense. American people pay for healthcare. American people pay more for healthcare than anyone else in the world. One of the primary goals of healthcare reform is to bring down healthcare costs for individual Americans. Rational Americans shouldn't really give a shit if they're paying for it via taxes or in the private market--they should give a shit which is cheaper for them.

  • kbolino||

    American people pay more for healthcare than anyone else in the world.

    If that was an apples-to-apples comparison, it would mean something.

    One of the primary goals of healthcare reform is to bring down healthcare costs for individual Americans.

    Its goal was to bring down prices; the mechanism by which it strove to do that was through increasing costs. It remains an exercise for the reader, apparently, to determine how that is possible.

    Rational Americans shouldn't really give a shit if they're paying for it via taxes or in the private market--they should give a shit which is cheaper for them.

    When I'm the hospital and my life depends on the doctors and nurses treating me, I will be comforted by the notion that they have no connection whatsoever to me, and that a horde of bureaucrats got paid with the better part of their former salaries.

  • Will Nonya||

    Defense is a constitutional requirement even still though if you spent all of it on healthcare instead the entire defense budget is roughly only enough to cover a third of the healthcare spending in the US.

    One thing that people who advocate for "something" to be done ignore is what causes our healthcare to be so expensive. The key reason can be aggregated as government. There are whole host of regulations which serve no useful purpose but to increase the cost of healthcare.

    About 20% of the us healthcare market is price fixed through government programs as are most of your favored social medicine programs in other countries. This means that those select few get lower prices for new medicines and new equipment or techniques but the cost of developing, approving and marketing those pieces of advanced medicine falls back to the 80% in the (relatively speaking) "free" market. So socialized medicine has a part in the high cost of American healthcare. This is pretty well documented yet nothing has been done to reduce regulatory cost so that these cost can go down and no one asks who will pay for this research and development once that remaining 80% becomes price controlled?

  • The Knuckle||

    Would it be prudent to point out that states have far more latitude in enacting ACA style plans? There simply shouldn't be federal program for this.

  • Gilbert Martin||

    "Unless you're an anarchist you obviously do expect me to pay for some of your upkeep"

    It is an unequiocal and absolute fact that you have never done anything that constitutes doing so.

  • Tony||

    You going to Best Buy, picking up a TV, making it home safely, plugging it in, and watching grown men bash their heads against each other is all made possible because I'm here to help pay for the grand civic infrastructure that makes civilization possible, certainly including the relative peace, security, and other social guarantees provided by law and order, and possibly including the very electricity and roads you directly used in this scenario, depending on our proximity.

  • Gilbert Martin||

    Nope.

    You are making an affirmative condition claim. Any affirmative condition claim you make about any conceivable aspect of existence has to be proven to be so with unequivocal and absolute definitiveness or it's not proven at all and the negative prevails by default.


    Consequently, the ONLY thing that would ever constitute proof of you "paying for my upkeep" is an explicit transfer of cash, marketable securities or other property of sustantial market value directly from you to me.

    Just as the only thing that would ever prove the man-made global warming theory is unequivocal and absolutely definitive proof of a perfectly linear one for one correlation between the variations of man made so-called "greenhouse gasses" and global temperatures that track consistently over every single second of the entire timespan of human existence on the planet.

    Just as the only thing that would ever constitute proof of the old liberal theory of poverty being the root cause of crime is unequivocal and absolutely definitive proof that without exception, every single poor person who has ever lived on the planet was a criminal.

    You liberals and your affimative condition claims.

    You're always on the wrong side of the absolute rules of evidence.

    You automatically lose every argument before you ever get started.

  • Tony||

    Wow you are extremely, extremely bad at this thinking business.

  • Gilbert Martin||

    That's another claim you cannot prove to be true and therefore it's false.

    You lose again.

  • Brian||

    Tony:

    You going to Best Buy, picking up a TV, making it home safely, plugging it in, and watching grown men bash their heads against each other is all made possible because I'm here to help pay for the grand civic infrastructure that makes civilization possible, certainly including the relative peace, security, and other social guarantees provided by law and order, and possibly including the very electricity and roads you directly used in this scenario, depending on our proximity.

    I had no idea just how important you really were.

