Charles Krauthammer proclaims “Obamacare Version 1.0 is dead” and helpfully proposes a version 2.0. Basically: No public option, no death panels end-of-life counseling, softpeddle government “best practices,” abandon cost-cutting, and guaranteeing universal coverage.
What’s not to like? If you have insurance, you’ll never lose it. Nor will your children ever be denied coverage for preexisting conditions.
The regulated insurance companies will get two things in return. Government will impose an individual mandate that will force the purchase of health insurance on the millions of healthy young people who today forgo it. And government will subsidize all the others who are too poor to buy health insurance. The result? Two enormous new revenue streams created by government for the insurance companies.
And here’s what makes it so politically seductive: The end result is the liberal dream of universal and guaranteed coverage — but without overt nationalization. It is all done through private insurance companies. Ostensibly private. They will, in reality, have been turned into government utilities. No longer able to control whom they can enroll, whom they can drop and how much they can limit their own liability, they will live off government largess — subsidized premiums from the poor; forced premiums from the young and healthy.
It’s the perfect finesse — government health care by proxy. And because it’s proxy, and because it will guarantee access to (supposedly) private health insurance — something that enjoys considerable Republican support — it will pass with wide bipartisan backing and give Obama a resounding political victory.
Krauthammer admits that “The financial and budgetary consequences will be catastrophic” but figures it’s a smart way to force people to swallow real socialized medicine because, when the bills come due, “the only remaining option will be to give up the benefits we will have become accustomed to. Once granted, guaranteed universal health care is not relinquished. Look at Canada. Look at Britain. They got hooked; now they ration. So will we.”
Dave Schuler thinks this would “carefully preserve most of the worst features of our present system.”
There are virtually no incentives at any level for controlling costs. Unfortunately, since we already pay nearly twice as much for healthcare per capita as an other OECD country and in this form healthcare reform would do nothing to change that, that would all but certainly result in stunting the growth of every sector of the economy other than healthcare which employs fewer people per dollar spent than most other sectors of the economy do (that’s what it means when you say that pay is higher in one sector than in another). See my previous post this morning.
So far as I can tell, Krauthammer is being serious here. But it may be the weirdest thing he’s ever written.
Update (Steve Verdon): My own personal view is that either way we will not address the real issue with health care, the costs. People are too obsessed with the side shows and partisan point scoring to tackle the actual issue. As such, things will continue on their unsustainable course for awhile, then “reform” will be forced on the country due to the unsustainable trajectory we are on. What will happen then? I don’t know, other than it probably wont be good.
Update (James Joyner): Ronald Bailey thinks Krauthammer is merely “predicting” rather than advocating this chain of events. That makes more sense although the irony is clearly too subtle as I’m still not getting it.
Meanwhile, Ezra Klein argues that “We ration. We ration without discussion, remorse or concern. We ration health care the way we ration other goods: We make it too expensive for everyone to afford.” But, as Bailey explains, that’s not what rationing means.