Michael Barone

So why did the Obamacare architects want to take from the poor and give to the relatively rich? Because they want to make health insurance less like insurance -- which protects you against unlikely and unwelcome events -- and more like an entitlement.

Equalizing premiums tends to move in that direction. The fact that Obamacare policies are like auto insurance policies that cover oil changes is, for the Obamacare architects, a feature -- not a bug.

Of course, reducing health care outlays once the insurance premium is paid makes health care consumers less price-conscious. It means that market mechanisms that have reduced the cost of noninsurable treatments -- cosmetic surgery, Lasik treatments -- will not be operating.

And it increases the likelihood that health care providers will act like the callous unionized employees in Britain's National Health Service who let patients in the Mid Staffordshire hospitals die unattended or lie in their own waste.

The problem for Obamacare architects is that people are resisting being conscripted into their service. The low penalties for remaining uninsured in early years, plus the difficulty of using healthcare.gov, mean that many young people are not signing up.

This means that insurers will likely be stuck with a group of subscribers who are relatively sick and will have to raise premiums sharply next year to avoid losses -- the death spiral you have been reading about.

It also means that others, particularly those not eligible for subsidies, may go shopping outside the website for policies that cover catastrophic costs and leave them free to decide whether and how much to spend on routine care.

The Obama administration's response has been lawlessness -- suspending the law on employer mandates, subsidy verification, subsidies for federal health exchange policies and availability of pre-existing policies.

The insightful liberal journalist Thomas Edsall asks on his New York Times blog, "Is the federal government capable of managing the provision of a fundamental service through an extraordinarily complex system?"

The answer, on health care as on food, shelter and clothing, seems to be "no."


Michael Barone

Michael Barone, senior political analyst for The Washington Examiner (www.washingtonexaminer.com), is a resident fellow at the American Enterprise Institute, a Fox News Channel contributor and a co-author of The Almanac of American Politics. To find out more about Michael Barone, and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. COPYRIGHT 2011 THE WASHINGTON EXAMINER. DISTRIBUTED BY CREATORS.COM