The impossible trinity of ObamaCare

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Michael S. Bernstam:

The problem with ObamaCare is not that it is poorly designed or sloppily implemented. The problem is in the nature of things: The Patient Protection and Affordable Care Act, as it has been envisaged, is inherently impossible. To see this, forget ObamaCare for the moment. Think health care in general. Health care can be many things for many people:

  • It can be universal (extended to all people) or selective (available to some people).
  • It can be comprehensive (covers all conditions and cures at any age) or rationed.
  • It can be affordable or prohibitively expensive.

But there is one thing that a health care system cannot be. It cannot be everything for everyone.It cannot simultaneously be 1) universal, 2) comprehensive, and 3) affordable.This is the impossible trinity of objectives.

  • If it is universal and comprehensive, it is prohibitively expensive and hence unaffordable.
  • The only way to make it universal and affordable is to ration services, but then the system is not comprehensive.
  • If it is comprehensive and affordable, it can be such only for those who can afford it, and hence not universal.

As in the Omnipotence Paradox, even God can do only what is in the nature of His (and our) universe and cannot do what is ontologically impossible, viz., cannot make 1+1=3. Let alone the 44th president of the United States.

Ever since Chancellor Bismarck introduced national health insurance in Germany in 1883, nations have struggled with the above trilemma of universality, comprehensiveness, and affordability.

The ultimate problem with ObamaCare is that it cannot be affordable for all, cannot be comprehensive, and cannot be universal. 

Many approaches have been tried: governmental and private insurance with and without the enrollment mandate and mandatory coverage of conditions, with and without subsidies and price controls, with and without governmental provision of services, and any mix thereof.

One result was the same: Every system, even if it started with the trinity of objectives, ended up with reaching two at most and none at worst.

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This sounds a lot like the Liberal unobtainable “equal outcome” mantra they like to whine about and run their mouths off about….Especially the clown occupying ‘our’ White House…

Yep, Liberalism truly is a disease.

@FAITH7:

It’s not really liberalism, It’s socialism. An all powerful State that is forcing it’s will on the people is the opposite of liberty and a liberal reading of our Constitutional rights which were recognized as the sovereign rights of each and every citizen. Just as the Constitution was designed to create a government with limited powers. Our current Leviathan “Federal” government is swiftly becoming exactly what the founders wanted to avoid, an arbitrarily tyrannical oligarchy that endeavors to make the public fearful, submissive peasants.