Four More Years

View 749 Friday, November 09, 2012

It’s time to stop brooding over the election and do some rational analysis. We have four more years of President Obama. What will the consequences be, and what is the prudent way to prepare for the various contingencies?

As I was preparing to write that, the news of the Petraeus resignation came in. I generally don’t comment on breaking news, and I certainly don’t know enough to analyze either the cause or consequences of this story. Many questions arise. It seems impossible to believe that the timing of all this, breaking just after the election and just before the Congressional inquiry about the Benghazi issue, is coincidental. General Petraeus’ indiscretions were not all that much of a secret the troops. Many generals deployed overseas have had extra-marital affairs. The troops generally knew, and the wives generally found out. And just what did the FBI think it was doing conducting an investigation of Company affairs? Who was involved in covering up what? Why did Mr. Petraeus bring up the Mohammed Video long after almost everyone acquainted with the facts knew it was irrelevant? Was he ordered to do that? There are few who could issue such an order. And what will Mr. Petraeus, now an unemployed civilian, tell the Congress? Anything at all? None of this makes enough sense to justify serious comment, and indeed even some of the questions seem silly, but someone must ask them. We are dealing with an honorable man, and there must be some logic to his decisions.

The election is over, and the Republicans lost. There were probably election irregularities – there generally are – but not enough to have affected the result. The issues in the election were not obscure. President Obama took pains to say that a vote for him was a vote to continue his policies, and the outcome of the election was important. This probably cost him votes – he got fewer than he did in 2008 – but it certainly was not deceptive. The electorate knew the stakes, and Romney got fewer votes than McCain did. There is a sense in which both candidates lost this election, but the practical outcome was that Mr. Obama won Four More Years. Everyone had an opportunity to give a definitive opinion. Only a relatively small number did so. Those who did made a decision. That decision has consequences.

There will not be a repeal of Obamacare. There probably won’t be much of a compromise on the coming rise in taxes. We can speculate on what the next budget will be, and what happens if there isn’t one. Mr. Clinton and Mr. Gingrich used the election of 1994 to cut spending, reform welfare, and balance the budget; it is not likely that the current President and Speaker will be able to work such miracles.

Meanwhile the spending continues. The deficit rises. Some inflation is certain, and there is a possibility of hyperinflation. We will continue to borrow money but also to create it by running the printing presses. Inflation will wipe out many living on fixed incomes and/or savings: inflation is a tax on savings, and it is a rather brutal one. That will swell the rolls of those needing public assistance, requiring more spending, which will probably bring more inflation.

That is the first lesson: prepare for inflation.

Obamacare will become law. That will end many current health plans. Yours may go away. The Obamacare Act is so badly drafted and has so many fundamental flaws that there will be many law suits, and a bonanza for lawyers; we will be years finding out what was in that Act. As of now no one – not one person on this Earth – actually knows. We do know that this election can and will be viewed as a referendum on expanding the health care obligation of the government. Obamacare was designed to eliminate most private health care systems, and over time it will achieve that. It can’t be repealed for at least four years; there is some question of whether, given four years of implementation, it can be repealed at all.

It can of course be amended, and since its author wants a ‘single payer’ health care system, it might be prudent to examine various implementations of that. The candidates seem to be the British and the French systems. Both are expensive. So is Obamacare. It is now time to have a rational discussion of centralized single payer health care systems.

One of the largest expenses of health care is the last two years of life. The question is, whose obligation is it to pay for expensive extreme measures to prolong life? And is there any limit to be imposed? Who decides to terminate payment? Inevitably that will be called a death panel. Perhaps they ought simply to be named death panels.

I was musing today about this question, and I came up with a very strange idea. I describe this: I am not advocating it, and in fact I don’t even know how it might be implemented. I describe it as one way of looking at the problem.

Suppose that for every person for which expensive and drastic measures are proposed to be paid for out of the public purse, a death panel of 100,000 people is created. They are told the name and conditions of the subject. They vote how much to tax themselves to keep this person alive. Will you pay a dollar a month? For how many months? Send in your dollar with your vote. If the expenses turn out to be less than $100,000 a month (and if that much is available my prediction is that this is what it will cost) then the money is credited to your account when you are appointed to another death panel (and you will be, of course). When fewer than a majority of the death panel votes to continue paying for this patient, public payment stops. This does not prevent family or charity from continuing to pay for care, but it does end public obligation.

Now as a hard science fiction writer I am immediately suspicious of the possibility of implementing and enforcing anything like this, but my purpose was to come up with a scheme that lays the obligation and decision on the same people and come up with a mechanism for doing it. At least those making the decision are paying for its implementation.

All right, my death panel is silly; but what mechanism will we use? All indications are that one of the crushing costs of public health care are those paid for terminal care. Get those under control and the task becomes somewhat less impossible. Could we have a rule that says that the public is not obligated to pay for more than four weeks of care for someone who cannot say he wants that care? Eight weeks? A year? Who makes that decision? If we have to accept universal health care, what does that mean? It can’t mean unlimited obligation because we don’t have unlimited resources. What are the limits? With insurance companies the limits are more obvious – when the company goes broke there is no more money. With government you can continue printing money but that too has consequences.