Headlines in recent months have attracted attention to technical problems associated with HealthCare.gov, the primary website associated with the federal Affordable Care Act. While some technical issues remain to be resolved, Hadley Heath, senior policy analyst at the Independent Women’s Forum, focuses her attention on other, more far-reaching flaws in the law known popularly as Obamacare. Heath shared her concerns with Mitch Kokai for Carolina Journal Radio. Here’s an excerpt:
Kokai: Pre-Obamacare, knowing what we knew that was good about American health care and what was bad about American health care, does this law address any of the problems? If it does, does it make them better or make them worse?
Heath: I would say, absolutely, there was a lot agreement among Americans on both the right and the left that our weak point in American health care was how we pay. And to be even more specific, that we pay too much — that we have some of the highest public spending on health care. We’re at least equal with a lot of the biggest spenders in the world, per person, in the United States. The government spends about one out of every two health care dollars, even before Obamacare.
That’s important for people to keep in mind — that we didn’t have a free market system. We did not have free enterprise in the health sector. It was very heavily regulated by the states and by the federal government. A large portion of people get their insurance through the government already, through a Medicare or Medicaid program, so we didn’t have what we would call a free-market system.
Now Obamacare takes this in absolutely the wrong direction by doubling down on regulations, by bringing even more people into what we might call an entitlement program because … the main way that Obamacare seeks to make private insurance more affordable is through subsidies in the exchanges. And the exchanges are far more than subsidy delivery vehicles. … Subsidies don’t actually serve to bring down the cost. They don’t target the root of our cost problem, which may be a stifling and a lack of competition. But instead, they cover up the cost, or they hide the cost from people who will be going into the exchanges.
So that’s a concern I have, that you can’t actually reduce costs by shifting costs. And that was a big problem we talked about before Obamacare with people consuming health care at maybe an emergency room, and they’re uninsured, and they don’t pay, and they default. Well, we have a lot of other cost-shifting problems in health care that Obamacare didn’t address, like Medicaid and Medicare. When they under-reimburse, there’s a cost shift onto people with private insurance. And the same thing will happen as we shift costs onto taxpayers, who pay twice effectively for health insurance, once [for] their own premium, and twice in a subsidy.