  • Brian||

    Tony:

    But it is, relative to modern standards of civilization, a bit on the sociopathic side of moral opinions.

    Translation: I usually don't go for morality (what, you think your NAP is written on stone by the sky god?), but I won't let that get in the way of accusing you of sociopathic morals.

  • triclops||

    That's great if all you care about is "universal healthcare". If you care about the consequences of such a plan, and weigh costs and benefits of alternatives against it, you wouldn't be so sanguine about the unmitigated abortion you have been cheering for because "it's better than nothing". Obamacare is the worst of both worlds. Crony Capitalism and retarded government interference on a whole new level. You should be so proud.

  • Tony||

    Absolutely fine. Let's put money on it. To my mind, the way Obamacare fails is if it reduces the number of people who have access to quality healthcare and/or we see healthcare cost increases at a rate higher than pre-Obamacare. If you have another measure, I'm all ears. But I suspect it's an article of faith on your part that it's a failure, and conversations that depend on faith claims are conversations that can't go anywhere.

  • kbolino||

    The low signup rate, the slipped deadlines, the cancellation notices, the higher prices, the premiums as yet unpaid are all "articles of faith" according to you?

  • Tony||

    If you're truly approaching the question in good faith, you'd acknowledge that it's too soon to judge the entire thing a success or failure.

  • kbolino||

    So before it can meet its stated goal, it must first head in the opposite direction?

  • Will Nonya||

    The law hasn't failed but those administering it so far have.

    The problem is that the law isn't built for widespread success and the only way it will succeed is through an administration that uses all of the leeway given to HHS to right the ship before the economics become unsustainable.

  • OneOut||

    "If you're truly approaching the question in good faith, you'd acknowledge"

    ROFLMAO

    Translated: you are only right if you agree with me.

  • Rasilio||

    Actually moron we have always had universal access to healthcare. What we don't have is universal access to unlimited health care services and products and you know what, no system anywhere can deliver that.

    The simple fact is as with all other markets a near completely deregulated free market would provide the greatest quantity of health care products and services to the greatest number of people.

    Sure under that system some people would die earlier than under other systems and others would be forced to suffer with diseases which were otherwise curable because of cost concerns, the thing is the same statements would be true of ANY system of health care provision because perfection is unattainable and scarcity a constant. A complete free market in health care just so happens to be best from both a utilitarian and a moral position

  • Don'tTreadOnMe||

    ^^So right but a lone voice in the wilderness….

  • JPyrate||

    So Tony. Instead of letting a free market keep prices competitive, or letting individual actors collectively bargain for the best prices, you support a system based upon mercantilism mixed with the worst aspects of socialism ?

  • Bryan C||

    Nothing will deliver universal access to healthcare.

  • Carolynp||

    "And laissez-faire capitalism will never deliver universal access to healthcare." Obviously, neither does socialism. Best estimates suggest that after spending a trillion dollars on this clusterfark there will be MORE people without access to healthcare, some stats suggest there will be twice as many. Yay liberals!!

  • Libertarius||

    "Single payer" is a shabby floating abstraction; just *who* is the so-called "single payer"?

    Is it everyone in-general, and no one in-particular?

    Oh that's right, it's the government. But the government is not a perpetual free lunch machine, or a supernatural entity endowed with the ability to conjure and "distribute" free shit; the government is funded by those who are alleged to be its beneficiaries.

    The "single payer" is anyone who pays taxes, or anyone on-the-hook for the debt created by our kangaroo monetary system. The "single payer" is YOU, and hence "single payer healthcare" is a cynical myth propagated in the name of fooling duplicitous leftoids into believing that the "single payer" is actually someone else.

    Healthcare is not an alternate dimension to which the state can arbitrarily grant "access" by the wave of a magic wand. Healthcare is a highly specialized service provided by highly trained medical professionals, who I hope will reject the slavery into which the left is attempting to condemn them. By all evidence, the early retirements of many doctors indicates that they already are.

    Atlas shrugs.

  • ||

    *who* is the so-called "single payer"?

    medicare and medicaid.

  • Tony||

    Liberals are aware of how single-payer healthcare works. Sort of like how single-payer national defense or single-payer national parks work. It is such a pity that all soldiers, park rangers, teachers, road construction workers, firefighters, and police officers are slaves though. Any minute now we'll have total anarchy as they all realize their plight and go Galt.

