Lots of buzz on Twitter for this one, but I’m not sure why. Of course this is what the bill is about; this is what The One means when he talks about “common sense,” “middle of the road” solutions. And the “maldistribution” doesn’t only apply between rich and poor, it applies between young and old and the healthy and sick too. Look no further than the new (and, it should be said, hugely popular) exemption for preexisting conditions. As Robert Tracinski explained eight months ago, once you take away the industry’s right to decline a particular risk, you’re no longer talking about insurance. You’re talking about welfare.

So let’s ask the question the left never asks: how is it possible for an insurance company to pay for these giant medical bills? What makes it possible is a whole set of statistical calculations. For every person who needs open-heart surgery or chemotherapy, there have to be a certain number of other people who are paying their premiums but haven’t gotten seriously ill. If the insurance company has gotten its calculations right, the expenses for any one person’s catastrophic care are balanced out by the premiums other people pay “just in case.”

You can see how Obama’s demands undermine this whole system. To ask insurance companies to cover a patient after the tumor is diagnosed is to ask them to take on a known expense. Combine that with another Obama demand: that insurance companies can’t charge higher rates for those who are at higher risk of getting sick. So if insurance companies have to take on a known expense and can’t charge a higher rate for it, how are they going to pay for it? By raising everyone else’s rates, redistributing their wealth to the new freeloaders.

This isn’t insurance, it’s welfare. And that’s the whole point.

Right. That’s why you need a mandate — not only to cover the costs of emergency care for the uninsured, as Romney insists, but to squeeze premiums out of people (healthy young people, mostly) who probably won’t need care at all. And what if that’s not enough of a corrective to the “maldistribution”? Well, then you add some taxes and squeeze a little more revenue that way. Why, here’s a nice tax now that already has Obama pal Deval Patrick panicking about the job losses it’ll create within Massachusetts’s medical-device industry.

But I’m sure it’ll all work out for the best. And if it doesn’t, who cares? It’s here to stay. That’s how entitlements work, you mean conservative, you. Click the image to watch.

baucus