ObamaCare's Last Gasp

Fight until the last gasp.

Shakespeare (1564-1616), King Henry The Sixth

President Obama has told ABC News the June Supreme Court decision will be the health law opponents “last gasp” at defeating ObamaCare ("Obama: Health Law an ‘8 of 10’ Lawsuit a Last Gasp, “ Associated Press, April 8, 2015). Obama said that he cannot conceive of justices “would make such a bad decision” and that the biggest challenging awaiting the health system is expanding Medicaid.

Spoken like a true champion of government-controlled health care and protector of his signature domestic legacy. He may be right, but the odds are more like 5 of 10 or even less. The issues here are who shall control the health care system and who shall have the last gasp.

Shall it be government? Through ObamaCare and the Centers of Medicare and Medicaid spends over $1 trillion annually, government controls physician fees and regulates hospitals, and covers 125 million Americans? Shall it the multibillion dollar health insurers, who cover more than 150 million Americans? Shall it be the so-called Medical Industrial Complex, which includes hospitals, physicians, pharmaceutical firms, medical device makers, and other health care providers, who collectively spend over 80% of health dollars? Or shall it be health care consumers, who are spending the dollars that make the system go?

In a larger sense, shall it be government or market -driven? There is a struggle going on for control of health care – a $3 trillion dollar industry that accounts for 17% of federal spending. It is a struggle for power. Everybody denies they seek power. They want the best and most efficient care for Americans. It is also a struggle for how to apportion the money. Entitlements are the fastest growing segment of the federal budget, of business expenses, and household spending.

Is government or markets, and in what combination, best equipped to cope with a $18 trillion federal deficit, which will be over $20 trillion by the end of Obama’s term, and which will be passed on to future generations? This is not an idle question in a nation with an aging population. It will be a fight until the last gasp.