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Politics : A US National Health Care System?

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From: TimF	1/9/2017 2:24:26 PM
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Washington’s Role in Our Health Care Choices Is a Problem Tom Miller The Affordable Care Act failed to deliver what it promised. Enrollment in its state-based marketplaces fell well short of initial projections and stalled. Insurance premiums there spiked significantly higher in recent years. Many participating private insurers incurred substantial losses and started looking for the exit. These marketplaces increasingly operate like poorly structured, but very expensive and inefficient, pools of higher risk individuals without other insurance alternatives. Most A.C.A. coverage gains were limited to individuals heavily subsidized by taxpayers or pushed into expanded Medicaid coverage. The average Medicaid benefit costs of adult enrollees newly eligible under the A.C.A. ended up about 49 percent higher than estimated costs for similar Medicaid adults enrolled before the expansion. These and other storylines peddled by A.C.A. advocates about saving money through insurance expansion just did not check out. Criticisms of the A.C.A. extend well beyond those issues. More fundamentally, opponents are rightly skeptical of the federal government's growing role in their personal health care choices. The most consistent source of strong reactions against the law involves its individual mandate to purchase government-approved coverage. In reality, this mandate never worked as imagined. It was riddled with exceptions (at least 12 million individuals claimed them). It was enforced weakly and imposed only modest penalties. Up to 7.5 million individuals chose to pay them last year rather than purchase more expensive coverage that they did not want or could not afford. Republicans will need to deliver something else that works better, while avoiding overpromises and disruption of care. Some sort of “repeal” of many portions of the A.C.A. is important – done, of course, in a manner that improves, not worsens, people's lives. nytimes.com Note: The link is to a whole debate, the quote above is just part of one reply in the debate

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