David Brooks has an interesting column appraising the implementation of ObamaCare. However, he taxes my impulse control and nearly prompts head-banging and hair-pulling with this:
Everything is turning out to be more complicated than originally envisioned.
Envisioned by whom?!?!? Anyone who has ever renovated a bathroom has had an opportunity to learn that there is no project so simple that it won't be underestimated. One might have hoped that the wizard who removed lots of the asbestos from Altgeld Gardens had learned that, but no.
To continue the gloom:
Then there is the technical cascade. At some point, people are going to sit at computers and enroll. If the data process looks like some 1990s glitchmonster, if information doesn’t flow freely, then the public opinion hit will be catastrophic.
Then there is the cost cascade. Nearly everybody not in the employ of the administration agrees this law does not solve the cost problem, and many of the recent regulatory decisions will send costs higher.
Then there is the adverse selection cascade. Under the law, young healthy people subsidize poorer, sicker and older people. But the young may decide en masse that it is completely irrational for them to get health insurance that subsidizes others while they are healthy. They’ll be better off paying the fines, if those are even enforced, and opting out. Without premiums from the young, everybody else’s costs go up even higher.
Then there is the provider concentration cascade. The law further incentivizes a trend under way: the consolidation of hospitals, doctors’ practices and other providers. That also boosts prices.
Obama will be fining healthy young people of favored ethnic or gender status? I can relieve that concern - pigs will fly first. Unless the only non-enrollees are Mitt Romney's sons, it will be waivers all around. Why bother electing patronage politicans unless they deliver the patronage?
Brooks closes with a deplorable false choice:
Regulatory regimes can be simple and dumb or complex and sprawling. When you build complex, it takes a while to work through the consequences.
We have the trifecta of complex, sprawling and dumb.
TO WHICH I SHOULD ADD: Chicago machine politicians, to pick a nearly random example of Big Government types, aspire to create an impenetrably complicated governing structure with themselves as the indispensable intermediaries between their constituents and that indecipherable government.
ObamaCare is simply the Dems attempt to bring that ploy to the national stage. Eager Democrats lok to the day they can double their staffs and provide endless constituent service as broker to Health and Human services.
And what about the notion of a government of laws, not of men? In practice, if the government is allowed to write enough complicated rules we end up with a de facto government of men. Which is great for professional power brokers, if not the rest of us.