  • RightNut||

    soldiers, park rangers, teachers, road construction workers, firefighters, and police officers

    Don't all those professions, except soldiers, have massively powerful unions backing them? All those professions are also massively inefficient and sometimes abusive.

    Not the best analogy.

  • Tony||

    The question is about their status as slaves, not whether they are efficient. If doctors are slaves under single payer, it can only be true that firefighters are slaves as well.

  • RightNut||

    Slave is hyperbole, but when your choice is accept less money than your work is worth, or quit, you have no good options.

    And unlike the professions you named doctors require a great deal of education and training.

  • Tony||

    Just like slaves! Also, like doctors, slaves were among the highest paid professionals in society. Oh wait, no, slaves weren't paid at all, as is required by the definition of a slave.

  • Will Nonya||

    So you've just contradicted your application of the slave label to all of these groups because slaves cant be paid?

  • Tony||

    Slaves are people owned by other people who are forced to work against their will for no pay. The Venn diagram overlap of doctors and slaves is surely quite miniscule in this country.

  • kbolino||

    Oh wait, no, slaves weren't paid at all, as is required by the definition of a slave.

    That is not the definition of slave. Skilled slaves in antiquity were paid. And even American slaves, who were given no direct compensation, were paid in the form of shelter and food. That doesn't diminish the fact they were slaves.

  • Tony||

    Fair enough. Doctors still aren't slaves.

  • kbolino||

    The term slave is a strong one, but it becomes increasingly apt as the person's freedom disappears. You are right, though, that doctors are always free to quit and join the welfare rolls. And young people will still be free to not become doctors. That will work out great for the system!

  • Tony||

    Since we have every other advanced country on earth to choose from as examples of the consequences of universal healthcare schemes, would you care to point out which ones treat doctors as lowly quasi-slaves?

  • kbolino||

    You are confusing the trappings of some historical examples of slavery with the condition of being a slave itself. Good doctors don't work for the NHS in the UK. They either work for the private parallel system or they leave the country and work elsewhere. But the bigger issue is the many people not inclined to go into medicine (or often anything else) because the people who work in those professions are treated as replaceable objects rather than talented professionals.

    They are not enslaved in the same manner as a black man in the South in 1840 but they are definitely devalued and dehumanized.

  • Will Nonya||

    The UK doesn't enslave it's doctors. It saves that honor for the patrons of the NHS.

  • Brian||

    Tony:

    Since we have every other advanced country on earth to choose from as examples of the consequences of universal healthcare schemes, would you care to point out which ones treat doctors as lowly quasi-slaves?

    You could figure this out if you'd use your own arguments consistently.

    OK, you want to create the biggest insurance possible by going to single payer? In a free market, if a single payer occurred, what would you think? You'd call it a monopsony, the buying analogue to a monopoly.

    Usually, progressives frame anyone sitting on the other side of a monopoly as a victim. That's where your single payer health care wants to put doctors and insurance people (if it tolerates insurance people without banning them from their trade outright).

    You can quibble over the appropriateness of the word slavery, but progressives are well aware of the arguments against monopolies, and ignoring them here is inconsistent.

    I know we all have to pretend that every idea democrats have is a win for practically everyone, but it isn't. You're basically telling doctors that they need to sit on the other side of a monopoly in all negotiations, and, if they don't like it, they can leave the country.

    Your policies do have victims. It's not a win-win for everyone, regardless of all the "if you like it, you can keep it" BS.

  • Ann N||

    slaves is not a hyperbole.

    if you've ever seen the denzel washington movie 'John Q' you see what healthcare entitlement looks like.

    its a dad pointing a gun at a doctor and commanding him to save his sick son.

    this is the real concept behind single-payer.

    the only option besides slavery is to negotiate for fair value, which thing govt is less efficient at doing, and which will be astronomically more expensive due to preexisting conditions and entrance of new consumers who were previously unable to pay but Dear Leader compassionate helped them.

    it will be more expensive, yet obamacare was sold on reducing costs.

    its a bald fraud.

