Seven years ago there was a broad consensus in America that the our healthcare system was broken. Tens of millions of people were uninsured, countless millions more were underinsured, having insurance that they could hardly use because of high deductibles and other out of pocket expenses. Furthermore, health insurance premiums were rising at much higher than the rate of inflation, and policies were leaving more out of pocket expenses for consumers to pick up. The situation was obviously unsustainable.
While it is true that under Obamacare some people have benefited greatly, and the number of people without insurance has decreased. On the other hand, the ranks of the underinsured has skyrocketed as middle class people have seen their costs increase and are foregoing appointments and procedures in order to avoid hefty out of pocket costs. And the taxpayer is picking up a bill that grows with every year as the system had inadequate cost containment mechanisms. Meanwhile, premiums and deductibles are skyrocketing. A collapse is imminent. All Obamacare did was redistribute the winners and losers in the healthcare game while postponing any real solution by at least seven years. It therefore must be considered a complete failure.
The debate over Obamacare, both before and since it’s passage, has been largely partisan and ideological, with serious policy analysis taking a back seat. During the election campaign, President Trump voiced its determination to repeal and replace Obamacare, although he was short on specifics. He stated that he wants a system that will cover everyone while bringing down costs. House Speaker Paul Ryan revealed a replacement plan that does neither, but will leave President Trump on the hook when the system collapses, which is only a matter of time without a real solution.
But a real solution that meets the President’s objectives if possible. Having formerly worked for a major insurance company and having conducted a major study of the Obamacare system, I have gained a rare perspective and expertise on the nuts and bolts of the Obamacare system. What I will do in this policy proposal is to utilize that experience to analyze the economic and social shortcomings of the present Obamacare system, explain why the ideologically driven market-based alternatives are not the answer, and then finally outline a proposal for a new national system that will optimize economic rationality, social fairness, and political logic.