If you’ll forgive a teensy-weensy plugette for the new paperback edition of my latest book, somewhere in there I mention that health spending in Canadian provinces has increased over the last decade from an average of 35 percent of government budgets to 46 percent today. In Ontario, it’s predicted to consume 80 percent of tax revenues by 2030. Across the pond in London, the NHS is famously the third biggest employer on the planet, after the Chinese army and the Indian railways.
I used to cite these comparisons as a cautionary tale to Americans. But a couple of years back I concluded Obamacare is going to leave these Anglo-Euro-Canadian pikers for dust. If you want a sentence that encapsulates the monster growing in the government basement, this one from Avik Roy’s post below is pretty good:
According to an analysis by Representatives Wally Herger (R., Calif.) and Dave Reichert (R., Wash.), Obamacare’s cuts to the Medicare Advantage program, by driving seniors out of that program and back into traditional Medicare, could earn AARP over $1 billion over the next ten years, because AARP makes nearly half a billion dollars per year collecting royalties from supplemental Medigap policies sold by private insurers.
As Avik points out, the AARP makes roughly twice from Medigap “royalties” what it collects in membership dues. There is an argument to be made for a genuinely private health system — the market determines the rate for mending a broken leg or curing your incontinence. There is an argument, if one is so inclined philosophically, to be made for a public health system of the Continental kind — simple, universal, and “free” at the point of demand. But there is very little to be said for the malign mutation of pseudo-public and ersatz-private health care that Obamacare massively expands, one that piles third party upon third party and ensures that the paperwork and cronyism will metastasize faster than any cancer and that America winds up with a system that has all the worst aspects of a government program — delays, bureaucracy — without even the redeeming features of universal access and an equality of awfulness.
And, given the starting point of our overall societal health (the worst obesity rates, childhood diabetes, etc), the upshot isn’t likely to be pretty. This will be a disaster way beyond that Ontario 80-percent-of-revenue stuff.
The one and only.