Monday, March 22, 2010

Obamacare Passed: Now What?

According to Yahoo! News Obamacare has passed the senate and will now be sent to the President for his signature. If you're a long-time reader of this blog you know I've been following this issue for several months since it was born, and it is certainly sickening to many to see that the efforts to prevent this legislation from going through have failed.

But strangely enough I'm not offended in the least by this event. If anything, I find that my resolve has been boosted as a result.

As I stated in my last post no matter what the outcome is the opportunities to help bring about a rational culture is neither lost nor finished. The passing of this legislation, in fact, may be a golden opportunity for philosophical activism. The latest Rasmussen report, which has been updated since my last post, now indicates that even more voters oppose the plan and even fewer people support it, now resulting in a 13% gap. Even with the 3% margin of error that is still a dramatic split. Given this, do you think that America is going to sit idly by and accept its "fate"? I doubt it. I predict that the legislation will go into effect even despite current procedural difficulties, but I also believe that Americans will be more receptive to Objectivist ideas than ever, and in the long-run it's the ideas that matter.

This could be a significant advantage. You know the saying "You can't tell a kid not to touch a hot stove"? The meaning of this saying, in the context of its example, is that you cannot teach a kid that touching a hot stove is bad for him unless he has a conception of what it is to be "burned." Once he gets burned is when he'll learn that it is not good to touch a hot stove. Of course we could have avoided such a legislative outcome in America if the culture had a better epistemology, but instead we now may have the opportunity to touch a hot stove with both hands on the burners, and our bodyweight bearing down on top. Given the inevitable failure that's going to occur of Obamacare people are going to be looking for answers again. As a reminder, here's a sampling of what failures are going to occur not just as a matter of the concrete effects of this particular legislation, but rather as a matter of principle given the nature of this type of legislation and all others like it:

1.) Rationing and long waits; shortages: Since health insurance will be extended to all it will inevitably lead to a decline in efficiency since there isn't an equal increase of service providers to accommodate the soon-coming deluge of demand. When you tell someone they can have as much of something as they want at no cost then they have a perverse incentive to take more than is rationally justifiable or to be reckless; people will start going to the doctor for things they otherwise wouldn't if they were making the decision based on their finite supply of money ("Hmm, I've got a cold. Better go see the doctor.").

And if that weren't sufficient on its own to cause inefficiencies and shortages, there is a likelihood that a significant number of doctors will leave the medical profession as a result of this legislation, thereby decreasing available service providers and further undermining the medical industry's ability to accommodate demand. What people seem to forget to take into account when considering lowering the payments of doctors or insuring more people is the nature of the doctors' job: not only did it take years of practice, learning, and hard study to bring them up to the level of competence they have achieved, but there is also the risk inherent in their work that they have to deal with. They could err and accidentally give themselves an illness or fatal disease (e.g. by accidentally being pricked by a syringe), or, worst yet from a psychological standpoint, they could cause a patient to become sick, sicker, or even to die. It is a very stressful job by its very nature, and when politicians put upon doctors more work and risk for lesser reward the likelihood is that many doctors will soon find their work just isn't worth the effort anymore, and so will quit.

2.) Skyrocketing costs: This is a complex area, but the economic effects of this legislation could not only exacerbate the depression (if it be a depression) we're already in, but also make it last the rest of the time this legislation remains in effect. The above mentioned increase in demand will obviously drive up costs to astronomical levels. Doctors quitting will contribute to expenses even more. Ignorant politicians dictating medical decisions, the new taxes, the establishment of new government agencies, and so on: Even more.

Another thing that has been misunderstood in the debate is the actual nature of insurance itself. The reason you insure yourself is to protect yourself against risk, not so you can just withdraw money whenever your situation necessitates it, without having paid into the system first. Insurance companies charge their costumers a certain amount so that they can pool the money and make it available to whatever costumers submit a claim and satisfy the criteria for being awarded money; otherwise it would be impossible for the companies to exist. Regulations have lead to today's unaffordability. What are companies to do if laws mandate which conditions and treatments they *must* provide coverage for, regardless of whether or not the particular costumers agree to pay for it, or even need it? Raise prices, since covering a broader spectrum of things means the companies has to satisfy a potentially greater number of claims in that regard. What are companies to do if laws mandate that they accept any and all applicants regardless of preexisting conditions and as soon as they submit an application? Raise prices, since the company needs to build itself up so it can pay out the claims, as it is taking on greater risk. What are companies to do if politicians enforce price ceilings? Withdraw from the particular markets that have such regulations, since insurance companies need a certain amount of funding in order to maintain a resource pool large enough to satisfy its costumers. What happens if all these past mentioned laws become national federal law? Insurance companies jack up their prices even more, or go out of business. With Obamacare we may see not only higher prices, but also the possible elimination of private insurance through economic suffocation.

3.) Possible further governmental intrusions: As I've mentioned on this blog before, an egg company in the United Kingdom had one of its commercials, known by the phrase "Go to Work on an Egg," censored by the UK government since it was deemed as promoting an unhealthy lifestyle, and was therefore a potential risk for increasing medical care costs (conventional nutrition again). Under this same justification the American government could impose further controls in other areas of life as a response to the failures of socialized medicine, stating that such measures would "cut costs" or "increase efficiency." Remember the proposed ban on butter? What about the proposed ban on salt, which has been taken seriously enough to be made into an official bill? There's already extreme restrictions on raw dairy products.


And so on and so forth. (For an excellent and thorough analysis on why socialized medicine is a failure on principle, distinct from any concrete instance of it, consult Moral Health Care vs. "Universal Health Care." It's from a subscription journal, but this particular article is available in its entirety for free.)

What the Democrats have passed through last night will inevitably blow up in everyone's face if put into effect, and it's still a question as to what degree it will go into effect, if it goes into effect at all. From what I gather from my reading, there's still plenty of complicated issues unresolved: some states are passing legislation to nullify parts of this legislation, or are even going so far as to sue the fed; Republican John McCain has mentioned an intention to attempt to repeal this measure, there's constitutionality concerns about some aspects (such as mandatory insurance), there's the soon-coming public outrage, and so on. As I said above, things are not lost yet; there's golden opportunity abound.

While I understand that some may be disenchanted and demotivated today, I feel reenergized and full of resolve. To quote Betsy Speicher: "Reality is always on the winning side."

I cannot help but exclaim "en guarde!"

1 comment:

Beth said...

Thanks for your fighting attitude and the words of hope in this potentially discouraging time. It truly helps to see someone ready to plunge forward rather than spend time grieving over this set back.
May you soon go from en garde to touche.