The trillion dollar Obamacare experiment to reform America’s health system won’t work. But the primary reason why it won’t work is not what you may think.

Although a majority of Americans want nationalized health care repealed, that probably won’t lead to the demise of the law. A July 19 Rasmussen Reports poll found 60 percent of voters want the law overturned. And 61 percent of voters think health costs now will go up, not down. Sixty-two percent thought the federal deficit will increase, with 54 percent believing the law is “bad for the country.” Still, repeal seems unlikely. Congress would need a two-thirds majority to both pass a repeal and then override the presumed veto. Only a new President, friendly to repeal, could kill the law, a Fox News.com story noted.

What about the doctor shortage? “Aging baby boomers will create a growing demand for medical services,” said The Foundry June 18. “Nearly 40 percent of doctors are 55 or older and on the cusp of retirement—and the number of students on track to graduate from medical and nursing schools will not be adequate to replace them.” Obamacare expands health coverage by adding 16 million more people to the Medicaid rolls. Medicaid pays doctors notoriously low reimbursement rates, usually not enough to cover the cost of seeing the patients.

But Department of Health and Human Services Secretary Kathleen Sebelius smilingly says the government is subsidizing an increase in health-care providers: $250 million to train more primary-care doctors by 2015, and new physician’s assistants, and nurses, even though that will still fall short of needs.

What about the states that have sued the federal government to repeal Obamacare? Some have argued that a state can “nullify” a federal law believed to be unconstitutional. This was a principle propounded by Thomas Jefferson and James Madison. When a state proclaims that such a federal law is void, then it is not a law within that state. State attorneys general have pointed out that the added millions eligible for Medicaid will swamp state budgets. States pay nearly half the costs of Medicaid. A March 23 Bloomberg article said Medicaid makes up about 15 percent of total national health care expenditures. As Attorney General Bill McCollum of Florida has declared, the law is an “encroachment on the sovereignty of states.” States also have challenged the right of the government to impose a mandate requiring individuals to buy health insurance. The White House argued at first that Congress had the “inherent authority to mandate coverage under the commerce clause,” which allows the federal government to regulate interstate commerce.

But to guard the health law against that contention, the Obama Administration was forced to pull another rabbit out of its hatful of tricks. It changed its original concept of the health law provision making people buy insurance by redefining it, instead, as a tax. The Justice Department moved to dismiss a Florida suit against the law, arguing that courts can’t interfere with the government’s ability to collect taxes, The American Spectator reported July 17. But some argue a tax can only be paid to the Treasury, not a private entity. Otherwise it is unconstitutional. But who knows what the Supreme Court would decide on such an issue?

There may well be many sound reasons why in the real world Obamacare won’t work. But probably the most persuasive one is—to use a term in the vernacular: the law is bass-ackwards. It has the government, not the consumer, making the decisions. A persuasive study, released in July by the Galen Institute’s Entitlement Reform Project, concluded that only by giving beneficiaries their choices can this lead to “the revolutionary and cost-cutting changes the government has never been able to successfully impose by regulatory fiat.” The Institute is a nonprofit research organization devoted to advancing free-market ideas in health policy.

The 21-page study stated that the “more promising approach for addressing the significant challenges we face is a completely new relationship between the government and the beneficiaries of its programs. What is particularly significant is that putting the consumer in control in health matters already has been shown to work. It has worked since the prescription drug program of Medicare went into effect in 2006. Consumers were given control to make their own choices.

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