Obamacare

     So today marked the very beginning of the Supreme Court and its hearing of arguments regarding President Barack Obama's healthcare law. The main issue of course is whether the mandate in the law, which requires people to purchase health insurance or pay a fine, is Constitutional. The Obama administration says it is Constitutional and that the Commerce Clause grants them the power to do this because healthcare makes up a massive portion of the American economy (about 1/6 of it) and that all the people who choose not to purchase health insurance are thus affecting commerce and the economy and healthcare costs. The opponents say that the law is not Constitutional as the Commerce Clause is about regulating actual commerce not regulating people not engaged in commerce and that if the government can mandate people purchase a product from a private company, then it can basically mandate anything.
     It is believed that the ruling will be narrow, either 5-4 for the mandate or against it. I am hoping that the Court strikes down the mandate, but I am trying to make myself assume that the Court will rule in favor of it so that I am not disheartened if they rule in favor of it. Personally, I do not think the argument made by the proponents matters much. Yes, technically, a large number of the population choosing not to purchase health insurance may affect healthcare costs, but, that shouldn't matter in this argument. That still shouldn't give the government the ability to literally mandate people purchase something. Now if it is a tax, which is perfectly Constitutional, that is different.
     The Obama administration swore up and down that the mandate was not a tax, that it is perfectly Constitutional to actually mandate people purchase something when they were pushing for the law, but then when it began to get challenged, they changed their argument and began saying that they were viewing as being a tax. The two are very close, I mean if the government mandates you purchase something and if you refuse, you pay a fine, versus the government decide to tax you if you do not purchase something, there's not a whole lot of difference, but there's still a distinct difference between the two. It is perfectly within the government's right to levy taxes. It is not necessarilly within their right to mandate people purchase anything, not the federal government anyhow.
     There are four major issues at stake regarding this law:

1) The first is that if the mandate is upheld, then it means the government could probably mandate anything from now on. We no longer have a government with limited powers but now a government that can essentially do whatever it wants.

2) If the mandate is declared un-Constitutional, then it essentially ends the healthcare law, because the healthcare law depends on the mandate for its survival. Without the mandate, the whole thing will fall apart. So if the mandate is upheld, the entire law is upheld. What is disheartening though is just how much power the law gives to the federal government. Economic freedom is essential to having a free society. And healthcare is one-sixth of the economy. So whoever controls healthcare effectively controls one-sixth of the economy. With the healthcare law, the health insurance industry is essentially nationalized. Now the proponents of the bill say that the claim that Obamacare "nationalizes" one-sixth of the economy is right-wing scaremongering, that this isn't really the case, but I'm not sure I agree.
     Whoever controls health insurance controls healthcare, so by nationalizing the health insurance industry, the legislation essentially places the government ultimately in charge of the whole healthcare industry. If you read the annual reports of any company involved in healthcare, whether it be pharmaceuticals companies or medical devices firms or whatnot, they all comment about how the legislation will affect them.
     Now the law doesn't outright nationalize the health insurance industry, what it does is to do the equivalent of leaving the health insurance companies "private-sector" but regulating them to such an incredible amount that essentially they are run by the government. The health insurance companies had no problem with this (it's a myth that the big health insurance companies were against this healthcare law) because in exchange for giving up control, they get guaranteed profits, as people are now mandated to purchase their product or pay a fine (and for those who cannot afford healthcare, the government will subsidize them). Basically the law creates single-payer healthcare by proxy.
     So if it remains in place, we have essentially now placed one-sixth of the economy under government control and direction. The thing is that the United States is the last bastion of large-scale economic freedom in the world. America should work to preserve this, so that, no matter how bad things get anywhere in the world, people always know that there exists a light, a place where people are free and the economy is free.

