AMERICAN HEALTH CARE ACT

Imagine a country with zero crime, no homelessness or Caltrans holding up your morning commute–Imagine. Image a world with unicorns and rainbows, a healthy seven figure checking account for every man, woman and child–Imagine. Imagine affordable health care for all, no deductibles, copays or premiums–Dream on.

The late UCLA Professor Richard Brown, once commented that the Clinton healthcare initiative failed because the status quo was everyone’s second choice. This same logic applies to today’s failure to vote on the AHCA. Additionally, no one ever lost money betting against the rollback of an established entitlement program.

Before we go any further and blame it on the Democrats or the moderate republicans. Let’s consider the biggest buzz kill at any wine tasting or job interview is the discussion of religion and politics. The Republican opponents of the Affordable Care Act have not yet faced the fact the reason coverage is so expensive is because health care is expensive! You can’t have cheap coverage for expensive services. Therefore, something “cheaper and better” was never more than a slogan. That slogan showed the Affordable Health Care Act to be the bait and switch that it was.

Health insurance serves two purposes; protect against health related financial catastrophe and to finance health care. The ACA, with its high deductibles does a better job with the former than the latter. It will be hard to satisfy the diverse collection of stakeholders with anything much different.

This is another illustration of the fact that anything approaching universal coverage is challenging for the developed world’s outlier on healthcare cost. Medicare has around 15% lower costs than commercial plans. The only practical way out of the cost vs. access quandary is to harness the commercial insurance overhead/waste/profit and direct it toward coverage.