Rube Goldberg vs. Occam’s RazorColumnsFeaturedPolicyPolitics

RubeGoldberg

To say Obamacare has become a textbook Rube Goldberg contraption would be quite the insult to the estimable Mr. Goldberg, the late cartoonist who became famous for depicting highly complicated machines that perform simple tasks.

Now, I can already hear the screams from the left: insuring the uninsured is not a simple task.  Wrong.  If assuring universal health coverage at all costs is the goal, there were any number of straightforward ways to get there for those who did not choose to be uninsured (as opposed to the many, mostly young people who actively made decisions, most often financial ones, not to purchase health insurance).

We could have levied a surcharge on the overwhelming majority of Americans with health insurance.  Or we could have raised enough new revenue to simply add the unwillingly uninsured to the Medicaid rolls – without concocting a contraption that created upheaval among the vast majority of the insured.  We could have created assigned risk pools, as with auto insurance, that required insurance carriers to carry the sick and poor by increasing the premiums of their existing customers.

This is not to suggest that these are good solutions, but they would at least have the benefit of being in accord with the principle of Occam’s Razor, which states that the hypothesis based on the fewest assumptions, i.e. the simplest solution, is invariably the superior one.

But none of the simple solutions would increase the power of the state enough to satisfy the central planners of the left who see more government control as the answer to virtually every problem in the universe.

Instead, we got a law which gave the most power to the government that was politically possible – a law which from its inception has been unsatisfactory to everyone, from free market types who promote private solutions to the issue of universal coverage, to leftists who dream of a European-style single-payer system in which the government not only manages but provides all health care.  Not to mention the vast majority who have no ideological skin in the game, but just want the right to choose a decent product at a decent price and decide for themselves where on the spectrum between a gold plated plan and catastrophic coverage they choose to land.

It should be rather simple: if a law is wildly unpopular among almost everyone except the small minority who directly benefit from it at the expense of everyone else, requires extraordinary political gymnastics just to keep it from exploding altogether, forces its proponents to keep moving the goalposts years after it was passed into law, violates with impunity the basic premises upon which it was passed (that you can keep your plan if you like it and that premiums will be reduced), discourages added employment and forces people to violate their beliefs (and there’s a lot more, but I haven’t got time for the pain) it is just plain a bad law.

My original plan was to devote this column entirely to the two Obamacare-related cases pending before the Supreme Court, but those plans were interrupted by the bombshell dropped on Monday by the administration, which announced that a major component of Obamacare will be delayed.  Again.

For those of you naive enough to think Congress, the branch of government charged with actually passing laws, decided to amend the Affordable Care Act, think again.  Such a turn of events would signify a healthy functioning of our constitutional republic.  What happened instead is that President Obama decided it would be politically inconvenient to have lots more people lose their health insurance or their jobs in the run-up to the midterm elections.  So, he simply decided to change the law by himself.  Just like he did the last time it was politically convenient.

Just so we are all on the same page, this is the new current status of the implementation delays*:

Self/Non employed:  None.  Individuals must buy a qualified health insurance policy by March 14 of this year or face a fine.

Corporations with 49 or fewer employees:  None.  No mandate under Obamacare.

Corporations with 50-99 employees:  1 Year additional delay.  Instead of being required to offer or provide employees with health insurance or be fined (taxed) by the federal government as Obamacare required in 2014, or as required by the last “extension” in 2015, they will have until 2016 (or until Obama changes his mind again).

Corporations with 100 or more employees:  1 Year delay.  Instead of being required in 2014 to offer coverage to 95 percent of full-time workers, as Obamacare required, these bigger employers can avoid the fines by offering insurance to 70 percent of them in 2015 (or until Obama changes his mind again).

The naked political calculation behind these latests changes to this Rube Goldberg contraption laid the motives for this move so bare that no less an administration apologist than the Washington Post editorial board could not ignore it.  “The law is also explicit that the government should be enforcing penalties already; that’s the plainest interpretation of Congress’s intent. The administration shouldn’t dismiss that without exceptionally good reason. Fear of a midterm shellacking doesn’t qualify as good reason.”  Well stated.

