Opposition To The Affordable Care Act Is Often Ironic
A single-payer system whereby tax dollars cover every citizen's medical costs is a government takeover of health care. Obamacare is no such thing.
The Republican leaders of
There is a great deal wrong with the ACA. If Republicans and Democrats in
First, of course, you have to buy the idea that coverage for all is in the national interest. This is the one aspect of the ACA debate that ought to be a no-brainer. There is a reason, after all, that private employers continue to buy insurance for employees. Healthy people are better, more productive workers. Healthy children are better students who become better, more productive workers. People with coverage get more appropriate, more efficient and less costly care than people without coverage.
Health care is a shared cost in this society. The only question is whether we'll cover the cost efficiently through some sort of an organized payment program (subsidized insurance exchanges,
The Obama administration rejected any thought of scrapping private insurance in favor of a national single-payer system along the lines of
The administration's primary solution to coverage for all was to force nearly everyone into the arms of an insurance company and force insurance companies to embrace every paying customer. Consumers would be forced to buy, and insurers would be forced to sell what the government deemed adequate coverage at an acceptable price. To make sure even low- and middle-income consumers jump into the actuarial pool, the government subsidizes the purchase.
Both sides of that transaction have to be secured or actuarial mayhem ensues. The insurance industry could be forced to accept any customer, even a customer in terrible health, and charge even the medical basket-cases the same rate as healthy people if and only if everyone is a customer. That way low-cost (healthy) consumers offset the expense of covering high-cost (unhealthy) consumers. Absent those healthy consumers, the insurance companies start failing, leaving mounds of unpaid medical expenses behind.
To get there, the ACA contains a lot of really annoying provisions. You can only buy insurance on the state and federal exchanges during the open enrollment period, beginning Saturday, because if you could buy it and drop it at will only the unhealthy would ever buy insurance. You are penalized by the
A government formula dictates what coverages must be provided and what percentage of our incomes can be spent on coverage to keep insurers from abusing consumers, but the result is some consumers have more coverage than they need and other consumers are facing potentially unaffordable out-of-pocket expenses.
All of these annoying provisions make perfect sense if your goal is to preserve private insurers at the same time you maintain private health care providers' cash flow. If Republicans remove buttresses like mandatory coverage or subsidies for low-income customers, the insurance industry will revolt and the edifice will likely collapse. The Republicans then will be called upon to live up to their promise not only to repeal but to replace Obamacare.
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