Beyond Obamacare

NOW that Republicans in Congress appear to have at least temporarily abandoned their crusade against the Affordable Care Act, it seems like a good time for lawmakers to come up with plans to fulfil their promises to increase access to health care and to lower costs.

Change might not come soon enough for the 29 million people without health insurance or the many millions who struggle to afford high premiums, deductibles and other health costs. But even the ACA, the 2010 health law also known as Obamacare, was the product of many years of spadework and was based on a Massachusetts health reform bill signed into law by Governor Mitt Romney in 2006.

Obamacare has helped 20 million people gain access to insurance, and it appears to have helped slow the growth in health-care costs. But even former president Barack Obama has said that there is still work to be done.

The US spends much more on medical care than other rich countries, yet its citizens live shorter lives and suffer from more illnesses and injuries than people in other industrialised nations.

One option that appears to have gained support among the public is a single-payer system, which proponents like senators Bernie Sanders and Elizabeth Warren call “Medicare for All”. A Kaiser Family Foundation poll found in June that 53% of Americans favour such a system.

This was up from 46%, according to an average of seven polls conducted in 2008 and 2009. But moving to a single-payer system from one dominated by employer-paid health coverage would be a big leap, and in any case the political climate is clearly not ready for it.