This President sees no need to follow laws he considers inconvenient, even those he did everything in his power to pass.  Even more unfortunate is that the courts will likely not bother to force him to do so.  A challenge to the new implementation time frame, if brought at all, seems unlikely to succeed.  But there is another provision of Obamacare that is already scheduled for judicial review and it goes to the Supreme Court next month.  The “contraceptive mandate” is the first challenge to the implementation of Obamacare other than the law itself, to reach the high court.

The challenge comes from two cases where business owners claim a religious objection to certain contraceptives and assert that making them pay for it violates their rights. Under Obamacare, contraception is a service/product that employers who offer health insurance must provide without a copay or any additional charge to the employee.  This puts them in the position of paying for the contraception of their employees in direct contravention of their religious beliefs, which forbid the use of certain contraceptives.

There is an exemption in the Obamacare regulations under which religious organizations may be exempt from the requirements.  Another court case will hash out the particulars of that provision, but it looks like the government may be on the losing side of that one.  But the issue to be decided next month is different because it doesn’t involve traditional religious entities, but for-profit corporations.

The government would have us believe that people must leave their religious beliefs at the company door.  While many people’s religious lives do not permeate their professional ones, for many, faith envelopes the entirety of their lives and beings.  Whether that involves making a buck, or doing volunteer work, people animated by their faith do so not apart from their faith, but as one with it.

The excellent Cato Institute brief in support of the companies challenging the mandate puts it plainly “[t]he government contends, however, that individuals cannot exercise religion in their professional lives while acting on behalf of a corporation.  Central to the government’s position is the notion that human adherence to religious principles either does not occur or must be ignored in the context of corporate activity.  Whichever way the idea is stated, it has no basis in law or reality.”

As George Washington said, “[g]overnment is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master.”  Bypassing Congress by unilaterally enforcing nakedly political solutions to avoid the political ramifications of this disastrous contraption, and playing 52 card pickup with something as central and personal as people’s healthcare, is not only a fundamental violation of Occam’s Razor, but a concoction that would make even Rube Goldberg blanch.

  • Chris

    Pretty good piece.
    FWIW, every single liberal I know wanted single payer. Which I think supports Tim’s point.

    • David Obermark

      I am not a liberal, and I am in favor of single payer. I am a moderate. Why am I in favor of single payer? Because health care costs under the previously existing system, and now under ObamaCare, will bankrupt our society. If you support providing affordable healthcare costs for all, like I do, then single payer is the cheapest way to do it.

      The strongest argument against it is that this would be another big government program, and that once the government gets involved costs would go up, not down. Big government ruins everything it touches they say.

      Strong argument, usually buttressed with examples of failed government programs. But I will rebut in advance with this: Look at all the nations that have single payer. Their costs are much, much lower then ours when measured on a per capita basis and this is while they are covering everyone. Under our system, the costs are twice as high and not everyone is covered. For those who say similar results are impossible in America, I would ask, why not? Where is the American Spirit? If they can do it so well, why couldn’t we do it even better?

      Single Payer (Socialized) Medicine, that is what I am in favor of. It too is not perfect, but until Jesus comes back and shows us how to do it better, it is the best we can hope for.

      • DJRippert

        David:

        I have never quite understood the “health care will bankrupt society” argument. When I graduated from high school in Virginia (1977) people spent almost none of their disposable income on “digital technology”. There were no airbags in cars. The term “PC” meant nothing – not personal computer, not politically correct. A Texas Instruments calculator was about as fancy as it got. Fast forward 37 years. People have more computing power in their cars than the Apollo 11 capsule (by far). Cell phone bills can run to the hundreds of dollars per month per phone. If you don’t replace your old PC every four years you’re living in the stone age. Why don’t people claim that the escalation of spending on digital technology will bankrupt the country? Health care employs millions of people. Things like heart transplants – which were science fiction when I was born – are commonplace today.

