Don’t you know that economics — and facts — are irrelevant, to those who (truly) believe?

Nationalized single-payer will be the national equivalent of the Department of Motor Vehicles. Lack of competition kills innovation and customer service. Additionally, by extension, all healthcare providers become de facto employees of the government. And any information given to the government and its agents can and will be used against the political opponents of the party in power.

I stand corrected. However, throughout his presidential campaign Obama’s plan was not only not single payer, it didn’t even have the individual mandate or any penalties for not buying health insurance — that has been tried in New York and it doesn’t work, for obvious reasons. If you don’t allow insurers to deny people with preexisting conditions and you also don’t have any penalties for not getting insurance, then obviously rates will skyrocket as they did in New York State, which had precisely that system. But an insurance market in which a large number of people cannot get health insurance at all because of preexisting conditions is a very problematic situation that really can only be fixed via some form of government intervention.

>is far from “unregulated”

Libertarian purists always bring up this argument to explain nearly any economic failure or inefficiency — it’s not unregulated *enough*! If only it really were a pure unregulated market! Etc. Of course there’s no market in the world that is a completely pure, unregulated market. The fact remains, however, that the health industry in our country is the *least* regulated of any industrialized nation, and it is also by far the most expensive per capita, and the average outcomes measures are only middling. We do well in a few areas (some cancers, etc.) but very poorly in many others (prenatal care, for one). Overall, our system is middle-of-the-road, despite its sky-high cost.

France, a country that many of you deride, has very short wait times, total choice of doctor, and a largely private medical system with a single payer government insurance program + supplemental insurance. And France’s health care costs are lower than ours, with at least comparable results, despite the fact that their market is much more government-controlled than ours.

The Austrian explanation for market bubbles and crashes as somehow always being related to the market not being “pure” enough just flies in the face of both scientific studies and common sense. Market bubbles are obviously driven by speculative frenzy — ever since the tulip bubble, we’ve seen it. Markets alone don’t solve all problems. That’s why I’m not a pure libertarian even though obviously there’s some validity to Hayek’s critique of central planning.

Obama doesn’t support single payer? Watch him on youtube: http://www.youtube.com/watch?v=fpAyan1fXCE

Obamacare doesn’t set prices? What about the 3:1 age rating band? (ratio of premiums for 64 and older vs. younger participants).

The “knowledge problem” identified by Hayek is much deeper than a simplistic contrast between “Soviet-style” and “unregulated” systems. And it’s not about what you call “information bottlenecks.”

In any event, the current system is far from “unregulated.” E.g., over the last 60 years, our betters have given us the Wage and Price Controls of WWII and the ascendance of insurance-based payments; Ted Kennedy’s HMO Act of 1973; countless insurance industry regulations; etc.; etc.; etc. The U.S. system is just less onerous than the rest of the world, where healthcare providers are adept at prescribing pain medications but limited in their ability to innovate and provide complex delivery systems.

Market actors establish the terms and conditions of their transactions, as well as prices. Surely you’re familiar with the idea of regulatory costs. What you call “the vast majority of Obamacare” is an array of rules conjured up by Congress (remember the “Cornhusker Kickback” and “Louisiana Purchase”), K Street insurance and other lobbyists, and a host of bureaucrats that have supplanted what would emerged through the trial-and-error process of voluntary exchange.

First of all, single payer is not as horrible as it sounds — especially when you allow supplemental insurance (as does nearly every country that has single payer). The advantage of single payer is that you streamline a lot of paperwork, which saves money. The disadvantage in terms of lack of competition is greatly ameliorated by the fact that you can buy supplemental insurance. However, at present, I still believe a regulated exchange has a chance of being better than single payer. And your thesis that Obama is secretly trying to bankrupt the insurance companies is mere paranoia, not supported by anything whatsoever, least of all Obama’s consistent opposition to single payer throughout his career — and the fact that insurance companies came out IN FAVOR of Obamacare.

>you can’t repeal the law of supply and demand

Of course not. But the vast majority of Obamacare, aside from Medicare and Medicaid, does not fix prices — and Medicare and Medicaid have always had fixed prices. The prices are elastic and can change based on supply and demand.

However, it appears that the website contracting nightmare is vast and perhaps going to become a complete disaster:

http://www.slate.com/blogs/future_tense/2013/10/21/healthcare_gov_problems_why_5_million_lines_of_code_is_the_wrong_way_to.html

500 million lines of code — seriously. The contractors involved here are beyond incompetent. They should never be hired to build anything again.

A great example of this is the recent reduction in Medicare reimbursements. A drop in the amount of reimbursement is causing a shortage of primary care doctors who will take Medicare patients.

Additionally, you argument about about unregulated markets is silly. In fact, it is regulated markets that allow inefficiencies to continue to build until such time as the market corrects it. A look at the most recent Real Estate bubble, brought on not by Wall Street but by underwriting standards promulgated by Fannie Mae and Freddie Mac, is a perfect example. The government was convinced that they were helping the “markets” by lowering underwriting standards so that “everyone can own a house”. Until suddenly, people (the market) realized that houses selling for $1,000 a square foot was unsustainable. Again, the government increased demand, without taking into account that the law of supply and demand can only be delayed, not repealed.

The whole system is designed to fail. The “problems” with the website is planned so that the government has something to blame for the failure (bad website) instead of the real reason, bad economics.

I do. Hayek was obviously right that a centrally-run economy would be massively inefficient, because of information bottlenecks. No matter how well-meaning, a state-run economy is never going to work well. That’s an argument I made against Soviet-style economics many years ago in my debates against some of my far left friends.

But there are problems with unregulated markets as well; tragedy of the commons and market bubbles and crashes. I do not buy the Austrian explanation that all bubbles are somehow due to government intrusion. Study after study shows that speculative bubbles form and massive market instability results due to psychological factors (people being afraid to miss out on the rising market even if it has risen above all rational calculations of value.) Hence, some prudent regulation can improve the stability of markets even if most of the operation of the market is in the private sector.

I think the entrepreneurial strength of the US is partly due to the more friendly policies we have both in terms of law and culture with respect to risk taking. However, countries like France, which are far more socialist than we will ever be, aren’t Stalinist hellholes. They’re less dynamic in terms of their economy and I agree we shouldn’t go as far as they have, because I prefer the American attitude towards risk. I’m in the tech industry in the US because it is more dynamic than that in other countries. That’s partly due to our more favorable systems that support investment and entrepreneurship.

But we can in my view have social programs, health insurance exchanges, some regulation of financial markets, etc., without destroying the entrepreneurial economy. California is about where my politics lie and it is to the left of what you guys prefer but still a huge driver of the tech economy. Their regulatory and tax environment is still capable of producing massive innovation.