The Fundamental Assumptions Underlying O'care are all wrong

The following is a comment I posted on Samizdata (a site I highly recommend BTW) in response to a post about some fresh new piece of Obamacare lunacy.  It really is the stupidest law ever, gang.

The remarkable thing about O’care is that its fundamental assumptions are so flawed. First, that the US healthcare system is ‘bad’, ranking 37th in the world according to WHO when in fact when you control for auto accidents and murder (both much more common in gun and driving mad America) American life expectancy turns out to be highest in the world.

Second, they assume that health insurance improves healthiness. The only two large randomized studies to test this (Rand back in the early 80s and Oregon Medicaid in the past few years) could find NO quantitative health impact of having insurance (although the Oregon study found a self assessed 30% reduction in ‘depression’ – of course if someone else suddenly began paying a big chunk of my rent or food bill I’d probably become less depressed too).

Third, there is an assumption that health insurance equals access to health care. One that my English friends on this website have much more familiarity with than we wasteful yanks. The best actuaries estimate a successful O’Care will increase unit demand for healthcare services by 30% without increasing supply. And in the US today, the poor’s health plan Medicaid already has huge problems with access. As does Romneycare in MA where getting in to see a new physician typically takes between 1.5 and 2 months vs. days or a week in the rest of the country.

Finally, they assume that even if everything turns to crap at least it will be more equal crap. But in fact, systems that ration care bureaucratically often offer less equality of access: bureaucracies reward people who can follow rules, make appeals, leverage connections, and live in places where lots of affluent doctors want to work (i.e. near their homes). There’s no real evidence that this system offers more equality of access than the US system. Indeed, the US wouldn't get the highest (gun and car death adjusted) life expectancy in the world if large parts of the population couldn't get access.

Leave it to the Progs to do the exactly wrong things for the precisely wrong reasons. Again and again and again and…