  • kbolino||

    Any minute now we'll have total anarchy as they all realize their plight and go Galt.

    Just like the slaves in the South! Oh, wait...

  • Will Nonya||

    I'm not sure soldiers in a volunteer army could be considered slaves.

    I assume you also mean to include sailors, airmen and marines? You're obviously not ignorant or arrogant enough to assume they are the same or to try and intentionally offend these other groups...

    Of course if you are then just go find a nice big Marine tell him he's nothing more than a soldier and a slave and let me know how good your healthcare is.

  • Tony||

    Nobody who gets a paycheck is a slave. Perhaps libertarius meant to use the term "indentured servant." Either way--whatever doctors are under single-payer healthcare, firefighters are the same thing under single-payer firefighting.

  • Will Nonya||

    The federal government doesn't mandate single payer fire fighters and it doesn't determine the rates local fire fighters are paid or the level of service they must provide for those rates.

    There are many places in the country where the local fire department works on a subscription basis. If you don't pay for the service they'll let you watch your house burn. I'm pretty sure no one would want to continue carrying that analogy to healthcare.

  • Tony||

    I'm always puzzled by the argument that evil slavemaking collective action becomes perfectly OK at the sub-federal level. At any rate, publicly funded firefighting is the go-to example for explaining the utility of collective action. Fire is an indiscriminate and universal problem humans face, so we combat it most efficiently by pooling our resources and dealing with it when needed. It is perfectly analogous to healthcare in that way--all humans have healthcare needs, and can rarely predict when we'll need to pay to address them.

    Every other civilized country on earth has figured out that it's just as beneficial in terms of efficiency when healthcare costs are universalized.

  • kbolino||

    Every other civilized country on earth has figured out that it's just as beneficial in terms of efficiency when healthcare costs are universalized.

    Every other "civilized" country has as much, if not more, debt than we do, so I'd say they haven't figured anything out any better than "we" have.

  • Will Nonya||

    My friend your puzzlement comes because you fail to understand federalism.

    However the main point is that there are things the states are empowered to do and there are a limited and enumerated set of things the federal government is allowed to do. When the federal government does something stupid or bad it hurts everyone. When a state does it the damage is compartmentalized. It's also much easier to move from one state to another if you disagree with their policies than it is to move your family out of the US.

    I cant disagree that making other people pay for all or part of your healthcare will make it cheaper I only disagree that they should.

    With healthcare we're approaching this problem from the wrong end and all we've done for a generation is impose laws aimed at imposing "fairness" without recognizing we're exacerbating the problem we're claiming to be fighting.

    If you want healthcare to be more affordable then examine the causes not the effects to determine what has to be done.

  • Don'tTreadOnMe||

    So we have a federal firefighter service now? What are you talking about? The fact is that firefighters are paid varying rates throughout the country…including volunteers. And those rates vary by a large number of factors quasi related to workload, availability and other factors. Again, what ARE your talking about? Healthcare is just that same and there are regional differences in provider/hospital pay as a result. So is that uncivilized somehow? You seem to be on this 'enlarge the pool and costs will come down' mantra. Do you realize that doing so effectively increases costs and reduces access? Look at the average time to getting your hip fixed in the NHS versus the US. You up for that, dude?

  • Brian||

    Tony:

    At any rate, publicly funded firefighting is the go-to example for explaining the utility of collective action.

    Yeah, collective action is great. You know, there are private fire fighters, too.

    It is perfectly analogous to healthcare in that way--all humans have healthcare needs, and can rarely predict when we'll need to pay to address them.

    Practically any economic or insurance activity you engage in is collective action, mitigating risk. Is there some point? You're making a great case for health insurance. Can you jump to the part where single payer is the only way this is possible?

  • Brian||

    Tony:

    Every other civilized country on earth has figured out that it's just as beneficial in terms of efficiency when healthcare costs are universalized.

    First, what does "healthcare costs are universalized" even mean?

    Switzerland doesn't have a single payer health system. They have compulsory insurance, and no medicare. Their system is still universal. But the costs aren't "universalized", whatever that means.

    Singapore doesn't have a single payer health system. They have mandatory HSAs and no medicare. Singapore has excellent health outcomes and is cheaper then Europe. Would that be cool with you?