3) Single-Payer Healthcare: Single-payer healthcare is the Holy Grail for the political left. I think it is because of their unwavering belief in the competency of government and also that they have never really been able to get over the fact that socialism doesn't work. I think it also stems from a major lack of understanding of the subject of universal healthcare. Contrary to what many believe (and this includes people on the right-wing as well), universal healthcare does not have to be socialist healthcare.
     Many pundits on the left will say for example, "In Europe, they have socialist healthcare and its great," while pundits on the right will say, "In Europe they have socialist healthcare and its terrible." What neither pays attention to is that in some of the major European countries, while they have universal healthcare, it is not socialist healthcare. For example, France and Germany, both major European nations, have universal healthcare systems, but neither one has socialist healthcare. Instead, they both have systems that are a complex combination of public and private, both being multipayer systems. In fact the French, having a literal quasi-socialist country, do not want socialist healthcare.
     The Left in America ignore this however, desiring full-on, government-run, single-payer healthcare for the United States. The problem is that, contrary to the claims of the Left, single-payer has some major problems, namely rationing. The argument for single-payer is the same one made by the socialists for why any industry should be nationalized, which is that it will get rid of all the inefficiencies of the private-sector by centralizing the whole thing into one government-run, single-payer system. But in practice, it results in the same thing any socialist, government-run system does, which is rationing. Part of this is due to the fact that centralizing the system does not result in the reduced costs that the system is supposed to create.
     Rising costs and rationing have happened in virtually every nation that has tried single-payer. For example, the British system has had problems with rationing for years, as it is a full-on, government-run, single-payer healthcare system. Because of the rationing, Britain has had some of the lowest breast-cancer survival rates out of all Westernized nations and the country has been working hard for years to address the problems of rationing in the system.
     Sweden, due to out-of-control costs in their single-payer system, had to adopt partial privatization of healthcare. Canada, due to rationing that began occurring in their system after outlawing private-care, has seen the rise of private clinics begin popping up, although they aren't really legal. But they have occurred because people do not like the waiting times in such a system. If one studies universal healthcare systems, they find that single-payer is not really the ideal way to go for a healthcare system. The ideal option is to have a system that is some combination of public and private, but which lets the market play a large role, so as to allow for choice and to keep costs down.
     The political Left in the United States however has no desire for such a system. President Obama himself said repeatedly when campaigning for President in 2007 and 2008 that he desired a full single-payer system for the United States, that he desired to create a "Medicare for all," if you will. Creation of a system combining public and private elements is not on the agenda, as I said, likely due to an ignorance of the fact that not all universal healthcare systems are single-payer and an unwavering, ideological faith in the capabilities of government to run an industry (and one as complex and massive as the U.S. healthcare system!).
     Proponents of single-payer also enjoy pointing out the incredible popularity of Medicare, so why not give it to everyone is their reasoning? On this, they miss a few points:

a) Medicare's exponentially-increasing costs. Medicare has been EXPLODING in cost for decades. Now in a healthcare system, one has generally three options, two of which can be provided: universal coverage, freedom of choice, and cost controls. It's not really possible to have all three. You can have universal coverage and freedom of choice, but you will have no cost controls and thus exploding costs. This is essentially how Medicare as a single-payer system is right now, and this is why it's so popular. Because it hasn't had the rationing implemented into it yet in order to contain costs. If it isn't reformed, then that will come in the future at some point, as the government eventually is going to hit a wall regarding Medicare costs. But for the time being, and since it was created, the government has essentially operated on the lie that Medicare is a single-payer system that covers all elderly and gives freedom of choice, with no rationing (not of the kind seen in other single-payer systems anyhow). So it has been very popular. No old person has complained of how they needed care and the system made them wait X weeks or months to see a doctor, and then it was a doctor they didn't like.
     Now if you have universal coverage with cost controls, you must remove freedom of choice. Or you can have freedom of choice and cost controls, but then you must remove universal coverage. One of these or some combination will occur in the future with Medicare if it isn't somehow reformed to save it. This issue leads to the second point the Left are missing, which is:

b) If Medicare is exploding in cost with the current recipients, then how on Earth could the program be applied to all Americans? Listening to President Obama and the political Left, one would think we could apply Medicare to the entire American population and everyone would magically receive the same quality care as the current Medicare recipients get. The fact that Medicare with the current recipients is exploding in cost to the point of being the major breaker of the federal budget, and that applying it to everyone would cause the costs to explode to an insane amount, is never addressed.
     I was rather amazed during the Presidential campaign of 2008 that none of the Republican candidates ever bothered to point this out. McCain was particularly inept as a candidate in this sense. If applied to all Americans, Medicare would have to begin severe rationing of care, simply to contain the costs.
     Another point the political Left make, when it is pointed out to them that government running the healthcare system will result in rationing, is that the private-sector rations care as well. Weeeeelllll.....sort of, but I mean that's like saying that the agricultural and food distribution industry rations food, so why not just let the government run it? When a critic of socialism says that the government "rations," what they mean is that the government rations a lot LESS efficiently than the private-sector and rations by bureaucratic fiat as opposed to the price-system. Anyhow, in writing all of this, my point is that the political Left very wrongly (I think) see single-payer as the way to go for healthcare.

