Devaluing the Dollar by Trashing Private Health Care

By Eric Singer

The main driver of the col­lapse of the dollar is the liq­uidity pro­vided by the Fed at nom­inal interest rates, which invites a world­wide army of investors to short the dollar and buy for­eign stocks and bonds. If the dollar con­tinues to fall in value, these investors are effec­tively paid to borrow as long as their other invest­ments are higher in dollar terms when they unwind the trade. Pro­fessor Roubini has a good article on this sub­ject. He pre­dicts that cur­rent policy is cre­ating an inter­na­tional stock market bubble which will be fol­lowed by a collapse. 

It is not a coin­ci­dence that the dollar’s decline rel­a­tive to other cur­ren­cies and gold has accel­er­ated over the last three months since the health care debate has cul­mi­nated for the moment in the pas­sage of H.R. 3962, the Afford­able Health Care for America Act. To get a true sense of Congress’s irre­spon­si­bility, it is nec­es­sary to out­line at least a por­tion of the breath­taking scope of what they are attempting. As listed before, the Act is grossly infla­tionary because it man­dates or results in (1) more cov­erage require­ments per person, (2) more people cov­ered, (3) fewer doc­tors per patient to pro­vide care, (4) more adverse selec­tion, (5) unre­formed and unre­pen­tant tort lawyers, (6) sharply higher health care union­iza­tion, and (7) less pri­vate inter­state com­pe­ti­tion. The sim­ilar Senate pro­posal, which would effec­tively end much of pri­vate insur­ance, is dis­cussed in an ear­lier CWDM here.
By CBO esti­mates, the Act com­mits U.S. tax­payers to spending over one tril­lion dol­lars over the next ten years. Through the magic of a pro­jec­tion that would be fraud­u­lent if done by a pub­licly traded com­pany sub­ject to Sar­banes Oxley, the law was deemed to be a revenue-enhancer because it col­lects taxes begin­ning in 2011 while pro­viding ben­e­fits only begin­ning in stages in 2013, one year after the pres­i­den­tial elec­tion. Deficits in the years beyond 2019 have been ignored by con­gressmen touting the bill. Among other major eco­nomic drags in the bill is the require­ment that we all pur­chase insur­ance directly if our employers no longer pro­vide it.  This is because the employers will pay a cheaper pay­roll tax in order to shuck us off to the gov­ern­ment pool, a tax on so-called gold-plated insur­ance plans, new taxes on phar­ma­ceu­tical and med­ical device com­pa­nies, and a 5.4% income tax sur­charge. Including state income tax rates, many suc­cessful United States entre­pre­neurs will now face over 50% mar­ginal tax rates, which will sharply reduce their incen­tive to start new small busi­nesses — are the back­bone of job-creation. In their talking points, the Repub­li­cans plau­sibly claim that the bill may cost five mil­lion addi­tional jobs. 
There is not the slightest chance that the assump­tions under­lying the bill will be reflected in reality once people have the chance to game the system. In the same way the gov­ern­ment could not keep up with the accel­er­a­tion of demand cre­ated by the cash-for-clunkers ini­tia­tive, health care insurers and providers will not be able to keep up with the dis­tor­tion in demand cre­ated by not having use of the system tied to a cost. Many employers will opt to pay an 8% pay­roll tax rather than pro­vide pri­vate insur­ance. Mil­lions of employees, knowing they can wait until they are sick, will pay the penal­ties asso­ci­ated with not having insur­ance, or ignore them alto­gether, only seeking insur­ance once they feel they need serious cov­erage. The penal­ties range up to a mis­de­meanor failure to insure (up to $25,000 and one year in jail) to a felony failure to insure (up to $250,000 and five years in jail). Rep­re­sen­ta­tive Camp (R-MI) put it well when he said that “This is the ulti­mate example of the Democ­rats’ command-and-control style of gov­erning — buy what we tell you or go to jail.” These penal­ties are so severe, so unjust, and so uncon­sti­tu­tional that they will never be uni­formly enforced (if they are enforced at all). 
These facts, cou­pled with how invin­cible we feel when we are young, will result in many mil­lions of people delaying cov­erage for years knowing they cannot be denied gov­ern­ment cov­erage for any pre­ex­isting con­di­tion. In a Fitch forensic survey of a 2007 mort­gage pool that went bust, 47 out of 47 mort­gage appli­cants lied to get their loans. Sim­i­larly, this law will encourage many U.S. cit­i­zens to work off the books now that they have cov­erage. As a result, as an unin­tended con­se­quence of this act, fewer people are likely to actu­ally be insured. While the poor may gain cov­erage, the middle class will lose cov­erage. And our smartest stu­dents will veer away from medicine.
With new health care industry taxes, the destruc­tion of pri­vate insurers, and the like­li­hood of more arbi­trary reim­burse­ments, the phar­ma­ceu­tical and med­ical device indus­tries will stop inno­vating in the United States at the level that brought them to the top of the world in knowl­edge com­pet­i­tive­ness. The large inter­na­tional com­pa­nies will do more and more of their drug inno­va­tion elsewhere. 
There will be a migra­tion away from inno­va­tion in the United States and towards a focus on process: “Did you get to see a doctor?” or “Did you get to see a nurse prac­ti­tioner?” instead of “Did you get well?” The vibrant health care industry, with its equity in public com­pa­nies alone valued at $1.9 tril­lion in today’s dol­lars, will likely be bisected in value over the next five to ten years as the same forces that made Amtrak unprof­itable are brought to bear. For those fam­i­lies for­tu­nate enough to own some stocks in a pen­sion or a retire­ment or pri­vate account, the average losses attrib­ut­able to the wipeout of health care could be on the order of $15,000 to $20,000 per house­hold in today’s dol­lars. The losses are likely to be unequally dis­trib­uted, with health insurers losing the most. 
This is above and beyond the annual burden that will be imposed by forcing everyone to buy non-economic, government-based insur­ance. To the extent the dollar col­lapses, it may well be that in dollar terms, the industry does not lose as much value. But in real terms, the loss of value will be clear. For example, all sorts of drugs, oper­a­tions, and pro­ce­dures that are con­sid­ered rou­tine today will be con­sid­ered unnec­es­sary and unre­im­bursable tomorrow.
Con­gress acts as if we can borrow and borrow and never have to worry about repaying. We have issued $12 tril­lion in debt, and the new law would add another tril­lion at a min­imum. This is in an economy with only $14 tril­lion of nom­inal GDP. As the total United States debt begins to climb to over 100% of our GDP, other nations will increas­ingly move away from the dollar. 
Every time Con­gress spends, or evens threatens to spend, without get­ting full value in return, they effec­tively destroy value com­pared to what might have been and what should have been. Dis­re­specting the dollar by trashing pri­vate health care will do nothing but destroy one of our truly world-class indus­tries, result in fewer people get­ting actual health insur­ance, waste­fully spend money we don’t have, and invite fraud on a level that will make Fannie Mae blush.
Eric Singer is the Fund Man­ager to the Con­gres­sional Effect Fund that seeks to avoid polit­ical risk  by investing in the equity market only when Con­gress is on recess, and pri­marily in interest-bearing instru­ments when Con­gress is in session.
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