Monday, May 12, 2014

Elizabeth Kubler Ross Is Rolling In Her Grave. Laughing.

Who would ever have thought that the five stages of grief could apply to politics? And yet, Nick Gillespie (!) and  The Daily Beast gives us the first hard evidence that the GOP has reached acceptance:

Last month, even as President Obama touted the “8 million people” who signed up for individual coverage under the Affordable Care Act, he granted that the program was far from perfect—or even complete. “There are going to be things that need to be improved,” he told the press, insisting that there wouldn’t be “any hesitation on our part to consider ideas that would actually improve the legislation.”

OK then. Even though I think Obamacare is a truly epic mistake (more on that later), here are three obvious ways to make the president’s signature legislative achievement better, cheaper, and more cost-effective.

The three ways?

Allowing people to purchase plain vanilla “catastrophic health insurance”: In other words, the same crap policies that insurance companies have been issuing for decades to people who don’t give a damn that they’d file bankruptcy and stick us with their medical bills.

Force insurers to compete across state lines: In other words, nationalized health coverage is an improvement over “states first”. Gillespie’s not wrong here, of course, but the reason it wasn’t included specifically is because idiots who like Gillespie’s way of “libertarian” thinking would have been all over socialized medicine like white on rice. So great idea, really rotten politics.

Grow the supply of medical care: In other words, the market should determine pricing and the best way to encourage the market to determine pricing is to increase supply and let microeconomics hold sway. In theory, it makes sense. In a MACROeconomic world, however, it’s not supply that’s going to determine how pricing is structured.

It’s demand. The only way Obamacare works is if more and younger people start engaging in preventive care. Indeed, Gillespie even accounts for as much when he notes that there are effective barriers to competition in many states under the current system. There was actually an oversupply of doctors and medical facilities, and those facilities were concerned about protecting their profits. If they were truly inundated with patients (and not artificially creating over-demand), they’d welcome clinics and offices to shunt off some of their diminished capacity.

A large part of the problem is introduced as far back as medical school admissions. Indeed, to become a doctor requires you already have financial resources beyond those of your patients. That is not conducive to a classical capitalist solution to the delivery of healthcare. If anything, it’s going to retard the growth of the medical industry as doctors will demand a certain level of comfort in their lifestyle, rather than accept the market for what it is (read that as income from practices).

Still, I should give kudos to Gillespie for finally admitting that Obamacare is not going to go away, even if somehow Marco Rubio manages to survive the primary and general elections and steal the White House back for the GOP.

It’s a start.