        Why isn’t health care just another fast growing industry like digital technology? Why is increased spending on health care always seen as bankrupting the country while increased spending on digital technology is seen as the economic high point of our generation?

        • David Obermark

          Just stop thinking theory and look at reality. Health care costs keep going up. We spend billions on medical research to keep coming up with more and more expensive ways to provide humans with maybe a few more months of life (but you too might be one of the lucky winners who gets years).

          I am willing to continue to debate this if you wish. The point that I would attempt to make is that as long as we are willing to spend endless streams of money on healthcare, the costs of healthcare will continue to grow endlessly.

          • DJRippert

            David:

            As my kids would say, “Take a chill pill”. This isn’t a debate. Just a discussion. Health care as an industry seems to get vilified. If any other industry in America were growing as fast as health care politicians would be falling over themselves to take credit for the growth.

            I guess your contention is the growth in health care spending has not been accompanied by an equal growth in health care benefits (outcomes). OK – that’s perhaps a fair point. However, perhaps ironically, by the time my father (a retired Naval officer who went on to a second career in hospital administration) was my age he had suffered the first of what would be four heart attacks. I have the same genes but the diagnostics and treatments (cholesterol meds, blood pressure meds) put me in a far better position, health wise.

            Personally, I’ve worked my whole adult life in the software / technology industry. My industry is celebrated for revolutionizing modern society. Nobody bats an eye when people spend large percentages of their discretionary income on technology that enables Twitter, blogs, Pinterest, Words with Friends or any of the other myriad distractions produced by my industry. But one more dime spent on healthcare … well, that’s bankrupting America.

            Finally, I think Obamacare is the second worst fiasco ever in the healthcare space. The only worse fiasco was the Republicans’ utter lack of any plan whatsoever. If 99% of American society is upset at the growing costs of health care then both major parties ought to have a plan to deal with that complaint.

          • David Obermark

            People can only spend discretionary income on the newest electronic widget. Health care is a totally different animal.

            Any discussion is really a debate, a sharing of opinions. Get real.

          • DJRippert

            Since you seem to struggle with both logic and articulation I’ll try to help you. It’s the least I can do to make up for what is obviously a failure of the American educational system in regard to your writing.

            By saying that people only spend discretionary income on electronic “widgets” you seem to haphazardly imply that health care is right – like personal safety and adequate nutrition. If health care is a right then government’s job is provide for citizen rights at the lowest possible cost. Hence, increases in health care costs are bad even if those increases result in more people being employed in the health care industry. Something like the logic of a police force. High crime rates might argue for a large police force employing a lot of people in relatively good jobs. However, government’s goal is to reduce crime rather than employ lots of policemen because safety is a right.

            Is that about it?

            Health care is not really an animal as you say. Rather, it’s a right?

          • David Obermark

            My gosh, you couldn’t make your point without hurling insults?

            Your point of view on this topic is suspect. You are employed in the healthcare industry. More spending in the industry guarantees your job.

            I will leave it up to anyone reading this thread to judge whether your insults or my comments were more truthful.

          • DJRippert

            You’re funny. You write, “Just stop thinking theory and look at reality.” and “Get real” then complain about the tone of my comments.

            You think health care is a basic human right. So, Obamacare (or something like it) makes sense.

            The problem with your argument is that health care is far from binary. It runs the gamut from defibrillating a person in the midst of having a heart attack to enhancing a person’s self-esteem with botox injections.

            Where the “right” end? Where do the “options” start?

            If birth control pills should be a mandatory part of a health care plan should the government hand out free condoms as well?

            The real problem with Obamacare, in my opinion, is that it flowed out of a “knee jerk” political thought rather than a fundamental discussion of the appropriate role of government in guaranteeing “rights” to the people.

          • David Obermark

            Just look at what health care costs our society and how much it costs providing more in other societies that cover everyone. I’m “funny”? You’d be comical if it where not for I am trying to take you serious.

          • DJRippert

            America spends more, per capita, on automobiles than any other country. Does that entitle the government the right to nationalize the automotive industry in order to bring per capita automotive spending in line with other countries?

