An excellent source of information on Obamacare is the Galen Institute, in Alexandria, VA, a non-profit, free-market-oriented research organization devoted to health policy.
Its President, Grace-Marie Turner, just published a column in Forbes on The Avalanche Of New Obamacare Rules Will Come In January, 2013. She notes that the federal government has already issued 13,000 pages of regulations (it takes 18 to define “full-time employee”), but that HHS is way behind on providing all the rules needed for implementing the 2,700-page law. The result is chaotic uncertainty for everyone involved in the system – health care providers, state governments, employers – and of course consumers.
But it gets worse, because even if Romney is elected, unwinding ObamaCare will be difficult.
Going beyond Turner’s article, the word in Washington is that it is improbable that the Republicans will have the filibuster-proof majority in the Senate necessary for outright repeal. It also seems improbable that 10 Democratic Senators will put country above partisanship and vote to remedy the error of passing the law in the first place by repealing it. That is not how they play the game in any case, and there will be serious political pressures on the Dems to hold firm, from both labor and business.
The unions and the Dems see organizing federalized health care as the road to future cornucopias of union dues, much of which will be recycled into campaign contributions. The health care industry is silent about repeal. Its members were bribed and bludgeoned into supporting OmamaCare, and will be reluctant to reverse course. They have already spent great sums preparing for implementation, which they would see as wasted if repeal happened, and they will be reluctant to give up the potential bonanzas that persuaded them to support the bill in the first place, such as subsidized insurance costs and other benefits. Besides, health care executives bet their careers on the law, and may see no good line of retreat.
So the prognosis is for continuing confusion. Turner’s article points out that, if Romney wins, then “Congress will surely begin actively blocking any new rules that come out and working to unwind those already on the books.” On the other hand, if Obama wins, then “his Rube Goldberg health law may well implode from the nearly impossible task of re-engineering one-sixth of our economy to fit his centrally-controlled archetype.”
The lesson is that the election will not end this business, even if Romney wins. The Tea Party army better not disband, because preserving the U.S. health care system will require continuing political outrage, and pressure.
For a sensible discussion of health care policy, see After the ACA: Freeing the Market for Health Care (Oct. 18, 2012), by Prof. John Cochrane of the University of Chicago. Prof. Russ Roberts of George Mason University, at the free market site Cafe Hayek, calls it "The best essay on health care, ever . . . . wise, witty, and full of good economics." He adds: "It’s a defense of allowing health care to emerge from the bottom-up rather the top-down. Cochrane explains why the current legal and regulatory framework keep those bottom-up solutions from happening already."
[D]oubling down regulations on an already highly regulated system, full of protected and politically connected incumbents and rent-seekers, has little chance of achieving [any of our] goals. Whether in the post-office model (government provision), or the 1950s-style regulated airline, utility or bank model (the ACA) this effort will just produce less efficiency, more costs, and another generation of bright ideas dashed.