He makes two points that I haven't seen expressed this well before, including by me despite 25 pages of trying:
A striking (and ominous) development in American politics in recent decades has been the emergence of government as an aggressive promoter of routine middle-class consumption... The tendency—already evident at the state level—will be to require generous, subsidized coverage of routine health and "wellness" services involving lifestyle, cosmetics, amenity and child development; of "preventive medicine" such as weight-reduction programs; and of "alternative medicine" such as massage and herbal therapies. At the same time (as already evident under Medicare) the treatment of infrequent but costly catastrophic diseases and conditions will be limited in the name of cost control, and the case-by-case discretion of doctors and other providers will be closely monitored and restricted.This is, of course the opposite of the economic function of "insurance."
America is a large, wealthy, dynamic and heterogeneous nation. It is also the only major country that continues to maintain a health-care system with substantial elements of competitive supply, pricing freedom, patient choice, and diversity in approaching complex and uncertain medical problemsNo, health care is not a stable good like asphalt, where the government can just come fix your potholes the same way now as they did 30 years ago. But "competitive supply, pricing freedom, patient choice" are already vanishing, and quashing diversity is the direct point of Obamacare.