Vail Daily columnist Butch Mazzuca: Waiting game with health care |

Vail Daily columnist Butch Mazzuca: Waiting game with health care

When Nancy Pelosi uttered her now infamous words, “We need to pass the bill so you can find out what is in it,” even the most optimistic Democrats should have known this was only the beginning of a saga that would eventually lead to the nation’s highest court.

The fact that the Affordable Care Act was passed in such a questionable manner virtually guaranteed it would come down to nine jurists rendering a decision on its constitutionality.

Democrats wanted health care for everyone, a highly commendable notion. Health care impacts us all, and its rising cost had to be addressed.

So after the Republicans punted on the issue, the Democrats took up the cause. However, due to the dodgy manner of how the process was handled, the president and the Democrats in Congress shouldn’t be surprised that a different law would play a significant role in the matter — the law of unintended consequences.

Unintended consequences are outcomes not intended by a purposeful action. This concept can be traced back to distinguished American sociologist and National Medal of Science winner Robert K. Merton, although Adam Smith, of “The Wealth of Nations” fame, first made reference to this concept back in the 18th century.

In recent days , the law of unintended consequences has come to be used as a warning that intervention in a complex system (in this case, a sixth of the U.S. economy) tends to create unanticipated and often undesirable outcomes.

Politically speaking, it’s akin to Murphy’s Law, and is commonly used as a wry or humorous warning that politicians always think in terms of short-term gain — i.e., the next election cycle rather than long-term consequences.

Regardless of where one stands on the issue, the fact remains that the law is far too encompassing (2,700 pages) and creates more government bureaucracy when efficiency should have been the goal. It’s filled with uncertainties, ambiguous new taxes and far too many arcane codicils that our elected officials never bothered to think about, much less read.

Democrats bet on the come and pushed the legislation through without popular support, assuming Americans would like it once they got used to it, reinforcing the long-held liberal belief that government knows best.

According to Merton, possible causes of unintended consequences include the world’s inherent complexity, perverse incentives, human stupidity, self-deception and the failure to account for human nature or other cognitive or emotional biases. Judging from the fact that this legislation is now before the U.S. Supreme Court, it’s hard to argue with Merton’s position.

Merton also listed several benign causes of unintended consequences. Among these are ignorance (it’s impossible to anticipate everything), thereby leading to incomplete analysis, errors or incorrect analyses of the problem; following habits that worked in the past but may not now apply; and focusing on immediate interests, which when it comes to politicians always seem to override the long-term welfare of their constituencies.

Since the bill’s passage into law, the Congressional Budget Office has doubled its cost estimate from $900 billion to $1.8 trillion. However, considering the government’s track record on estimating the cost of new programs, it strains credulity to believe that its eventual cost won’t be three or four times that amount.

Regardless of how the Supreme Court rules, this issue isn’t about to go away. If the law is upheld, the arguments and sentiments against it will continue and reducing our deficit and debt will be all but impossible. If it’s struck down, the problem of increasing health care costs remain, and the onus will then fall upon the republicans to find a solution.

Assuming the president wins a second term, which is about than a 50-50 proposition at the moment, the electoral math (redistricting within states, population shifts and the large number of Senate Democrats who are up for reelection) favors the Republicans to retain the House and quite possibly gain control of the Senate.

If Obama is re-elected and the Republicans gain control of both houses of Congress, it’s going to be interesting to see how the irresistible force and immovable object deal with health care moving forward. But first we must wait for nine jurists to tell us where the starting point is.

Quote of the day: “Hillary Clinton is attacking my plan, but what she’s not telling you about her health care plan is it forces everyone to buy insurance, even if you can’t afford it, and you pay a penalty if you don’t.” Barack Obama in a 2008 campaign ad criticizing Hillary Clinton for proposing a mandate to buy health insurance.

Butch Mazzuca, of Edwards, writes regularly for the Vail Daily. He can be reached at

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