Individuals have to buy insurance, because only a combination of them can form a (large enough) pool.

And I note that your analysis that this is good only holds in a situation like today, where there's a labor surplus. In the future it could be a very bad thing, especially if individuals in otherwise productive parts of their life don't work and therefore don't pay for the Baby Boomers' retirement promises like Social Security and Medicare.

ADDED: one thing we can be very sure about this law: there's going to be a bunch of "UNINTENDED consequences", and some of them will be bad. Some are likely to be very bad; one thing recently remarked on is that VCs are pulling back sharply from funding biomedical ventures, right now due to uncertainty, but things like the medical device tax are a component of that, and of well documented existing company retrenchment.

Most basic research, whether in natural sciences, mathematics or the humanities.

The equation 'large-scale government endeavour = bad' is so simplistic, it is painful to hear otherwise smart people repeat it over and over. The real world is way to complex for this kind of black-and-white armchair economics.

(I'll concede that it depends on what you want to measure, but it's hard to argue that cheap trucking has only been a negative)

Or how the "stimulus" produced a counter-reaction that's got the establishment utterly terrified, and using the full force of the state to repress. Which doesn't tend to end well, per Pareto "history is a graveyard of aristocracies".

As an example, the entire Silicon Valley ecosystem started from the confluence of government programs, such as one where private investor dollars were matched by government dollars to create the very first valley VCs. I don't think anybody inside or outside of the government, projected the immensity of the impact of those programs.

Or y'know... about 90% of the stuff that spun out from NASA.

Anyway... I get it: you're a closed-minded ideologue and you weren't REALLY asking a question, you were just being snarky. So I'll stop pretending that I respect you now. And I'll stop pretending that we're having a conversation.

What's the NASA spinoff you allude to? I expect it's, again, what had been promised. Part of the plan was to bring about technological innovations. The development of velcro, or things like it, was part of the plan.

What I actually asked for is any example of what you claimed to be a certainty: a large, complex government program having unintended positive results.

I wasn't being snarky, I was trying to demonstrate that the record here is nearly, if not entirely, on the downside. History shows us governmental programs failing in a myriad of ways, but this isn't balanced on the upside. I honestly can't think of a counterexample within my parameters (large size and complexity, and having unintended positive results).

EDIT: A better way to state my question occurred to me. What I'm looking for is not quantitatively unexpected results, but qualitatively unexpected results, because I think that's what is implied in the above back-and-forth about these qualitatively unintended bad results versus a certainty of unintended good results.

You're pretending that if something good happens after a government action it was all intentional and thus there were never any unintended positive impacts of anything, ever. Because government is full of far-sighted individuals who totally grokked that ARPAnet would eventually be used for every conceivable form of communication, entertainment, and commerce.

The world is complex. Governmental programs aren't all good or all bad. Reality isn't compatible with your small-minded ideology. Deal with it.

I'll admit that I'm walking a dangerous line with the "no true Scotsman" fallacy. I stand by my judgment of the examples cited, but agree there is some room for debate.

I think the NASA example fails not because I'm being too narrow, but because the initial stated objectives were so fuzzy and broad. More importantly, these stated objectives were probably just secondary, a rationalization to enable the true objective - the nationalistic desire to win the "space race" against the Soviets. JFK, who initially got the whole ball rolling, actually wanted nothing to do with space exploration. His backing of it was really just a political ploy. (of course, in pointing this out, I'm making your point to a certain degree: JFK set out to score political points, and in the end he wound up bringing us velcro and ICBMs - yes, I'm being snarky there)

That said, you've also given me the best reply to my question: ARPAnet. While it wasn't large at the time, it was certainly complex (beyond my ability to understand all of its technology, anyway). And since it was developed for defense purposes, the end positive consequences are in a whole different ballpark than what was originally planned.

Anyway, what really drives my questioning here is a Megan McArdle post from yesterday [1] about a political science class at John Hopkins about policy failures. She quotes the prof. as talking about opening minds to critical thinking about the endless ways in which the best-laid plans can go awry.

[1] http://www.bloomberg.com/news/2014-02-04/learning-from-iraq-...

