It took a while, but I finally came across an article on the ACA (also called “Obamacare”) that I resonated with. Ross Douthat does not need to argue that the law will destroy civilization as we know it. He admits that many will probably benefit from the law. But in the final analysis (if that is even possible with such a ridiculously complex piece of legislation), he writes.
Now an effective levy of several thousand dollars on the small fraction of middle class Americans who buy on the individual market is not history’s great injustice. But neither does it seem like the soundest or most politically stable public policy arrangement. And to dig back into the position where I do strongly disagree with Cohn’s perspective, what makes this setup potentially more perverse is that it raises rates most sharply on precisely those Americans who up until now were doing roughly what we should want more health insurance purchasers to do: Economizing, comparison shopping, avoiding paying for coverage they don’t need, and buying a level of insurance that covers them in the event of a true disaster while giving them a reason not to overspend on everyday health expenses.
If we want health inflation to stay low and health care costs to be less of an anchor on advancement, we should want more Americans making $50,000 or $60,000 or $70,000 to spend less upfront on health insurance, rather than using regulatory pressure to induce them to spend more. And seen in that light, the potential problem with Obamacare’s regulation-driven “rate shock” isn’t that it doesn’t let everyone keep their pre-existing plans. It’s that it cancels plans, and raises rates, for people who were doing their part to keep all of our costs low.
You can find the full article here.
The article does not fully address my two ‘gut-level’ objections to the law:
- Many well-intentioned government servants believe that they have found the ‘solution’ to problems that have heretofore eluded society. Thus, they see only the positive and never realize the cost of certain kinds of legislation.
- More specifically, the health care system already involved a great deal of physical complexity laid over top of a myriad of individual financial and moral choices. Government action, almost by definition in cases like this, would almost certainly gum up the works and unintentionally create problems, even those they could not foresee.
I thought of the health care controversy as I read David Lawday’s enjoyable biography Danton: The Giant of the French Revolution. Danton’s outsized personality stands in sharp contrast to the cold Robespierre, who eventually turned on Danton and had him executed. Their faces tell the whole story:
Danton styled himself a man of the people. He claimed to truly understand the people, for he (and not Robespierre) thought and acted like one of them. He laughed, enjoyed food, women, and friends. Thus, as he had a seat in government and understood the people, he naturally assumed that government action would work to benefit the people and help fulfill their wishes. The video below may not reflect an actual historical meeting between Danton and Robespierre, but it accurately depicts the different personalities of them both.
One can easily get drawn into Danton’s huge personality, but we should remember that he sanctioned horrible butcheries both before and after the fact, in the name of the people. Danton was not a thinker. He did not inscribe his speeches, he wrote few letters (that have survived at least), and so we know little of his motivations. Lawday allows himself to make his best guesses, and paints a portrait of a man who had no love for violence per se, but believed he could successfully manage it once unleashed. He later seemed to change his mind about this during the Reign of Terror, and this shift factored into his execution.
Unfortunately Danton’s greatest legacy to the Revolution was the Revolutionary Tribunal, the government’s supreme tool in legitimizing political murder on a mass scale. Danton had some good motives in starting the tribunal. He saw the random destruction engaged in by “the people,” and thought that direct government action would relieve the masses of the burden of imposing justice, or at least their version of justice. This in turn would limit the violence that plagued the Revolution, for government would surely exercise more restraint and wisdom than the masses. In a speech advocating for the establishment of the tribunal he reportedly said, “Let us be terrible, so they do not have to be.”
Tragically, the Tribunal simply gave legitimacy to the worst impulses of the Revolution, and the amount of deaths and imprisonments skyrocketed. This same tribunal eventually tried Danton himself and found him guilty without allowing Danton to call any witnesses for his defense.
The ACA and the Revolutionary Tribunal remain vastly different things. I hesitate to include mention of them both in the same post, for in 99 out of 100 ways they have nothing to do with each other.
But they do share one thing in common–they both spring from the mistaken belief that government can enter a complicated situation and with a wave of a wand make everything alright. It usually fails to work, even with the best of intentions.
On the subject of good intentions, Marginal Revolution posted a link with this abstract. . .