USA TODAY International Edition
Opposing view: ‘ A radical centralization of health care'
Ten years have passed since the passage of the Patient Protection and Affordable Care Act, better known as Obamacare, and the law has been more or less fully deployed for six. In practice, although it may have made health care more accessible to some, it did so at the cost of making it less affordable and worse quality for many others.
On one hand, Obamacare definitely did reduce the number of Americans without health insurance. On the other, it also massively increased insurance premiums, deductibles and out- ofpocket maximums for millions of Americans. Thanks to insurers narrowing their networks and many fleeing Obamacare’s exchanges, many of us who liked our doctors, or our insurance plans, didn’t get to keep either.
In practice, Obamacare’s main thrust was a radical centralization of health care. The core of any marketplace is competition and price signals, and these have been nearly entirely obscured across much of the health care system by government mandates that favor inserting third parties between health care providers and patients. Obamacare didn’t invent these problems, but it did increase them.
Instead of ( unconstitutionally) subjecting everyone to a one- size- fits- all health insurance plan with deductibles so high that people can’t afford to use them, health care reform should allow for a diversity of choices.
Let people compete with the current model by keeping more of their own earnings to spend on health care services of their choice, tax free. Remove barriers to competition that promote hospital monopolies and shortages of care. Reform government- provided payments under Medicare to focus on quality, not quantity, of care. Stop encouraging states to overspend on Medicaid and incentivize them to find better ways to care for the poor.
In 10 years, Obamacare has inexorably steered health care toward bureaucracy, stagnation and eventually total government control. The way forward now, better late than never, is innovation, competition and choice.