As I read it, it was part of the fight for the hearts and minds of the 3rd world, the "Western" 1st World's approach to things vs. the Communist's 2nd World approach. Eisenhower let the Soviets orbit the first satellite to de facto establish his Open Skies policy, which the Soviets were mightily objecting to (the principle that outer space overflights were beyond territorial claims like those for airspace) ... but that the usual internal infighting led to our being visibly behind the Soviets in the most visible form of high technology. Which severely weakened our sales proposition to the 3rd World....

One explicit objective that developed, especially after LBJ took over, was uplifting the South with high tech. The opportunity of spending an extra billion in Texas is why we didn't build any infrastructure in space....

Actors within government are generally aware that their actions have some negative consequences. They have a lot of smart people who tell them about problems that can (and will) occur, along with some likelihoods of the magnitude and frequencies of those problems. So under your classification scheme, there really aren't many unintended downsides of governmental action.

You seem to be conflating the public marketing of a policy (it will be sunshine and rainbows) with the internal understanding of a policy (it will solve a few problems, create a few different problems, and hopefully net positive).

Yes. I'm doing that consciously, because I think it's appropriate. The very nature of the question is that when it's presented to the public, only the public marketing is on display. At the time we're debating a policy, we can guess at the internal agenda but we never really know for sure until later (if at all).

So if we're trying to learn from history and apply it to today's policy debate, of what use is a history that separates the hidden agenda - a factor that we are unable to know and make use of at the time the decision is being made?

It's true that I'm not impartial here, but there's every indication that you're not either, yet you're trying to pin it all on me.

Of course problems and potential failure modes were debated; that was part of the public marketing. But there clearly was a hidden agenda that we still don't know. Why else would they have worked so hard to pass something overnight -- as if it were an emergency -- and including language making it so far from what anyone wanted and containing provisions contradicting what had been promised (and with every indication that (at the outset, anyway) those promises were sincere?

But where in the debate do you see any discourse about the hidden agendas of either side? How in the world can we include this in today's discussion when even now it can only be speculation? And how can I be intellectually dishonest with it, then, if we can't know what it is?

Sidebar: The debate we had included raging dishonesty on both sides. On the pro side we had misdirection about the problems the bill was putatively intended to solve (preexisting conditions were already significantly addressed by HIPAA; uninsured could already get catastrophic care at hospitals, financed by the government) and funding (expenditure estimates were cooked by showing a runtime starting years before actual outlays began, in order to minimize the deficit impact). On the anti side we had hyperbole about "death panels" and about the government taking over the industry, etc.

I acknowledged that there was room for debate, yet you offered none. I explained why I thought that I was on the correct side of the line (because the NASA case had objectives too fuzzy to judge), despite it being a close call.

I also acknowledged that a further example you gave (ARPAnet) was, in fact, a pretty good response to my initial question. You didn't pursue this point, yet I think it demonstrates that I'm not dishonestly throwing out all counterarguments.

You accuse me of "purposefully conflating completely different arguments to try to score cheap political points." Yet in my remarks about JFK and the space race, which in the sequence of the conversation seems to be what you're referring to, I was quite explicit in admitting "in pointing this out, I'm making your point to a certain degree".

I don't believe that your claim that I'm moving the goalpost has merit. I was pretty explicit in that I was looking for positive results that were qualitatively unexpected. The examples cited to me (with the exception of ARPAnet) were positive ones, but they were quantitatively unexpected. Saying "that worked better than we thought" is very different from saying "that had benefits that we didn't foresee".

Turning this around, now, and looking back on your own claims... your initial statement was "One other thing we can be very sure about this law: there's going to be a bunch of 'unintended consequences'", i.e., with certainty there will be positive consequences that weren't intended. Based on the context (that we're discussing employment effects of a sort that I don't recall ever seeing discussed in the PPACA debating), and the connotations of the word "intended" (as contrasted to the word "expected"; to me, the latter might have referred to quantitative differences but this doesn't work so well for the former), I interpret this to mean that there is a certainty of positive consequences that were qualitatively unintended.

You were intellectually dishonest.

It seems to me that -- as you're accusing me -- you're making brash and unfounded ideological pronouncements. That's what I intended to challenge, because it sounds preposterous to me. If the outcome you promise is certain, then there must be such a laundry list of them from past endeavors that you'll be able to rattle off a list in no time. I couldn't think of a single one (although, as noted above, ARPAnet is one example). So I challenged for examples.

