Wednesday, March 24, 2010

ObamaCare and My Cognitive Dissonance Moment

Liberals, rejoice; conservatives, despair: After what felt like an interminable, mind-numbing debate, Barack Obama's signature health reform bill is the law of the land. And sadly, we as a country are probably in for months and years of continuing debate, not to mention lawsuits challenging the law's constitutionality and entire political campaigns devoted to upholding or repealing the most significant piece of social engineering legislation of our time. What a dreary prospect.

It's been an exhausting national debate, not least because the various bills, the final law and the underlying issues are so complex and detailed. I've opposed the basic plan all along, on constitutional, philosophical and economic grounds. But now that it's passed, I'm not here to rehash those arguments yet again. Because, having followed the news coverage of congressional Democrats celebrating their legislative victory, I realized I have a much more basic problem with ObamaCare: It makes my head explode.

To elaborate on that a bit, I cannot reconcile the things I hear liberals say about this legislation with other things I hear liberals say about this legislation. For months now, I've been listening to Barack Obama, or Nancy Pelosi, or another Washington Democrat make certain claims about health care and health reform. I hear those claims, and I say "Uh huh...," and then Obama, or Pelosi, or Senator Whoever immediately goes on to conclude something that makes me go "Huh?" It's gotten to the point where no amount of aspirin can cure the headache this causes me.

And so, rather than delving into the minutia of the law, I humbly submit the following list of basic claims about health care reform that I, personally, cannot hold in my mind simultaneously without suffering severe cognitive dissonance. Or a massive stroke.

1) "The present health insurance system is dysfunctional (uh huh...). We need to make sure everyone in this country has health insurance! (huh?)

So health insurance is outrageously expensive, maddening to access and bad at actually doing the things it's supposed to do? And this is a reason to expand it to an additional 30 million people? This isn't evidence that it's a bad system that we should have gotten rid of years ago? This doesn't cause Democrats to pause and ask, "Hey, maybe the reasons the current system sucks for the people who have health insurance are related to the reasons other people don't have insurance at all"?

2) "Our country is facing a serious fiscal crisis due to the unfunded liabilities created by government entitlement programs. (uh huh...). So we need to create a new, bigger entitlement program! (huh?)

I know, it sounds crazy, but I didn't say it. Obama said it: "Make no mistake: health care reform is entitlement reform."

Previous entitlement programs, mostly Social Security and Medicare, are threatening to bankrupt our government, so we need to cut them and put the money into a new entitlement program that's available to more people? Once again, the first part of the statement sounds reasonable: the federal government's current unfunded liabilities (that is, the value of the future benefits it has promised to pay but won't have the funds to afford) is $43 trillion. Toss in the national debt of $12.5 trillion, projected future deficits and some other liabilities, and our country is in a $62.3 trillion hole.

Yet somehow, the solution to entitlement spending is ... entitlement spending? Despite a proven track record of previous entitlement programs growing far beyond our capacity to pay for them? I can just hear the earnest, liberal policy wonk going: "But this time it'll work...!"

(And in case you were wondering just how much money $62.3 trillion is, the total value of everything produced by our entire economy in 2009 was $14.2 trillion. In individualized terms, that would be equivalent to a worker earning $50,000 with debts of $219,366.)

3) This one might be my favorite: "We're going to force insurers to cover people with expensive health problems at the same cost as everyone else (uh huh...), and health insurance is going to become more affordable." (huh?!?)

This, in essence, is what Obama's plan boils down to: Somehow we're going to make sure that the people who need medical care the most are going to get it, while still making sure that insurers stop ripping off the rest of us by keeping costs under control. Both halves of that goal are perfectly noble in and of themselves, but they are what logicians call "mutually exclusive." You can have one, or the other, but not both together. Say, did somebody mention something about baking a cake, eating the cake, and then still having the cake?

I think there might be a 4) and a 5) somewhere on this list, but for the sake of my own (mental) health, I should probably stop there. Besides, I've got a cake to bake.

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