            After all, cars are very useful in seeking and maintaining employment, acquiring an education, etc.

            In the United States the government exists to guarantee the citizens their rights. Beyond that, government has no business interfering in the lives of Americans.

            If access to health care is an inalienable right then the government has the moral authority to take whatever measures necessary to guarantee that right. If access to health care is not a right then the government should do no more than regulate the health care industry like any other industry.

            Is access to health care an inalienable right?

            Until you answer that question, you have nothing.

          • David Obermark

            Yes I do have something, it is called the opinion of the majority. (Not that single payer is the way to do it, only that through some method, healthcare should be provided to all citizens. I only argue single payer is the CHEAPEST way to do it.)

            One might argue that providing health care is one of those powers reserved for the states in the 10th Amendment, however the Supreme Court seems to think it is not. If it is not a power reserved for the states, then a majority of the populace can decide, through their representatives in Congress, that health care is a right that will be delivered to all citizens.

          • DJRippert

            OK, so you think health care is a right. Now we’re getting somewhere. If you look above this comment in the thread you’ll see my conversation with Tim Donner. He emphatically believes access to health care is not a right and, presumably, should not become a right.

            This is the crux of the debate. Those who believe access to health care is a right like Obamacare or, possibly, even deeper government intervention into health care. Those who don’t think its a right see Obamacare as a gross overstepping of federal authority.

            I don’t see how Obamacare makes the cost of health care go down. The fundamental driver of America’s high health care costs is the sky high cost of medical procedures – especially as compared with other developed countries. How does Obamacare reduce the cost of an American hip replacement to something closer to the global average? It doesn’t. How does Obamacare lower the average cost of a C-Section in the US ($15,041) to the cost in Switzerland ($5,186), France ($6,441), The Netherlands ($5,328) or Britain ($4,435)? It doesn’t.

            Obamacare is not health care reform. At best, it is insurance reform. At worst, it is just another wealth redistribution scheme taking money from the young and healthy and funneling it to the middle aged and sick.

            Here are some interesting quotes from the New York Times:

            ” Michael Shopenn’s surgery in 2007 would have cost close to $100,000 in the United States. But it cost just $13,660 — including all medicine, doctors’ fees and round-trip airfare — at a private hospital in Torhout, Belgium. The Belgian government regulates medical fees, though most doctors’ offices and hospitals are privately run.”

            Given that doctors and hospitals in Belgium are not going bankrupt, the $13,660 must at least cover their costs. Does this imply that the US medical-industrial complex adds a profit markup of $86,340 on a procedure with a cost of $13,660?

            “The average price of a hip replacement rose from about $35,000 in 2001 to about $65,000 in 2011, according to Truven Health Analytics. The number of such procedures each year for patients under 65, paid for by commercial insurers, rose to about 90,000 from less than 30,000.”

            Compound inflation from 2001 to 2011 in the US was 30.8%. Hip replacement costs rose 86%. What the hell?

            From CBS News:

            “Researchers conducted a “secret shopper” study in search of a total hip replacement at two randomly-selected hospitals from each state and Washington D.C., in addition to 20 of the best orthopedic hospitals in the country. They found prices can range from $11,100 to almost $126,000 for the same procedure. That is, if the hospital would even provide researchers with a price quote.”

            Are you starting to get the impression that the American medical-industrial complex is a con game being run by scam artists while our elected officials stand mutely by with their hands in the pockets of the scammers?

          • David Obermark

            Well, it is not a fundamental right, it is a right that society could grant through law. The majority of Americans support doing this.

            If you are in favor of heavy regulation of the healthcare industry, then why not just go the next step to single payer? Either way you lose free market healthcare.

          • DJRippert

            The theory is that a single payer system will allow that payer to aggregate demand and get better pricing from providers. That’s what Belgium did and they have $11,000 hip replacements rather than the $65,000 hip replacements in the US. But there’s one problem with that logic … 48 million Americans receive Medicare benefits. That demand should be already aggregated. The population of Belgium is 11 million people. If aggregating demand causes prices to fall then why isn’t Medicare getting lower priced hip replacements than Belgium?