And only one of the examples met the conditions that I believe were implied by your original statement (or how I interpreted it, anyway), that is, positive qualitatively unintended consequences to a large, complex governmental program.

You may disagree with me, but I think the fact that we've only come up with a single example (in between the name-calling) pretty well shows that such outcomes are far from a certainty.

With so many dropping into the clearly subsidized roles this will push the costs of the program up. With the guarantees to the insurance companies built into the law the public will end up footing an even larger bill which requires increase taxes and health care costs for those working putting a bigger drag on the economy.

Having more part time jobs which is what will happen when the employer side of this kick is not better that keeping full timers.

We had to move for other reasons than her job, but consider that there are many people doing work that other people do, who are motivated to do things like start a business, but who are otherwise unable to do so because of the US healthcare system.

Additionally, consider my parents, who are also working not because they need the income per se-- they could retire and live well-- except for the costs and difficulties of purchasing health insurance on a private market.

So it isn't the case that people are just universally "going on the dole"... making private insurance closer to the same cost to purchase health insurance regardless of your status as an employee shouldn't affect the overall bottom line of the leeches who provide insurance.

So, like about 1 in 4 folks in Texas, we went without.

This is a common misunderstanding. For most people in this situation, the laws on the books already took care of the problem. If she already had healthcare insurance at her previous employer, if she could show continuous coverage, she would be able to continue to purchase healthcare insurance privately, despite her preexisting condition.

Whether the private insurance would be affordable to you is a different question, but it's not true that a preexisting condition was, before Obamacare, a complete roadblock to acquiring coverage privately.

Under HIPAA, continuous coverage ensures acceptance into group health care plans (for instance, employer-provided coverage) regardless of preexisting conditions.

Further, continuous coverage ensures acceptance into some form of individual coverage, of a kind determined by the specific state you're in.

I do not believe it is the case that continuous coverage guarantees acceptance into individual health care plans.

In 19 years of working, and (more relevantly) 15 years of marriage, I have never had a lapse of health care coverage for myself or my family. When we started Matasano, I had just previously left a full-time, full-benefits job at a larger company where I'd been working for 4 years. I elected COBRA when I left, and started shopping for individual coverage.

We were unable to get family coverage at any price in Illinois because of preexisting condition concerns for two members of my family. In both cases, the rejection cause was a total surprise, because the "condition" wasn't an ongoing health problem, but rather a piece of medical trivia that caused underwriters concern that there might have been more significant issues down the road.

I shopped for insurance myself, and then with a professional broker who I paid to deal with the problem, and who could not find a way around it.

We solved the problem first by my wife taking a full-time job outside Matasano, which got us group coverage, and then by starting group coverage at Matasano.

And you're right; I believe that there were options open to her, specifically our state's high risk pool, which wasn't a viable option due to price.

But, heck, if price isn't a factor, why do we need insurance at all :D ? I mean, we always have the option to just purchase healthcare directly; whether that will be financially feasible, is, of course, "a different question".

I actually worked with someone (who knows python, JavaScript, c#, t/sql, etc.) who had to work loading boxes at UPS on the night shift while he was between jobs because, while he could afford to quit and look for a new job, he couldn't afford a gap in his insurance. It's not that he was sucking down tons of services either - just having a gap would have been bad news.

Now I hear that jobs at Whole Foods and Starbucks are pretty good all around, but there are others that I think will rightly need to pay more going forward.

I don't get it. If we are footing the bill, then it will make higher taxes, but if the insurance companies foot the bill then health care costs increase. There's no reason for both to rise (unless we subsidize the insurance companies through taxes on the insurance companies...)

The "visible foot of the government" is quite enough. 2,000 pages of unread "law" can force all sorts of negative changes, and then there's the electronic health record (EHR) requirements in the "stimulus" bill, including the single sentence on requiring "meaningful use" which expanded into 700 pages of regulations, a lot of well paid consulting, and what looks like so far worse medical care as healthcare workers have to focus on the computer instead of the patient to avoid losing their jobs.

There's also the host of taxes in Obamacare; just the medical device tax alone will obviously raise the cost of care.

Risk corridors by themselves, obviously not. Except if you ignore the fungibility of money aren't they ostensibly paid for by taxes on policies??

On the other hand "guarantees" will put less pressure on insurance companies to put pressure on suppliers of health care, resulting in less displacement to other customers.