Wednesday, October 9, 2013

My Position on ObamaCare AKA PPACA

Right now the government is shut down because a faction of the GOP feels so strongly that ObamaCare will destroy America, that they are willing to do it first.

OK, I'm being a little facetious. But you probably figured out where I stand on the emotionally charged issue of the PPACA. I'm for it. Or, the extent to which I'm against it, it's because I want a single payer system and I want it detached from employers because I think that switching jobs shouldn't cause switching health plans and doctors.

Politics is the art of the possible and President Obama did what was possible. He didn't let the perfect be the enemy of the good--or the adequate. I think he was counting on a future where Congress would help tweak imperfections in the law, but Congress instead has gone nuts and wants no part of fixing it because they just want to destroy it.

Health insurance and flood insurance both have something in common. It's hard for the free market to sell health insurance plans because the cost structure of the event of getting sick often has significant future costs. If I get diabetes today, I might get limbs amputated in a decade. The cost is not yet incurred, but the insurance company sees it on the horizon. Flood insurance is similar--if I get flooded today and rebuild in the same spot, the insurance company will be wary about continuing to insure me because I'm still in a known flood zone. Private insurance has left the flood insurance market to the federal government for this reason. But, while not everyone builds in a flood zone, anyone can get sick.

Another problem with the free market system is that emergency rooms are required to take all comers regardless of ability to pay. In fact, Mitt Romney, during his campaign, kept saying that this is an alternative to getting health insurance. As if I can stroll into the emergency room and get chemotherapy.

An economist will tell you that the free market allocates resources efficiently. But it does it amorally. I don't mean immorally--I mean without regard to moral principles. A free market outcome might be moral or it might be immoral. The mechanism of the market takes price and demand into account, not moral judgments. That is why we have regulation. Regulation is designed to prevent immoral outcomes. Now, there are a bunch of people in the GOP who live by Ayn Rand's ideas. Her idea is basically that the outcomes of the free market, by virtue of being efficient, are therefore always moral. And any regulation interferes with efficiency, hence reduces the morality of the outcome. The most moral outcome is the most efficient as defined by the totally unregulated free market. If you can't afford insurance, well, you should have made better decisions in life and it's not the responsibility of anyone else to save you from your poor decisions. Just die already! That's why when Paul Ryan was asked if he preferred Ayn Rand's teachings or Jesus's teachings, he had to pretend he preferred Jesus's teachings.

Anyway, that's where I stand. I probably offended some readers. Oh well. Emotions are running high.

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