            There is something very fishy going on within the American medical-industrial complex. I am not sure that a single payer will fix the underlying problems.

          • David Obermark

            Very few people actually end up paying the inflated costs you cite. For example, my wife recently had a CT scan conducted as part of her treatment for cancer. The clinic tried to charge nearly $8,000, but with what TriCare paid and our deductible, they ended up getting around $500. It is my understanding that private insurance companies also negotiate similarly reduced rates.

            The problem with Medicare is that healthcare providers can refuse to accept the rates Medicare will pay and just not treat Medicare patients. If we had single payer, it would be accept the rates or go practice medicine in another country. Some might say that then we would not have enough Doctors because they would all leave. BUT, nations with socialized medicine have a higher ratio of Doctors to populace then we do. If THEY can make it work, then so can we.

            Socialized medicine will not solve all the problems, some will remain. But with socialized medicine, everyone would be covered and we would still save money.

          • DJRippert

            http://www.hss.edu/newsroom_joint-replacement-price-and-quality.asp

            “The hospital’s Medicare reimbursement rate is $19,024.”

            In America, 48 million strong Medicare pays $19K for hip replacements. In Belgium, a country with a total population of 11 million, the single payer negotiated rate is about $11K.

            http://www.nytimes.com/2013/09/01/opinion/sunday/doctors-and-their-medicare-patients.html

            “The analysts looked at seven years of federal survey data and found that doctors are not fleeing Medicare in droves; in fact, the percentage of doctors accepting new Medicare patients actually rose to 90.7 percent in 2012 from 87.9 percent in 2005.”

            Almost 91% of doctors not only see Medicare patients they accept new Medicare patients.

            I am beginning to detect the unmistakable odor of slimeballs in the medical-industrial complex.

          • David Obermark

            Which is why I am in favor of socialized medicine. It does not come without problems, however the problems are fewer and the costs are less. The nations who have it also get healthcare provided which is just as good as we get.

            I’m frugal. I am in favor of socialized medicine.

          • DJRippert

            Almost all of the doctors and hospitals in Belgium are private businesses who have to adhere to prices as set by the government.

            Socialized medicine in the United States will just put the corrupt and incompetent asshats in Washington who created this fiasco further in charge of American medicine. It’s the government’s mis-management of Medicare that is failing to get the same pricing for hip replacements for 48 million Medicare recipients as Belgium gets for 11 million citizens.

            America doesn’t need better doctors or better insurance companies, we need better politicians.

          • MD Russ

            The problem, David, is that people only buy health care insurance when they think that they are going to need it and self-insure when they believe that they won’t. That is why ObamaCare has the features of not excluding pre-existing conditions and the individual mandate. Those two features are working against each other. Requiring health plans to pay for pre-existing conditions is forcing higher premiums. Higher premiums are causing young and healthy people to opt-out and pay the IRS fine. That puts the insurance exchanges into a financial death spiral since the only people buying insurance are the high consumers of health care, which pushes premiums even higher which pushes even more healthy people out of the exchanges. So how do we solve the problem? The taxpayers, you and I, will bail out the exchanges.

            The biggest lie that Barack told about ObamaCare was not “if you like you present plan you can keep it.” The biggest lie was that it was going to lower the budget deficit. It hasn’t and it never will without significant tax increases, eh excuse me, without significant revenue enhancements.

          • David Obermark

            I am in favor of repealing ObamaCare and replacing it with socialized medicine. If it works in other nations, certainly we can make it work here in America.

          • MD Russ

            Aren’t you retired from the Navy? I would think that you would have had your fill of single-payer, rationed health care, socialized medicine. I sure was by the time I retired.

          • Tim Donner

            DJ, You make the common mistake of saying the opponents of Obamacare have not offered alternatives. They have – 145 separate bills, I believe – but because they are incremental, as they should be, as opposed to one large omnibus overhaul of our whole system, they are considered insignificant and receive little or no attention. It is entirely true that we need to reform our healthcare system, but why must we eschew the free market, which we embrace in every other realm? The left realized they had to do this health care takeover in one fell swoop, consequences be damned, because that was the only way to give them the measure of control they desired.

