If Obamacare really is better for US health care and
patients, both soon and long term, and not wildly
more expensive, then fine with me.

I don't know how much Obama's for Obamacare: He has
made lots of supportive comments, but he also
claims to want to shut down the coal plants. He's
going to do next to nothing on the second, so maybe
on the first he's just spouting stuff. From his
remarks that the American College of Surgeons shot
down, I doubt that Obama really knows enough about
US health care to like Obamacare very much.

For Obama "stuck his neck out", I don't see it. The
bill passed due to the Dem majority in both houses
of Congress and the pushing of Pelosi, Reid, and
Emanuel, and from all I can tell Obama had little to
do with it. Now that the bill is law, he can praise
it.

As Obamacare, Obama's name got attached to the
bill and the effort, but that was mostly just
politics by people who don't like either Obama or
the bill and similar to what was done with Hillary
care because it was obvious that we shouldn't trust
our health care system to Hillary. And nearly no
one would really want to trust their health care to
anything designed or implemented by Obama.

On the act itself, no doubt US health care could be
improved. Just how to do that is a serious
question. There is the academic health care
systems analysis economic optimization planning
community with Karen Davis, etc., but I've been too
close to such academics and wouldn't trust them to
hand me a band aid. Maybe what Switzerland,
Singapore, Sweden have is better. It appears that
lots of people complain about what England and
Canada have.

I was for improving the US health care system, but
when I saw the sausage making that resulted in
Obamacare, I concluded that the hard work of
designing a better system had not been done. E.g.,
I saw that what was proposed had been taken off the
shelf from some work by Senator Kennedy's health
care planning staff. Kennedy was dreaming; such
dreams are a good way to kill patients and waste
money.

My fear is that as Obamacare goes into
implementation, it will seriously hurt US health
care and millions of patients -- some soon, much
more later. And as the IRS goes around plucking
money from checking accounts, people might get
torqued.

Pelosi's remark "got to pass it to see what's in it"
may have a point: It may be that heavily what the
implementation is will be from regulations written
by rows, columns, and layers of paper pushers in
some big building about 70 miles from the Washington
Monument.

So, Obamacare will be implemented slowly. Maybe as
problems become obvious and people scream, the paper
pushers will modify the system. I hope so. Due to
the slow implementation, there will be some time to
modify the system as it is implemented.

Here is some of what I suspect will happen. In the
short term, people won't like the changes if only
because they are changes. Then people will really
not like the role of the IRS. In the long term, I
suspect that a lot of the best people and companies
will leave health care and, then, quality will fall.
Getting the quality back will be super tough. I
suspect that the flow of new, advanced, powerful
biomedical products -- drugs, devices -- will
greatly slow. I believe that a lot of seniors will
get much worst medical care. The Palin image of
"death panels" is not really wrong.

US health care is a patchwork system pulled together
piece by piece over nearly all the decades of modern
medicine. In some ways, the system works great,
likely the best in the world. In some other ways,
it's not very good. So, improvements are possible.
But improvements are not going to be easy, that is,
without damaging a lot that is good or spending too
much money.

My fear of Obamacare is that it was mostly just a
political football and from nothing like a serious
effort to design a better system. Instead, the
political part was, really, just the Kennedy dream,
a dream of 'good health care as a basic right for
everyone' or some such essentially socialistic
notion. Pelosi? She wants more socialism from a
bigger government. With Obamacare she was as happy
as the lead high school cheerleader just named
Homecoming Queen. The political part is that Pelosi
took the old Kennedy dream and pushed it through,
that is, pushed through that the US is on the way to
socialized medicine. So, in the US socialized
medicine is now a fact that will be difficult to
change.

That's what Pelosi wanted -- the principle of
socialized medicine, that the Federal Government is
directly responsible for the health care of everyone.
Just what the details will be and how it will work,
Pelosi didn't care. Instead she will let the
Executive Branch iron out any winkles and have
Congress modify the law in places if necessary. But
what she wants is socialized medicine; she's
confident it will be better. So, again, especially
to Pelosi, Obamacare was politics, that is,
socialized medicine, socialism, having the central
government directly responsible for each person's
health care, and not really about how to design a
better health care system. Good, bad, or otherwise,
Pelosi wants socialized medicine and just trusts
that it will be good.

Socialism keeps being attractive; has been around
the world for about 100 years. Some of the
attractions are that everyone gets together, joins
hands, sings Kumbayah, and sets up the central
government as responsible for some aspect of their
financial, material, etc. security. They assume
that, with everyone joined together, the idea can't
fail. So, no more rich people, no more poor people,
everyone just the same and good. The sales pitch
has worked off and on seriously for about 100 years.
That's what Pelosi wants -- socialism. She's a true
believer.

Mostly people who try socialism find that it's
darned expensive -- have the central government
spending ballpark 50% of GDP and doing the spending
as politics and, thus, inefficiently. The
Thatcher remark was "The problem with socialism is
that eventually you run out of other people's
money". In the USSR the workers concluded "They
pretend to pay us, and we pretend to work.". Russia
finally totally gave up and went back to a wild west
show. East Germany got rid of socialism ASAP.
France keeps struggling with high costs, slow
economic growth, high unemployment.

Switzerland? It's wealthy with a lot of healthy
people. So, they have a shot at pulling off
socialized medicine. The Scandinavian countries?
They are big into socialism and are accepting their
central government spending ballpark 50% of GDP.
Also the countries are small and culturally
homogeneous, and where they are not so homogeneous
recently they have been encountering big problems.

In the end I believe that you will discover that
Obamacare is really not about health care, really is
a threat to good US health care, and really was and
is about politics, in particular, some of the dreams
of socialism.

One of the dreams of socialism is a basic income for
everyone with an opportunity for more for anyone who
wants to work for more. Fine with me except for one
little point -- arithmetic. So far in the US, it
doesn't add up. That is, productivity is not high
enough. Instead, it is still the case that for the
productivity the US needs to keep the cars moving
and the store shelves stocked, the hospitals and
schools working, the software written and the Web
sites up, etc., some people have to work darned hard
and with the "basic income" provided wouldn't. So,
we still need the motivation of free enterprise.
Hopefully with more robots we will have enough
productivity to make the arithmetic work.

I believe that, as health care, Obamacare gets a
grade of D- for its design work, that it really is
not about health care but is about politics, really a
socialistic dream of Pelosi; I believe that
socialism won't work yet in the US, and the
Obamacare, due heavily to its bad design work, will
both in the short term and especially in the longer
term seriously hurt US health care. My prediction is
that as people scream, Obamacare will just get
repealed. For Obama, he will likely be out of
office then!