    It's not like every other country has some boiler-plate, democrat approved "single payer" policy.

    Also, your whole argument is just an inconsistent application of Argumentum Ad Europium: Europe does it, so we should, too!

    This is always applied selectively. For example, democrats think debt ceilings are weird and outdated, even though the EU adopted debt and deficit limits rather recently. Why doesn't "Europe's doing it, so it must be awesome" apply there?

    Or, Glass Steagall, which has taken on mythic proportions with democrats as the key regulation that turned the US into the wild west economy that lead to the housing crisis. Europe doesn't have anything like it. Is theirs a wild west economy?

    Argumentum Ad Europium would be more persuasive if it wasn't so selectively applied.

  • kbolino||

    Nobody who gets a paycheck is a slave.

    I don't know where this distortion comes from, but lack of compensation is neither necessary (ancient Greece and Rome) nor sufficient (volunteers) for slavery.

  • ||

    Sudderman translation:

    "Crazy conservatives were completely right about Obamacare not working but they are crazy so they must be wrong about it being designed to fail....please ignore the fact that left wingers are now pushing for single player to replace Obamacare."

  • Beezard||

    Hmmm. I think a slow drift towards single payer is way more likely since Obamacare than some injection of true competition and free market into health care. There is a massive backlash coming against it. From unions and other lobbies getting screwed. But that's just a matter of making exceptions until the hooks can sink. Few of the political players and voting blocks that oppose Obama care actually want a competitive free market system. It's not utopian enough, and I don't think that small fact should be underestimated. Even many conservatives want their shit paid for. Each failure of the system will be rewarded with a new layer of failure until we have some weird mutant thing that might as well be single payer.

  • Joao||

    This article underestimates just how leftist the US has become.

    I'm from Massachusetts where a likable, reach-across-the-aisle, Republican incumbent by the name of Scott Brown was voted out of office in this strongly Democrat state because his commie female opponent said "he hates women" and the masses went right along.

    Hillary will do the same, as will the national masses.

  • RightNut||

    Meh, Brown lost because of Obama's coattails. I would be surprised if a random person on the street even knew Brown was out of office.

  • DarrenM||

    That random person on the street probably didn't vote anyway.

  • AlbertP||

    If the purpose of the ACA was purely to give low income individuals better (financially speaking) access to decent health care, the only thing that needed to be done was to grant vouchers through a modified Earned Income Credit system which would grant such vouchers based on income and family size. Then they could shop for the type of coverage they wanted. The only thing one would have to do to qualify is to file your IRS tax forms annually.

    But the purpose of the ACA is not about providing financial support to poor working families and individuals so they have access to decent health care. The real goal of the ACA has always has been the Redistribution of Wealth. Case in point: since when have families-of-four making $93,000 a year needed government support to buy health insurance? Are families-of-four with this income somehow "low-income"?

  • XM||

    Some of what makes "single payer" even functional elsewhere will be either unlawful or unconstitutional.

    American simply does not have an iron grasp in healthcare that allows them to fiddle with salaries, hour, or quotas in order to save cost.

  • AlbertP||

    True, but Congress does have the power to collect income tax from any individuals as much as they want. And they can tax different types of jobs differently, so they CAN fiddle with incomes, hours, etc, at least indirectly.

    Of course that won't reduce costs (but why would they let that stop them) :)

  • Beezard||

    I'm not sure what makes Obamacare constitutional or lawful.

  • JeremyR||

    Instead, it was meant to destroy the existing health care system, and in the process pave the way for liberals to step in with the comprehensive health care fix the far left has always really longed for: single payer.

    Republicans seem to forget that they invented Obamacare. And implemented it first as Romneycare.

    And even this site was pushing a form of it.

    http://reason.com/archives/200.....tcontainer

  • Sevo||

    "Republicans seem to forget that they invented Obamacare. And implemented it first as Romneycare."
    No, Jeremy, "republicans" didn't; Romney did.

    "And even this site was pushing a form of it."
    And the form was different enough that those without an axe to grind would mention it, so we'll assume you won't.

