Christopher
DeMuth: A Referendum on ObamaCare and Liberty
Without an immediate course change, the
health-care law will become irreversible.
On Tuesday, Americans will go to
the polls to choose whether or not to nationalize their health-care system.
The choice for president will
have numerous other consequences. But in most cases we will be choosing between
tendencies shrouded in uncertainty. The candidates have staked out positions
and made some explicit promises—but how these work out in practice will depend
on many future contingencies, and many an earnest campaign promise has been
confounded or even reversed in the past. The health-care choice is singular not
only for its importance but for its certainty.
If President Barack Obama is
re-elected, ObamaCare's controls over doctors, hospitals, pharmaceutical firms
and other providers of medical care will be tightened, and the operations of
private insurance companies will be progressively restricted. Everyone involved
will know where the process is going—to a single-payer system or one with a few
chosen insurers subject to national public-utility controls—and will negotiate
the best possible accommodations to it. Within a few years, a new political
equilibrium will be in place, making the system irreversible and subject to
only marginal adjustment.
If Gov.
Mitt Romney is elected, by contrast, ObamaCare's controls will be turned to
promoting freer, more competitive markets, laying the groundwork for
legislative "repeal and replace." That will involve straightforward
policies to correct defects in health-insurance markets (portability,
restrictions regarding pre-existing conditions, special-interest state
mandates) while reversing ObamaCare's gratuitous further step of nationalizing
health care for everyone. It will also involve bolstering the solvency of
Medicare, reforming Medicaid and, one hopes, limiting the tax subsidy of
employer-provided health insurance, which now distorts consumer behavior in the
direction of wasteful consumption.
Which direction voters choose on Tuesday will have profound
consequences for the cost, quality and availability of health care in America.
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