Megan McArdle on Obamacare
18th June 2021
My critique boiled down to four main points: First, I doubted we would improve our overly complex, balkanized health-care system with yet another major program that would make it even more complicated. Second, I feared committing more than $100 billion to new spending every year, at a time when we hadn’t even figured out how to pay for existing entitlement programs. Third, I worried that having the government subsidize even more of our medical bills would lead to price pressure, particularly on pharmaceuticals and medical devices, which in turn would reduce incentives for innovation. And fourth, I simply didn’t believe many of the claims supporters were making — explicitly or implicitly — about Obamacare dramatically reducing health-care costs or bankruptcies or infant mortality, or improving life spans.
Eleven years on, that first worry seems overblown. Our system is still a Rube Goldberg-esque kludge, but not noticeably more so than in 2010. As for the effect on innovation, well, Pfizer and Moderna just brought two new cutting-edge vaccines to market in less than a year. And while I’m certainly worried about a fiscal crisis, Obamacare is the least of our worries, since no politician in either party appears to believe that government spending and government revenue have any relation to each other, or ought to.
On the fourth point, however, I think that my predictions have largely been vindicated. And that this is one major reason the others haven’t been.