          • DJRippert

            Tim – you may be right. However, 145 different ideas makes for effectively no plan. The Democrats got behind the health care reform plan known as Obamacare. What subset of the 145 ideas represents the thinking of the national Republican Party?

            I may have wasted too much of my life programming computers. To me there is a step-by-step logic to health care reform which starts with the question, “Is healthcare a right in America?”. Buying a car is not a right. Therefore, I see no reason for the government to heavily regulate the automotive industry and demand that every American buy a car.

            If access to healthcare is a right then the government has a proper and appropriate basis to mandate / guarantee that the right is met.

            It seems to me that the first step in this discussion is a simple yes or no answer to the question of whether access to healthcare is a right.

          • TimDonner

            The left loves to simply assert that healthcare is a right, as if this is backed up by any element of constitutional law or their own personal belief makes it the truth. Of course it’s not a right. It is a commodity.

          • DJRippert

            Thank you for answering the question of whether you see access to health care as a right. I believe the only rights the government should guarantee are the rights clearly delineated in the US and state Constitutions. If people want more rights they should amend the applicable constitution and add those rights. I would support making health care a right but it isn’t a right now. So, Obamacare fails my logic test.

          • MD Russ

            David,

            “…a few more months of life” adds up to 13 years on average over the past 75 years. And those are 13 quality years compared to the final 13 years of a life 75 years ago. Have you ever heard the expression, “60 is the new 40?” That is what they are talking about. If this trend continues then by 2085 the average life expectancy in the US will be 91. Will health care costs grow exponentially to accomplish that? Of course, but would you rather put the money into the out-of-control increases in entitlements spending that is projected to consume 50% of our GDP by 2050 or sooner? If you are going to live to be 91, do you really need to retire on Social Security at 62? And, BTW, why are payroll taxes capped at an income of $104,000? And why do we pay Social Security benefits to people who retire with a multi-million dollar net worth? $1M carefully invested can generate up to $70,000 per year before taxes without touching the principal.

            Reform entitlements benefits and we can crack this nut.

          • David Obermark

            Problem is that when Republicans talk about entitlement reform, most times they are talking about working towards eliminating entitlements. How about the military retirement you enjoy? Wasn’t that based upon after 20 (or more) years service, you would only draw that retirement check for an average number of years far below current life expectancy? But you screamed murder when military retirement was cut back even just a smidge. I get it, you are OK with entitlement cuts as long as your entitlements are not cut, grin.

          • MD Russ

            Another DNC talking point. Every time Republicans talk about reform of entitlements programs the Democrats pound the podium and scream, “the Republicans want to eliminate Social Security!” As for my entitlements not being cut, they have been. Went I stayed in the Army after my initial obligation, I was promised “free health care for life” after 20 or more years. That “free” health care is now costing me several thousands of dollars per year in TRICARE deductibles, co-pays, and supplemental insurance premiums. And it would have doubled every year for four years starting this year if the Armed Services Committee in the House hadn’t stopped DoD from doing it. And I pay for dental and optical care out-of-pocket since it is not covered by TRICARE at all and is never offered to retirees on a space-available basis.

            As for my retired pay, that is not an entitlement but deferred income. During the 25 years I was on active duty each annual pay raise increase was decremented 1.5 percentage points to account for military retired pay. (Except for the first three years of the Carter Administration when military pay was frozen at the 1976 pay scale.) I earned that money as opposed to someone who managed to show up for work enough quarters to qualify for Social Security.

        • Chris

          I want no part of the namecalling below.

          But I think David has a reasonable point.

          The increase in health care expenditures in this country specifically should raise a red flag. This isn’t computers, where expenditures are skyrocketing worldwide. This also isn’t cars, where Americans spend more on cars, have always spent more on cars, and increase their spending on cars at a reasonable pace.

