Dare I Say It, ACA Doesn’t Go Far Enough

Just like education and defense, health should be a core function of government.

Don’t get me wrong, I’ve had my share of frustrations dealing with government bureaucracies at the local, state and federal levels.

But our patchwork public-private system is a big reason health care in this country is so opaque, confusing, and expensive.

Worst of all, our employer-based model stifles entrepreneurism and, no doubt, erodes productivity.

Who hasn’t heard a friend or colleague lament that the health benefits are the only reason they are sticking with their job?

The Affordable Care Act might unfetter workers a little through the insurance marketplaces. The ban on pre-existing conditions should help as well.

My hunch, however, is that employer-based coverage is still going to be the best deal.

I suspect, too, that most employees will still rely on their HR departments to cut through the morass for them.

But just think about how much more mobile (and happy) we could be with a national plan that followed us wherever our career path took us.

Look, I’m no Pollyanna.

Even Britain’s beloved National Health Service has its problems.

Over the last couple weeks, I’ve talked with some local health care policy experts about my preference for a single-payer system in the U.S.

To a person, they cited the jobs and profits tied up in our current system as the reason such a transformation would likely never take place.

Some, however, expressed a preference for a Medicare-for-all solution.

That step would likely be much more politically feasible, they said, and it would retain some of the private-sector efficiencies embedded in the current system.

I know it’s unrealistic to think the U.S. will have a single-payer system anytime soon, if ever.

One of the most enjoyable conversations I had about this came with Barbara Schneider of Independence, a retired HR executive who has been deeply involved in educating [https://healthforward.org/news/education-group-offers-nonpartisan-information-about-aca] local audiences about the provisions of the Affordable Care Act.

She is hopeful that all the discussion the ACA has generated has made consumers a little more aware of the ins and outs of insurance. It might even prod us away from such a heavy reliance on employer-based coverage, she said.

“That puts a big expectation on how this thing is run,” Schneider said of the ACA. “We’ve got to focus on making sure it does run OK.”

Health Reform

Health Forward Foundation
2300 Main Street, Suite 304
Kansas City, MO 64108
(816) 241-7006