  • devan||

    How To Opt Out Of Obamacare

    Know your options and become savvy self-pay patients

    Join a health care sharing ministry. These are voluntary, charitable membership organizations that agree to share medical bills among the membership. They function similar to insurance, and are probably the best alternative to conventional health insurance. There are four of them, at least that I know of. Three are open only to practicing Christians (Samaritan Ministries, Christian Healthcare Ministries, and Christian Care Ministry) while a fourth, Liberty HealthShare, is open to anyone who agrees with their ethical commitment to religious liberty. They operate entirely outside of Obamacare’s regulations, and typically offer benefits for about half the cost of similar health insurance. Members are also exempt from having to pay the tax for being uninsured.

    From the article by Sean Parnell

    http://thefederalist.com/2013/.....iM_o.email

  • devan||

    Will Obamacare be repealed or won't it? Will Congress fund it or won't it? Will the web site be fixed or not? Blah, blah, blah. We the people just need to do what we need to do and Congress be damned. Resist. Refuse. Revolt. EXEMPT OURSELVES! We did not comply with Prohibition and we simply should not comply with Obamacare. For religious reasons. For privacy reasons. For the cause of liberty and freedom and in protest of the idea that the federal government (under one party rule, no less), can force private citizens to purchase anything with our own money. Are we citizens or subjects? Mice or (wo)men? Just say NO to socialism and to the corrupt, unionized, far left IRS: the gestapo of America's political class. After all, the federal government ignores millions of illegals who are breaking U.S. immigration law every day. Our Founders pledged their lives, their fortunes and their sacred honor. All we have to do is just say no to a scheme we all know is un-American and a violation of our most basic founding fundamentals of privacy, self reliance, limited government and individual freedom.

  • MaleMatters||

    Very good commentary. Very objective.

    On Medicaid: "...it’s hard to imagine someone with private health insurance looking jealously at a program that has no statistically significant effect on physical health outcomes and that has even been found, in a couple of narrow instances, to produce health outcomes that are worse than no insurance at all."

    That's true, possibly due to moral hazard. Here's what worries me:

    In 2009, President Obama said Medicaid is "a broken system." Did he propose plans to fix it? No. He is bringing millions of more Americans into the broken system. This is a prescription for disaster.

    "People respond to incentives, although not necessarily in ways that are predictable or manifest. Therefore, one of the most powerful laws in the universe is the law of unintended consequences." -From the book "SuperFreakonomics"

    That in mind, see:

    "Obamacare: Making a bad situation worse"
    http://relevantmatters.wordpre.....ion-worse/

  • PapaSnigz||

    The only way I can see Dem's trying to save face in this scenario is by calling for single-payer. I feel like a lot of the liberals that didn't want single-payer will now just so they have an excuse to get re-elected. I can only hope that the people won't fall for it...

  • PaulinePhelpsmee||

    up to I saw the check of $8495, I did not believe ...that...my best friend actualy earning money part time from their computer.. there friend brother started doing this 4 only fourteen months and as of now cleared the dept on there appartment and got a top of the range Ariel Atom. website here
    ++++++++++++++++++++++++++++
    http://www.tec30.com
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  • Andrew P||

    This analysis is wrong. First of all, Congressional Democrats (including Pelosi) told us at the time (when ObamaCare was still just a bill) that it was designed to bring about Single Payer. Obama wasn't involved in some detailed bill-writing conspiracy. He doesn't do details anyway. He is too lazy. Rather it was a conspiracy by Democratic Senators and their Congressional/Senate permanent staff "experts". They cobbled it to bring about 60 votes, which is the only reason it didn't enact single payer immediately.

    Reid recently said that ObamaCare will bring about Single Payer. He is right. What the Democrats understand is that (1) Obama will never sign a repeal bill. That means ObamaCare will not be changed for at least 3 years. (2) While reaction against the law will elect Republicans in 2014, that isn't enough to override Obama. (3) The business cycle will turn back to recession within that time or shortly afterward. Given that our current recovery can hardly be called that at all, and our position in the debt supercycle, the next recession is likely to be a doozy - and almost unfixable. When that happens the public will be so terrified of dying in poverty that they will elect Democrats to everything. The public will elect the most socialist candidates they can out of pure fear. And appeals to replace the ObamaCare disaster with Single Payer/ single Provider healthcare will have broad public resonance.

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