Map of life expectancy at birth from Global Education Project.

Wednesday, August 28, 2013

Facts are Stupid Things

Those are the immortal words of Ronald Reagan. (He meant to say stubborn, not stupid.) Anyway . . .

Many people have been noting lately that people know they're supposed to hate Obamacare, but they don't know why. The popular prediction now is that as the Affordable Care Act is actually implemented, and people find that either a) nothing happens, because the insurance they already have just goes on as before or b) they couldn't get insurance before, but now they can, and they can afford it; and there aren't any death panels and their Medicare benefits don't get cut and they can keep their doctor or pick one they want (assuming the doctor will take them, of course), and there aren't any government bureaucrats telling their doctor what to do, and everything is just fine, well then, they'll like it after all.

I am very reluctant to get into the prediction game, but that seems a reasonable expectation. However, we do have some problems. People in the Massively Resistant red states won't get the Medicaid expansion, and the federally run exchanges are likely to be kludgy and buggy. It is also essential that lots of young healthy people sign up, and I can't 100% guarantee that will happen in states with massive disinformation campaigns. Whether the wildly misinformed citizens of those states will correctly figure out who to blame for their problems is unclear.

There are also many technical defects in the Act which will need fixing, which an uncooperative congress won't do. And, in the long run, it will need more major surgery to achieve cost containment, which will be politically very difficult because your wasted money is profit for Merck and Hospital Corporation of America.

We may get this Rube Goldberg contraption to work for a while, and maybe that means a Democratically controlled congress sometime soon. But there's still only one way to have a sustainable health care system that can continue to cover everybody into the future, and that's universal, comprehensive, single payer national health care. There's no other way.

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