by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Can anyone create a national health-insurance system that is market-based, actuarially sound, covers every citizen for every important health problem at an affordable price for all, without threatening to bankrupt the country by the cost of its subsidies, without creating shortages, and without forcing health-care providers to accept price controls?
The preceding paragraph suggests elements of what a perfect program might try to do. It includes nine desires. We don’t believe any health system in any country meets all of them, because they are mutually contradictory.
The Patient Protection and Affordable Care Act meets two elements of this ideal program. It mandates coverage of important problems, and it has not yet created shortages in the supply of services. The law offers partial compliance with three others.
There are insurance markets, but they are restricted and artificial, giving no regard to supply and demand. Subsidies are not (yet) unaffordable to the federal government. Whether the insurance is affordable or not is arguable at best, and Obamacare has been losing the argument as time goes on.
Obamacare’s designers dodged the other four elements of an ideal system. …
… Republicans in Congress and the White House say they are certain they can do better, but they haven’t published a specific plan.
They shouldn’t hurry to make one up, either, although Trump has said he has one almost ready for prime time that will provide better and cheaper coverage for all. We await it, as we would await any miracle.
More constructively, this is a chance for Congress to legislate. Republicans and Democrats should plow the same ground another time. It will never be too late for a special bipartisan committee that reviews and remakes all of U.S. health-care policy.