Saturday, September 10, 2016

The Chicago Tribune:  Why ObamaCare Failed
It is newsworthy when the Chicago Tribune  uses the past tense to describe ObamaCare. The editorial board of the Tribune gives these reasons why ObamaCare “failed,” as if that was a foregone conclusion.
Here are reasons the Tribune offers.

·         It flunked Economics 101 and Human Nature 101.  It wasn’t flexible enough to let people buy as much or as little coverage as they wanted or could afford.

·         Its penalty for going uninsured ($695) were too low when stacked against skyrocketing premiums so people simpy skipped coverage.

·         It didn’t recognize the essence of insurance risk pools  - the lucky (the healthy) have to subsidize the unlucky (the sick).  The sick reap much greater benefits thatn the healthy,  yet insurers can’t exclude the sick, those with preconditions, or even ask them what ails them.

·         It allows Americans to sign up even after they got sick.  If you can buy insurance after you get sick, why buy it before you get sick.

·         It did not decrease health costs.   It increased demand for care while decreasing supply of physicians  and choices of plans.

·         It ignored the fact that too many carriers could not cover their expenses, or created condition that carriers could not even estimate those expenses in advance.  For every dollar earned,  insurers paid out $1.32  for services rendered.  Small wonder insurers, business beholden to stakeholders and shareholders,  abandon ObamaCare markets and raise premiums by double digits, sometimes by 45% to 60%, to offset losses.

The Tribune suggests federal authorities offer more flexible plans to let consumers buy what’s best for them, not coddle them by letting them duck in and out of the system,  when the need or don’t need care.   The new plan, says the Tribune, should kill the employer mandate, and instead offer tax credits for hiring and covering new employees.  And let insurers compete across state lines.   Competition is a wonderful antidote  for charging what the market will bear.
To these ObamaCare’s failings I would add this simple caveat.  Get over the notion that government can homogenize and standardize care through  centralized control.  Homogeneity and standardization violate two fundamental American values – pluralism and self-determination.   There is not simple, magical, structural,  managerial answer to universal, affordable, acceptable  universal coverage – no management  data-based “value’ evidence,  no quality control measures,  no compensation by performance,  and no amount of collaborative,  cooperative  synergistic  efforts  by federal authorities to enforce  ethical and elitist “truths” as perceived in Washington rather than on the frontlines of care.


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