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Over on my Political Questions Substack, I take up afresh the parallel between Luigi Mangione and Ted Kaczynski, aka the Unabomber, whom Mangione apparently admired.  Here I want to take up the fact that many people on the left are cheering Mangione because of their hatred of health insurance companies who are said to deny coverage, because of course health care should be free, just like Taylor Swift concert tickets. (Oh, wait. . .)

No one except Alyssia Finley at the Wall Street Journal is asking the salient question: I thought Obamacare had fixed all these problems? We were promised that the comically-named “Affordable Care Act” would make health insurance cheaper for everyone—it’s right there in the name of the law, after all. What—you mean it didn’t? Who could have seen this coming?

Any sentient human being, and probably some well-trained lab chimps, knew better. It is yet another vindication of the sociologist Peter Rossi’s “Iron Law of Evaluation,” which concludes: “The expected value of any net impact assessment of any large scale social program is zero.” Maybe less than zero in the case of Obamacare. (I teach Rossi’s Law on the first day of class to public policy students at Pepperdine. It is criminal how little Rossi and his work are known.)

Our first chart, courtesy of our pal Mark Perry, shows not only that hospital costs have increased more than any other segment of our economy, but that Obamacare had no effect on this trend:

And it turns out that Americans actually pay less out of pocket than many of our social democratic peers in Europe (which is one reason our health insurance is so expensive—duh):

Here are two propositions to keep in mind. First, the high cost of health care in America is largely because government has increasingly dominated the sector for 60 years now. In other words, we already have nationalized health care in all but name. The “private” insurance sector is distorted by endless government regulations and interventions. Prior to Medicare in 1965, health care costs were right in line with general inflation. Since 1965, health care cost has increased twice the rate of inflation. Post hoc, ergo propter hoc.

Second, the dirty secret of health policy since the failure of Hillarycare in 1994 is that the government demands that private health insurance systems do cost containment, so that they, and not the government, will take the heat. One of the superficial claims you hear from the left is that Medicare has something like a 1% administrative cost, while private insurance has something like a 25 to 30% administrative cost, the lesson being “See, government health care is cheaper!”

Now, assuming these widely-repeated figures are accurate (which I doubt), it is easy to have a low overhead if you are willing to have over $100 billion a year in fraud, as Medicare does. If private insurance tolerated this kind of fraud and extravagance, employer-based health insurance would be much more expensive than it is now.

Finally, Britain’s sacred National Health Service is increasingly unpopular in Britain because of long waits, and in many cases, finding patients relegated to telemedicine instead of getting to see a doctor in person (let alone get tests):

Face-to-face GP appointments petition hits 100,000

A petition, calling for mandatory face-to-face GP appointments after the death of a woman who was misdiagnosed over the phone, has received more than 100,000 signatures – the level for a parliamentary debate.

Laura Barlow, 33, from Sibsey near Boston, was told she had endometriosis during a telephone call with a GP, in October 2023.

After receiving a cancer diagnosis in mid-January, the mother-of-three was told in February she was so ill she should go home from hospital to spend time with her family. She died three days later. . .

This will be coming to the U.S. in the fullness of time if we don’t make sensible fixes.