Sunday, January 05, 2014

Is Obamacare "reform" or "redistribution" (aka Robin Hood with no Sherwood Forest before surgery)?

In “Obamacare” simply a redistribution of wealth, or is it real reform?
The New York Times weighed in on this in November (here), and Michael Moore Saturday here   and the Wall Street Journal Saturday here.
Moore believes that Americans are “entitled” to universal health care not driven by a profit motive.  But someone has to play gatekeeper for how people get treated, and how long people wait, and what happens at end of life.  But Moore (the well known “left wing” documentary filmmaker (“Sick in America”, which paid a visit to Havana), to his credit, gives examples of how the new Affordable Care Act can work both ways.
The WSJ editorial calls Obamacare simply redistribution, from the young and lucky to the unlucky.  
Personal responsibility” cuts both ways here.  But we have to ask ourselves, why are hospitals charging $500 for a single stich for a home-plate collision in a sandlot baseball game?  The reasonable charge would be more like $100. If it were more like the latter, the “young and healthy” wouldn’t have to pay as much to cover others.  Will unreasonable charges come down with universal insurance?
But then how will we pay for the innovation that gives us better drugs for HIV (without side effects) and particularly much less disruptive or drastic treatments for cancers?  How would we pay for the research that fixed my acetabular fracture in one try (getting back to work in three weeks) back in 1998?  How do we manage the horrible decisions at the end of life?
How to the Europeans – especially the Swiss and Germans, who seem to have pretty workable systems, do this?  We need to know. 

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