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Joel BelzVoices Joel Belz

Rough water ahead

The fiscal cliff was nothing compared to the dislocations Obamacare will bring

Rough water ahead

(Krieg Barrie)

If it seemed a bit too easy at the turn of the year to slip past that perilous fiscal cliff, and then a few weeks later to whisk unscathed through the smooth straits of sequestration, here’s fair warning: There’s rough water ahead.

And I’m not talking mostly about the debt ceiling issue at the end of March. That debate may produce a bit of a kerfuffle—but nothing like the really big tsunami that’s headed Washington’s way. The tsunami will spill sloppily over the whole country.

That’s what’s bound to happen over the next 12-24 months as federal bureaucrats go about implementing various aspects of the “Obamacare” health coverage legislation. Whether by incompetence or evil design, there’s no way anybody anywhere in government is going to be able to make the new system work. Forget all the arguments you’ve heard pro and con. In one sense, there’s only one thing you have to know—which is the absurdity of abruptly taking on health coverage for 30 percent more people with no concurrent plan to pay for that coverage.

There’s no doubt that Americans bought into such an impossible bargain in large part because the system we’d developed over the last couple of decades had become so miserable. “What more do we have to lose?” folks seemed to ask.

But the funding of this impossibly structured “Patient Protection and Affordable Care Act” is just part of the assignment. Those of us who argue that the free market should be the primary shaper of healthcare delivery need to remember how complex and detailed the task really is. Here, as I’ve said in this space before, are a few of the tough nuts to crack:

1) Healthcare, by its very nature, is usually both personal and urgent. You don’t typically ask your neighbor where he’s recently gotten a good deal on treatment for hemorrhoids. Nor is comparison shopping a handy device when the doctor comes into the waiting room to say he’s about to proceed with an $80,000 quadruple bypass. It’s just one of those places where the free market becomes a clumsy tool.

2) High expectations. Few of us think we deserve to live in any house we choose, drive any car we choose, or fly first class every time we travel. So why do we all expect Cadillac healthcare, no matter what our malady? We don’t believe in third-rate heart surgeons, and if our baby girl needs plastic surgery after a car accident, we’ll talk about payment plans sometime after the procedures prove successful.

3) Insurance. Because health needs are typically unpredictable, it’s natural that we turn to insurance to take some of the bumps out of the road. More and more through the years—and not primarily because of the Obama influence—we’ve tended to use insurance not just to smooth the bumps, but to buy the road itself. We’ve come to use insurance not just for the unpredictable, but for the predictable as well. Of necessity, costs soar upward.

In all this, as providers develop and test new models of healthcare delivery, Americans will be forced to roll with the punches. A big part of that will indeed involve financial issues. But unprecedented adjustments will be needed on the other fronts noted above—government intrusiveness, high expectations, and insurance implications. Healthcare consumers like you and me will discover how much these adjustments will upset our lifetime habits.

We’ll get angry—and we’ll probably be tempted to blame Obamacare for all that inconvenient discomfort and dislocation. Obamacare deserves stacks of blame—and not least because it was so crudely drawn and carelessly legislated a couple of years ago. But healthcare delivery for a country of 330 million people, even apart from the financial issues, is a highly complex assignment. The evidence suggests that the transition ahead is going to be boisterous, rowdy, noisy, turbulent, and unsettling.



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  • WORLD User 94453
    Posted: Mon, 04/11/2016 05:51 pm

    Given human nature, there's not a chance that the entitlement mentality can be reversed (unless God brings revival again to our nation).  That, coupled with the demographic, & fiscal inevitability of where the US is headed, means rough waters ahead are unavoidable. I am truly thankful that as a believer, I rest in the HOPE of our great King that sits on His throne.  Whatever comes to pass in the coming years, it's helpful to remember that we Christians in the US have it soft & comfy compared to most Christians throughout the world and throughout history.  HOPE reigns., 

  • joelazcr
    Posted: Mon, 04/11/2016 05:51 pm

    Health insurance companies will be prohibited from denying coverage because of a pre-existing condition, or from charging higher premiums because of current or past health problems, gender or occupation. The rules also would ensure access to catastrophic coverage plans for young adults and others who could not afford coverage otherwise.We know who is paying for this.  It gets much worse.  Any alien establishing legal status in the U.S. also has access to this.  Canadians spending the winter in the U.S. can buy a policy and get treated for any preexisting condition which they were denied treatment in their own country.

  • Janet B
    Posted: Mon, 04/11/2016 05:51 pm

    Most of us forget that, while housing might be a necessity, housing ownership, as well as car ownership and flight, is a luxury.  Health care of the quadruple by-pass type is also a luxury.  Just because something is available does not mean everyone should own one.  But that is the belief of most people in this country -- including any politician one listens to.  Don't get me wrong.  It is a gift from God that we have such good health care available in the United States.  But when we begin to see health care -- or home ownership, car ownership or vacations -- as entitlements, we are in trouble.  The people demand, the government gives, and we get the tsunamis that result from greed.

  • William H
    Posted: Mon, 04/11/2016 05:51 pm

    Just read, if you dare, about govt. run health care in the UK and europe.

  • Midwest preacher
    Posted: Mon, 04/11/2016 05:51 pm

    As a believer, I don't mean this to be pessimistic but we all need to be ready to die. That's just good planning.  Trusting in big government has brought us to the place where our freedom is in danger.   I now fear the United States government.  It has become intrusive and oppressive to certain parts of the population.