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07/01/2012

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The healthcare mandate is a tax on Amerikan citizenship: illegal aliens, foreign tourists and temporary residents (as well as Muslims and Amish) in Amerika will not have to pay it or participate in Obamacare in any way. On the other hand, an Amerikan tourist or temporary resident overseas will be subject to the mandate, regardless of the fact that Medicare, Medicaid and Obamacare are not available to him at all if he gets sick or injured while out of the country.

For young people and healthy people generally, the tax can be seen as a compulsory option: the option to abstain from Obamacare, only to subscribe and start paying insurance premiums when subsidized medical care becomes necessary. Considering that this penalty tax option is a bargain for almost all young adults and healthy seniors, I expect the appearance of a "death spiral," which will, no doubt, result in Congress' raising the penalty tax substantially.

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Obamacare won't work because it focuses on the demand-side, regulating demand, basically. There is no percentage in that. Even if you can manipulate demand in a way that keeps the price down, you are still causing a dead weight loss because consumers aren't getting what they want.

The only real way to fix the healthcare system is by policies directed to the supply-side. In particular, we need a lot more physicians. Countries like France and Germany, which are often held up as examples of socialist efficiency for the US to follow do have better healthcare systems, but it's not because of socialism. Rather, it is because they have twice as many doctors per capita as the US.

The problem is that the number of medical schools and their admissions is restrained by the Liaison Committee on Medical Education, which is an organization run by the AMA, teaching hospitals, and medical schools, which is designed to restrict the availability of medical school education. These restrictions need to be relaxed so that we can educate more medical students.

Of course, investment in the entire healthcare industry is skewed due to the bottleneck at the physician level. If you don't have doctors, then you can't build hospitals. If you don't have hospitals, then you can't operate various types of healthcare equipment. All of these restrictions ultimately end up reflected in the price of healthcare, and from there, are added to the cost of healthcare insurance.

Tim Fowler

Even though it was written as a mandate, its not a huge stretch to consider it a tax. What is a stretch is to consider it a constitutional tax. If its a tax, its still not an indirect/excise tax, or an income tax, or a tax "apportioned among the states according to population", so it should be considered and unconstitutional tax.

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