[zerospinboson]

Originally Posted by Harmon

This Iron Law is why any governmental "heath care" system will ultimately become tyrannical. It will not be run for the people needing health care, any more than the public schools are run for the students. It will not be run for the docs, except for the ones who, like teachers who become administrators, become members of the administration. And it will be a tyranny, because you will take whatever medicine it wants to give you, and prevent you from getting any medicine it does not want to give you.

First off, who the hell is this pournelle visionary that nobody's heard anything about but you, and why on earth do you see him as an authority?
Secondly, did you realise that health-related medicational practices are amazingly more well-developed in the US than in other parts of the world? The amount of pills you consume is amazing. What, 20% of the population takes antidepressants? I wonder how they survived before the advent of modern medicine.

The next-largest component of health care spendingin the United States in 2004 was prescription drugs. According to the OECD data, the United States spent roughly twice as much on prescription drugs ($752 per person) as the average OECD country in 2004.

Notice: This is not the fault of government, this is entirely because drug companies can influence what doctors prescribe, through "encouraging" doctors to prescribe "new" pills (that still have the highest prices).

The study found that brand-name prescription drugs still under patent were most expensive in Japan, with the United States ranked second among the nine countries.
In the other seven countries, on-patent prescription drugprices were 24% to 39% less expensive than in the United States.

Anyway, just because you can describe it doesn't make it true, nor even believable. Again: who the hell is Pournelle?
According to wiki, he's an essayist, journalist and SF Writer. i.e., a twit with no economics background whatever. The only thing I get from your story is that you live with lots of fears about "government" "taking over"
Especially because I can think of no supporting evidence whatever in favor of this "necessary consequences" argument.

You are evidently unfamiliar with the concept of private health insurance.

... The irony inherent in that statement is delicious.

Government's role in health care is to regulate for purposes of quality control and for insuring (so to speak) competition among providers, prosecuting of fraud, and providing transparency to the consumer.

You mean to say, imo [bla]. The rest is only true if you believe that government has only the rights written on some document back in the 1700s. Honestly, your constitution is becoming like the bible: not of these times. Later changes introduced through congress are legitimate, you know.

But once we let the government take over the funding we will get two things: increasing costs, and decreasing service delivered in accordance with government decree handled by a bunch of bureaucrats following Pournelle's Iron Law to the letter.

Again: "we will get"?
Anyway, let me point something out to you that proves the exact opposite of what you're saying:

As shown in Figure 1 and Table 1, U.S. per capita health care spending was well over double the average of OECD countries, which was $2,560 in 2004. Health care made up 15.3% of the U.S. economy in 2004, as measured by Gross Domestic Product (GDP) — up from 5.1% of GDP in 1960. No other OECD country devotes as much of its economy to health care.
(consider especially that you're not even helping 30% of the country)
As previously discussed, Americans do not lead the world in per capita doctor visits or hospitalizations. When Americans receive health care services, they appear to receive a higher-than-average amount of certain surgical procedures and advanced medical technologies, but generally do not have the highest levels in the OECD. This leaves price as the last remaining factor in the equation to explain the high level of U.S. health care spending. In assessing what drives the difference between U.S. health care spending and the rest of the world, some leading health economists responded this way: “It’s the prices, stupid.”
Put more formally, a report from the OECD declared that “there is no doubt that U.S. prices for medical care commodities and services are significantly higher than in other countries and serve as a key determinant of higher overall spending."
Spending on health insurance and administration can be broken into three parts. The largest part, at least in the United States, comprises the difference between earned premiums and incurred benefits of private health insurers.
(btw, this translates to either "corporations have too much power" or "corporations are inefficient". Which do you prefer?)

Whereas in europe most health care systems are public (although there are (partly) private systems as well, notably in Switzerland and holland), and incur less than half the US costs, even though resulting in a higher avg life expectancy. What answer does your dear libertarian Pournelle have to this? "in communism laws are different"?