4) The fourth issue at stake is that the passage of such a universal healthcare system fundamentally changes the relationship between the individual and the state. It is a way to move the country to being a European-style social democracy. Now having sound social safety nets is fine, but with a social democracy, the problem that can occur is that if the government begins to act like a parent, then the people essentially become the equivalent of adult children. We see the ultimate manifestation of this in Greece, with people rioting and fighting the police there all because the government wants to reduce their very lavish government benefits and require them to do things such as work more than 35 hours a week and retire later than 50 years-old (people complaining over this is laughable to Americans who work at least 40 hours per week, oftentimes longer, and can't start receiving Social Security until age 67). But note that the people of Greece don't just protest these reforms (because their country is bankrupt), they riot. They are the equivalent of adult children.
     Now government bureaucrats, in particular left-leaning ones who think the government should boss everyone around and regulate every aspect of people's lives, love the idea of an adolescent population. An adolescent population is a lot more malleable for winning votes and is a lot more dependent on the government from the get-go, so the power of said bureaucrats is pretty secure. Anyone who wants to run on reducing the size of the government can be defeated by the bureaucrat saying said person will take away the freebies. An adolescent population also is self-reinforcing, because the people come off as needy and in need of guidance from the maternal government whenever a problem of any kind occurs, which then justifies the creation and/or expansion of government programs. The Roman statesman Sallust is said to have once said,

"Only a few prefer liberty. The majority seek nothing more than kind masters."

This describes much of the European population to a tee, I think. What governments do not like is an adult population. Because adult populations tend to be much more rugged and individualist and will view any attempts by the government to control their lives with disdain. Adult populations do not need the government oftentimes, which thus limits the creation of government programs. And worse for the bureaucrats, they have no way to scare the people into voting for them (the horror!).
     Now in saying this, I am not saying I am against all government programs. Having a system of sound social safety nets is fine. But there is a huge difference between having a system of safety nets meant to provide a cushion for people who get knocked down due to bad luck or a bad economy or whatnot, versus having an outright social welfare state where the government acts like a parent.
    The other major problem is that European-style social democracy is not sustainable. The reason the European nations as they exist today have been able to create their large social welfare states is because they have not had to pay for their defense budget much at all to protect themselves, and they also have higher taxes, such as a VAT tax which the United States does not yet have (another major myth on the part of the Left in America is that we can have European-style social entitlements by taxing the rich; that isn't how it works. You pay for those entitlements by having a VAT tax which hits the poor and the middle-class, not the rich).
     The Europeans have not had to pay much for their defense because the United States has been protecting them for decades. The United States serves as the anchor for Western civilization. It underwrites global security and global trade by keeping the sea lanes open and in general being the country to handle any major problems that break out in the world. It is the United States that kept the Soviet Union at bay throughout the Cold War. Europe would never have been able to stand against the Red Menace on its own.
     We saw the skimpiness of the European military capabilities with the recent Libya operation. The European forces ran out of the munitions they needed only two weeks into the operation and have had to rely on the United States for things like air-to-air refueling, air transport, logistics, targeting capabilities, and so forth. To the extent that the European nations operate anywhere in the world, they rely on the United States for these things. It is easy to create a large social welfare state when one doesn't have to spend much of anything on defense. There have been attempts to create European Rapid-Reaction Forces, but none of these have panned out. And what the Euros do spend on defense, much of it goes to the salaries and benefits of their soldiers as opposed to training and equipment. For years, many of the European nations have failed to contribute the military forces to NATO required of them, because they all know that if push comes to shove, the United States can and will handle the problem.  The Europeans also lack the economies of scale in defense purchases the U.S. has (all the Euro countries purchase individually as opposed to pooling their resources together to make purchases).
     Despite these higher taxes and lack of defense spending, the European social welfare states are STILL unsustainable. The worst of the offenders, such as Portugal, Italy, Greece, and Spain, are on the verge of bankruptcy. But even the stronger EU economies that maintain more solid finances still have had problems. Germany, the strongest EU economy, doesn't spend much of anything on defense. And in 2005, reforms were pushed through to reduce the size of the German welfare state. The United Kingdom is having to engage in fiscal austerity measures and, while being essentially the only nation (or nations?) outside of the United States to maintain a world-class military capable of real power-projection, still spends less of its GDP on defense than does the United States. The small Scandinavian nations, many of which maintain solid finances, also have this problem of not having to worry about defense (and Norway gets 25% of its GDP from oil exports).
     So if the United States adopts a European-style social democracy, what happens then? How is the United States to continue its role as underwriter of global security and global trade, of the current liberal global order? The answer is that it would not be able to. In my not-so-humble-opinion, adopting social democracy, starting with Obamacare, could threaten the very existence of Western civilization, albeit over a longer term, in two ways:

a) Turning the American population from being adults into adult adolescents, which destroys the warrior culture our nation has and destroying our economic supremacy

b) Ending the ability of America financially to sustain its military (through a combination of economic weakness and excessive entitlement spending)

     Now some pundits have suggested that this is nonsensical thinking, for the reasons that the current liberal order of relative peace and prosperity does not require the United States to thrive. That it can, and will (as many just assume that the U.S. is in a state of permanent decline now because of one financial crisis) get along without the U.S. They also believe that the current liberal order is the natural outcome of things in human history.
     Now I think both of these are horrendously wrong arguments. For one, liberalism (as in free-markets, Western democracies, human rights and freedoms, etc...) is NOT any natural outcome. The NORM throughout human history is poverty, misery, death, destruction, and oppression. The current liberal order is really a historical anamoly in the course of human history and may end at some point in the future.
     And the idea that the current global order could survive without the United States I think is wishful thinking in the highest. There are lots of violent, power-hungry countries in the world. These countries are not just going to behave if the United States loses influence. To suggest that goes against the entirety of human history. The current order survives and thrives because the U.S. is there to underwrite it. From military, such as underwriting global trade and security, keeping the sea lanes open (it's America that will re-open the Strait of Hormuz, through which more than 50% of the global supply of oil passes each day, should Iran try to close it up), to economic, in terms of providing support for the World Bank and IMF to serving as one of the global economic anchors (Americans buy lots of stuff), America plays a major role in the current world.
     If ever displaced, rather than survive, the current order would likely be challenged, and possibly ultimately replaced by a different order, one that will be set up by whoever are the strongest countries at that time. When the Western Roman Empire collapsed, a Dark Ages gripped Western Europe. Islamist forces tries for centuries to push into Europe but were held off by the remainder of the Roman Empire, the Eastern Roman Empire which became known as the Byzantine Empire. When Constantinople was finally captured in 1453 by Islamist forces, that was the end of the Byzantine Empire. The British Empire was the underwriter of global trade and security throughout the 19th century. Ironically, by the end of the 19th century, when Europe was experiencing an unprecedented peace and prosperity with liberalism (or major aspects of it) being so popular around the world, it was at that time believed that major wars were a thing of the past.
      Then the 20th century hit, in which the liberal order collapsed, and we saw the rise of communism, socialism, fascism, dictatorships galore and two major world wars. So how could anyone think that the current liberal order would survive without the United States there to underwrite its security?
      Going back to healthcare though, the ability of the United States to continue to do this role requires it maintaining an adult population, a population that believes in hard work, individualism, and a warrior culture. These are necessary to maintain the strong economy, limited government (adult people don't need an outright welfare state), and strong military required for the U.S. to continue to play this role. If Obamacare transitions America towards going down the route of a social democracy, all of these, and thus the current global order, I think are threatened, albeit in the long-term. Social democracy will lead to a financially unsustainable welfare state, which will cut severely into military expenditures, and an adolescent population as a result of its dependency on the government, which itself will lead to a weak economy (as people won't want to work or start businesses nearly as much), which then makes the welfare state's unsustainability and military cutbacks even more certain.
     Having said all of this, I could end by saying something dark and grave like, "It all comes down to what the Supreme Court decides...." well maybe so, but I wouldn't rush that Western civilization is done if the SCOTUS rules the mandate Constitutional. But it will mean that, assuming President Obama is re-elected, that the United States has taken a major step in the direction of social democracy that is likely not going to be good for the economic and social health of the country in the long-term.