          We see the same thing in the exploding cost of higher ed. I know why that happens – the feds are making unlimited unsecured loans to anyone who wants one, which encourages schools to charge more. If the government got out of the loan business, costs would decrease.

          But I’ve never seen a satisfactory explanation for the increase in health care expenditures. I’d be interested if someone can explain it.

          • DJRippert

            This is most logical sounding explanation of why health care costs in the United States cost so much. I certainly can’t guarantee its accuracy but the facts and figures seem to make sense. The antidote seems to be clearly pointing at a single payer system in order to get better purchasing power. I have a bit of a question on that. Some US insurance companies insure more people than some countries have people. For example, there are something like 48 million people receiving Medicare benefits today. If that group was a country it would be the 27th most populous country on Earth – considerably bigger than Canada. If Canada can force down health care costs by aggregating the purchasing of health care for 35 million people, why can’t Medicare do the same for the 48 million people for which it is purchasing health care?

            I strongly suspect our health care cost problem has a lot more to do with our “bought and paid for” political class refusing to use the purchasing power it has than a lack of purchasing power.

          • Chris
      • MD Russ

        ” Look at all the nations that have single payer. Their costs are much, much lower then ours when measured on a per capita basis and this is while they are covering everyone.”

        This a tired old DNC talking point that is simply not true. When you compare the modernized countries that have single-payer with the US, then their per capita health care spending is either on par or higher. The few countries with single-payer that have lower costs than the US, such as Canada, ration health care. For example, in most cases in Canada there is a 6-12 month wait for an MRI because of the lack of scanners that the government is willing to buy. And, from medical research to new drugs, all of these countries rely on US research for breakthroughs–one of the most expensive components of health care costs.

        http://data.worldbank.org/indicator/SH.XPD.PCAP

        One of my principal gripes about health care costs is that the increase is always taken completely out of context. When Social Security was passed during the Great Depression, the life expectancy of the average American was 65. Today it is 78. The is a 20% increase in about 75 years. True, health care costs have increased much more than 20%, but is because of the Law of Diminishing Returns where the closer you move towards the finite life expectancy of the human body the greater each incremental costs increases in a geometric progression.

        Health care works in this country when you choose to pay for insurance rather than buy a bigger house or drive a faster car than you can afford. For those who can’t afford it, we have Medicaid and Medicare. The problem is that, as we are seeing in the Medicaid expansion debate, people think that the government should pay for their health care when their family income is higher than the median income where they live.

        • David Obermark

          The average per capita costs of health care in the United States is $8,508 (2011 figures – before ObamaCare). Sweden, Australia and France per capita costs are each less then half. So your statement ” When you compare the modernized countries that have single-payer with the US, then their per capita health care spending is either on par or
          higher.” is itself not true. Here’s a link:

          http://pgpf.org/Chart-Archive/0006_health-care-oecd

          As for “This [is] a tired old DNC talking point that is simply not true.”? First off, it is true as the statistics prove. 2nd, I did not get this from DNC talking points, I think for myself.

          • MD Russ

            The countries that you are cherry-picking largely have rationed health care to some extent or another. So does Germany. Take a look at Norway and Switzerland. Much higher than the US. And, as I said, all of these countries piggyback on US pharma and medical research. Your statistics prove nothing.

  • Antoninus

    No state has ever been successful in forcing 100% compliance with automobile insurance mandates, so why would anyone believe the federal government could force universal health insurance on everyone? The answer is that it was never about health insurance, but all about extending government dependence onto the middle class through a new entitlement!

    The best that states have been able to do was about 85-90% compliance, and that was by having no mandate to obtain auto insurance. I lived in Alabama where auto insurance was not mandatory and everyone had it because it was affordable. I lived in Louisiana where auto insurance is mandatory and could barely afford the legal minimum! Compliance in Alabama was about 90%, while it was only about 60% in Louisiana despite their network of complicated insurance laws.

    The point is that forcing Americans to buy health insurance is only going to exacerbate the situation of uninsured Americans. The system we had was much better than the system being forced upon us, but for even more reasons than the apparent ones on the surface.