The Right Coast

Editor: Thomas A. Smith
University of San Diego
School of Law

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Saturday, March 24, 2012

Paul Ryan's budget and Obamacare
Tom Smith

This is a rather long and wonky but still very enlightening read.  Levin explains why getting health care costs down is essential to avoiding a federal fiscal catastrophe and why something other than rationing by a panel of federal experts (who would not even have adequate powers to control costs anyway, and one fears what would happen if they did) is the preferred way to go.  

I hate to be such a gloomy gus, but the whole issue of the federal debt and how federal health care costs are driving it is, well, kinda hard to get your arms around.  It's rather complicated stuff.  How likely is it that a democracy transfixed by such canards as Inequality, the War On Women or this latest red herring in Florida (yes, a mixed metaphor) is going to even glance at Ryan's budget let alone  come to some sort of reasoned judgment that a more market based reform is better than Obamacare.  I fear that what we are looking at is a fundamental inability of the sort of giant, mixed-economy behemoth we have become to govern inself in a way that averts financial disaster.  I hope I'm wrong but I just don't see what the mechanism is that's going to stop it.  Here is California, at the state level, we seemed to be absolutely locked into a political dynamic that must end in fiscal disaster.  It's like the political equivalent of one of those ancient elks with antlers so huge they could not lift their heads -- probably mythical but you see my point.  Evolutionary dead ends abounded; why not in politics?

Steyn is even gloomier.

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"Evolutionary dead ends abounded; why not in politics?" That's why people my age were taught about the fall of the Roman Empire.

Posted by: dearieme | Mar 25, 2012 8:59:54 AM

It's not looking good.

Posted by: Jonathan | Mar 25, 2012 2:38:54 PM

Market rationing of healthcare has not happened either. Instead what we have is a market that is enormously subsidized by federal money and tightly regulated by multiple jurisdictions. People want healthcare on somebody else's dime but don't want the government involved in healthcare choices. As for the politics of cost control as they are, if the old have to choose between taxes and less healthcare, its going to be taxes.

You can ration healthcare through mandate or through the market. Currently we do neither, which is why costs are exploding. The market is supposed to ration healthcare by ability to pay of it actually is functioning, which I find monstrous. Actuarial rationing involves state decisions about who should receive healthcare, which libertarians find monstrous. If you want to control costs you have to do one or the other.

Posted by: molly | Mar 26, 2012 7:33:02 AM

We have a complex financial issue in a nation unendingly fascinated by the Kardashians and largely innumerate. It doesn't bode well for a good solution.

Posted by: krm | Mar 26, 2012 8:06:30 AM