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Texas Review of Law & Politics


This Article examines the probable fate that awaits the systematic implementation of ObamaCare. Any effort to pile a massive new transfer and entitlement program on top of a hundred years of previous reforms is likely to fall prey to the law of diminishing marginal utility of additional forms of government intervention. That consequence is all the more likely for legislation that has strong redistributivist objectives but which lacks any techniques for dealing with the massive costs increases embedded in the program. A recent history of the Massachusetts health care initiative provides some indication of the inability to constrain costs except through the imposition of price controls that could easily drive private carriers into bankruptcy. The well-known Dartmouth Atlas, moreover, provides no evidence that there are massive inefficiencies that these price controls can bleed out of the system. The complex system of private health care exchanges or the certain expansion of Medicaid and the unlikely contraction of Medicare are likely to add only greater pressures to an already unworkable system.

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