Monday, April 20, 2015

Facts, Big Question, and Unanswerables

According to the Obama administration, these are indisputable facts:

Since its inception, the health law has added 16.4 million to the insured rolls, and the rate of national health spending has declined to a historic low.

The administration is correct, the facts are correct. No one disputes them. But they are misleading.

If you pass a law penalizing people for not being insured, subsidize those who are not insured, spend $2 billion on healthcare.gov to promote the law, and engage in national campaign to sell the law, the number of uninsured will go up.

If the rate of national spending was going down even before you passed the law, and the rate of spending continued to follow the rate of decline after you passed the law and was coupled with a recession and a slow rebound from recession, it is problematic to attribute slower growth to the law alone.

The big question is: Has the law bettered the quality of care and improved the health of the American people?

After five years of the law, these questions and other questions remain unanswerable . Has it decreased premiums and other costs for the typical American taxpayer? Has it made health care more accessible for middle class Americans? Have Americans accepted its various mandates – that they must have a plan or pay a penalty, that employers must cover workers or pay the federal piper, that you must have a plan containing 10 essential benefits whether they apply to you or not? Why is the plan more costly than estimated? Has it slowed economic growth, and largely replaced full-time workers with part-time workers?

And, in the words of Cliff Asness, a managing and founding principal of AOR Capital Management, “Will government intrusion into the health-care market raise or lower the long-germ qualty of of care? What will it do to innovation? Is the Rube-Goldberg structure of ObamaCare the right – or even the reasonable way to go about this? Should we pass laws first, read them second, and force the courts and agencies to find the problems?” (“In Praising ObamaCare, They Bury It,” Wall Street Journal, April 16, 2015)

The real issues, which are unanswerable, are: What are the long-term effects and consequences of ObamaCare.

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