The worst part of the mandate is that every health care interest in country will start lobbying Congress to ensure that their procedure is covered by the mandate. Thus we will be forced to pay for care we don't want, didn't need, and doesn't work. This is exactly what has happened in Massachusetts since the mandate passed, and costs have continued to rise even faster than before. The dirty secret of medicine is that most we spend a huge amount of money on stuff that just doesn't work ( http://www.cato-unbound.org/2007/09/10/robin-hanson/cut-medi... ). The mandate will make this even worse. Recently I got a letter from my health insurance provider that by law they must cover mental health drugs now. This is despite the fact that these drugs do not work ( http://www.overcomingbias.com/2008/06/anti-depressant.html ).
The underlying philosophy is that health care is such a basic part of human life politicians must be in control of it. So from now on (assuming passage) when you have a health care problem, you'll be going to your Congressman to fix it. Insurance not covering something? Go to your congressman. Public plan not covering something? Go to your Congressman. More people need coverage? Go to your Congressman. Rich folks getting really cool benefits while poor folks don't have them available? Go to your Congressman.
Trying to balance the budget? Thought Social Security was impossible to change? You haven't seen anything yet. Try touching national health care once it's rolled out.
It's not "solving the problem" that sucks. We all know there are problems with the free market when it comes to paying for health care and we all know insurance pooling isn't optimum. The problem is the side-effects a huge national solution is going to have.
And those side effects sure look like they make Congressmen even more powerful than they are now.
I don't anything that comes out of the American political process could be called "designed". Nor do I think the Congressman have some malicious intent to grab power. Rather their is a selection effect whereby people who are over optimistic about the ability of government to solve problems end up in positions of power.
How could 2000 pages not have some sort of design? Have you seen the diagrams of all the things the bill creates?
I'll grant you that perhaps for many members they are so inept as to have this design be implied instead of explicit, that doesn't make the underlying pattern go away.
This is like the discussions we have with programmers who say they have no time for design. Look - you can't code without designing. The question is whether you're upfront about it, haphazard about it, or whatever.
You can't have 2000 pages of law without implementing some kind of design, no matter how you went about getting it.
SSRIs are not the only kind of "mental health drugs". They aren't even the only kind of anti-depressant drugs. Nor does the single meta-analysis cited even claim that they "do not work".
