Monday, April 2, 2012

Mandates?

David Frum wonders whether the Supreme Court's striking down of Obamacare's mandates might lead to a bigger---not a smaller---government role in health-care:
We are headed, it would seem, to a post-mandate future that looks something like this:
Medicare will provide fairly generous government health coverage to about one-quarter of the population.
Medicaid will provide much less generous government coverage to one-quarter of the population.
The population outside Medicaid and Medicare will subdivide into two main groups:
The affluent and those whose labor is greatly valuable to their employers will be covered by an ever-more-expensive and ever-shrinking private-insurance market.
The people who can't pay themselves and whose employers won't pay for them will drop out of the private market, and either look for ways to qualify for Medicaid or wait and pray until they qualify for Medicare.
Political pressures will induce politicians to open Medicaid to more and more uninsured people. Fiscal pressures will force politicians to make Medicare less generous and more Medicaid-like.
 Meanwhile, Mickey Kaus (an Obamacare defender) looks into limiting principles for a health-insurance mandate.

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