And so the death panels begin

The more “universal” the coverage, the greater the budget pressures, and so the forces yielding the long-term degradation of health care quality inevitable under coverage systems mandated by or financed through government are more powerful.  In short: “Universal coverage” is the opposite of actual health care, and bureaucratized decisions are the inevitable outcome of ObamaCare, a massive shift toward central planning.  Government simply cannot “cover” everything, and those in need of the medical services not approved for government reimbursement, or the supply of which is reduced, are not “covered” in reality.

And so we return to the central question: Who ought to decide the benefit/cost tradeoff?  We have two options: rationing by Beltway bureaucrats in the usual top-down, heavy handed, one-size-fits-all fashion familiar to anyone with experience dealing with a federal agency, versus a doctor/patient relationship in the context of a competitive contracting process with private health insurers allowed to charge actuarially-fair premiums.  Can anyone possibly believe that the former is more consistent with the interests of patients?  Well, yes: Many members of Congress continue to argue that under ObamaCare, no way, no how will government bureaucrats interfere with individuals’ health care choices.  Or, at least, they used to argue that until they heard the richly-deserved derision at the town hall meetings last summer.  One suspects that they will hear a good deal more from the voters this November.

Benjamin Zycher is a senior fellow at the Pacific Research Institute. He may be reached at benzycher@zychereconomics.com.