There are signs that the Democrats are really going to pass a health care bill. I remain skeptical, but if they do, I was wrong. I remain more skeptical concerning the design and the effect of the legislation. There are basically three reasons for wanting to reform the system: one is to cut costs; another is to extend care and insurance coverage to people not covered now; the last is to move the United States to a more European/Canadian style system.
I am pretty certain that the first will not be achieved by current legislation. I have doubts that the latter will fly when most tax-paying Americans realize that their health care costs are going to go up and their care options, if anything, will be more restricted. As for the last, I think the Democrats may make a great stride in that direction if they accomplish anything at all.
All the signs are in my favor on this count. Kausfiles notes this exchange from NBC's Dr. Nancy Snyderman and President Obama. The President said:
Snyderman: I haven't heard anyone ask just for the American public to pony up here, that this is going to require some give for all the stakeholders involved.
Obama: Well, let me - let me talk about what I think the American people are going to have to do.
First of all, the American people have to recognize that there's no such thing as a free lunch. Right? So, we can't just provide care to everybody that has no cost whatsoever, you don't end up having to make any decisions.
Now that sounds like responsible comment. If we are going to extend care to everybody, somebody is going to have to pay for it. That would be the people who are already paying for everything else. Are they going to go for such a sacrifice, when they realize how much it costs and what little it provides? Maybe they get something out of it, but they have to pay for that too, no? Maybe they should do this, out of charity and other virtues, but it might be a difficult sale when the invoice shows up.
Oh, and the President has this:
So, self-responsibility is going to be critical. This is probably not going to be something that's legislated. But I tell you what, every business out there is going to be looking at their health care bottom line. And increasingly what you're going to see is that businesses are going to incentivize their employees to stop smoking, lose weight, get exercise, get regular checkups.
Okay, so "self-responsibility" means that Obama's program will use business to make sure that we all quit smoking and go on diets and exercise. They "incentivize" good behavior, which means penalizing people who don't get on the treadmill. Maybe Ms. Obama will show up and lay my clothes out for me in the morning. Or maybe we will all be incentivized to dress in identical quasi-military jumpsuits every morning and do Tai Chi in the public squares.
The President was perhaps too candid in letting us know what he is thinking. When he says "self-responsibility" he means government taking a bigger bite out of taxpayer's paychecks and, apparently, a lot more public control (if indirect) over how we live our lives. Maybe we will all be better people for it. But I am thinking that sooner or later this agenda will become apparent to taxpayers and voters, and that it will please some considerable portion of them too well.
Why does an incentive have to be a punishment? Why can't you reward people instead? Extra 50 dollars a month to each non-smoker. Etc.
Posted by: FascistSocialist | Monday, August 03, 2009 at 10:05 PM