I thought it was interesting the angle taken by two Opinion pieces in the Wall Street Journal on Matvh 17th and 15th. Both pieces highlighted what for me is not well known or reported in the wider press. The point being that the regulation that comprises the Affodible Care Act (ACA) was going to continue to drive a greater wedge into public finances long into the future. According to the two articles, increased taxed and transfer payments from the federal governance were baked into the regulation or required as a result of how the regulation was to be sustained. In other words, ACA did way more than “tackle” the problem of offering healthcare to those that did not have it; it really did tinker with the entire system on which it relies nourishment.
The perspective offered by the Wall Street Journal goes some way to explain the Republical delight in how repealing and replacing Obamacare will in fact eliminate or significantly reduce this socialist wedge that woudl have other driven our Governmetn on to ever larger formats. We really do need to figure out how balance increasesing demands of an aging population with the need to fund a smaller government. If the government were a business, it would long have gone out of business. And it does not help to hear others say, “the governmetn is not a business” since, at the end of the day, it has to be funded. We cannot just borrow forever and print money when we feel like it. Every nation on earth that has gone this route has ended up in revolution or disaster. We all beleive the US is different. Let’s hope so.
– March 17th, How to Repair Obamacare’s Fiscal Damage
– March 15th, The Health Bill’s Fiscal Bonus
“Healthcare’s Bipartisan Dilemma” in today’s US print edition of the Wall Street Journal details several ideas and alternatives being discussed that might replace the ACA. Every example considers tweaks to the current system that abuses the market based approach. As with the ACA, the costs to cover sick folks is mashed together with the larger population of healthy people. The result, as with the ACA, is massive price and market distortion. In fact the very essence of risk (with respect to insurance and premium) is undermined. As such the free market is a monster.
There is a different way that should be considered yet it is not (yet) in the news. Literally, return the market to where it was: remove the entire ACA and permit risk to be priced into he market as it was.
For those that fail to get insurance, offer a subsidized state-health insurance. This is the equivalent of the UK’s National Health Service but at a state level. Federal funds and state taxes would be used to pay for the service. This idea was floated in the run up to the ACA being signed and this represents a simple subsidized pool. It would be transparent and visible. The costs of this aspect of healthcare would be clear.
Finally another issue in healthcare needs to be addressed at the same time: costs. Additional efforts need to be enhanced to shift the reward system for healthcare, public (Medicare, Medicaid etc) and private. Rewards need to be explicit and focused on health, not piece-rate and work. Visits to the doctor and specialist are not relevant; results are. This program needs to be led by business people in Washington, not politicians.
Along with this is a revamp of regulations to help reduce the risk of insurance against negligence. This part of the industry puts too much of a burden on costs and needs to reduced.