Healthcare
The
current healthcare law, the Affordable Healthcare Act[1]
passed in 2010, is an admirable attempt at creating a national healthcare
system that achieves universal coverage in a sustainable and nationally
affordable way. It is admirable in its
intentions but not its execution. The
Affordable Healthcare Act of 2010 is a deeply flawed law that does not
adequately address several core issues of the healthcare debate in a realistic
fashion. The Affordable Healthcare Act
is at best a bad patch on an already bad system. In addition to being inadequate for our
healthcare demands it may have many negative consequences in many aspects of
the United States economy and further divisions in American society. If the United States wants to move forward
with the Affordable Healthcare Act, many changes of a radical nature will need
to be implemented in the near future in order to make the practical application
of the law live up to the admirable goals of those who authored the Affordable Healthcare
Act. Or the United States will need to
produce a new, separate law to address our national healthcare concerns, in the
process making the Affordable Healthcare Act a worthy attempt assigned to the
historical scrap heap. If the United
States is serious about addressing its myriad healthcare concerns, one of the
two above prescribed courses of action will need to unfold. Given the relative weakness and deep
structural flaws of the current Affordable Healthcare Act, I advocate a
completely new law to address our nation’s healthcare concerns structured very
differently from the Affordable Healthcare Act.
I will discuss our current national healthcare concerns and challenges
confronting the United States, then outline the structural and societal deficiencies
and merits of the Affordable Healthcare Act, and finally I will outline a
general proposal for a framework of guidelines for a new national healthcare
system. I want to iterate again, that
these are ideas worth discussing and that they should not be taken as a
finished product that is actionable in any way.
First,
allow me to make a point regarding the absurd light I have witnessed many
discussions on the Affordable Healthcare Act devolve into and be consumed by to
a pointless end. I have come across a
peculiar situation, unfortunately all too often, where any criticism of the
general details or structure of the Affordable Healthcare Act is met with
counterpoint, ‘You don’t want everyone to have healthcare,’ or a similar phrase
producing the same effect. I believe
this rhetoric is unproductive for uneristic debate and is dangerous for our
democracy. For all intents and purposes,
everyone outside of a few radical far right wing ideologues wants every citizen
of the United States to have access to affordable healthcare. The idea that one side or the other seriously
doesn’t want American citizens to have healthcare is a rhetoric tool designed
for emotional appeal without logical or substantial grounding. We can all agree that we all want everyone in
the United States to have healthcare. I
defy one to find a serious American politician that readily admits to not
wanting American citizens to have healthcare.
If found they would be the rarest of a newly discovered species. A person may disagree with the methods of how
the Affordable Healthcare Act achieves universal coverage and changes the
American healthcare landscape AND still want to want every American to have
healthcare coverage. The only
disagreement lies in the methods used to achieve the goal of universal
healthcare, not in the end goal itself.
Therefore, in serious discussions regarding the merits of the Affordable
Healthcare Act, we can refrain from making the absurd assertion that simply
because someone disagrees with the mechanics of the Affordable Healthcare Act
they do not want people to have healthcare.
We should not mistake criticism of the means and details for rejection
of the end goal.
Another
undesirable consequence of the above described line of thinking is that it
damages uneristic debate, which is vital for a representative democracy built
with the concept of debate as a core tenant.
A functioning democracy should be able to entertain debates on the
merits of a law in a public forum.
Opposition to certain parts of a law and critiquing them in public
debate is part of American democracy and provides an avenue for dissenting
voices. Debate also allows a proposed
law to undergo the necessary criticism and revisions needed to improve the law
and reach enough of a consensus for widespread adoption. As I have witnessed often, the moment a
person makes a counter point to criticism of the workings of the Affordable
Health Care Act with the a similar comment to, “You don’t want everyone to have
healthcare,” the debate is effectively over.
In order for the political process to work in the United States in a
fashion that respects the rights of the party not in power, an avenue for
discussion and debate needs to be provided and nurtured. While many may disagree with criticism of a particular
laws merits and functional details, it is still vital to respect and provide an
avenue for the opinions of dissenters.
By denying this avenue to critics of the Affordable Healthcare Act we
are limiting our democracy. The above
point made in this paragraph applies not only to Congressional discussions, but
more importantly to interpersonal discussions between non-representative
citizens, in coffee shops, university classrooms, and other public forums found
in daily life. While seeming not as important,
one cannot dispute that the vast majority of public debate, by quantity,
happens outside of Congress and helps form the national character. Why don’t we build our national character on
a sound foundation.
Surveying
our current healthcare landscape in February of 2014 before the implantation of
the Affordable Healthcare Act, it becomes clear the United States does not
currently have a ‘healthcare system’ in the traditional sense of the word. We have a healthcare market, which entails
the benefits and costs of a market based system. Healthcare costs are set by the collective
decisions of the market participants and most healthcare infrastructure is
private. As opposed to a government run
healthcare system like Britain’s National Healthcare Service or Canada’s
healthcare system in which most infrastructure is operated by the national
government which sets prices as well. A
single payer government run system allows for price controls, but is dependent
on the competency of those public servants running the system. Generally markets respond to changing
circumstances, such as increasing pay to attract workers to jobs with
shortages, faster than government run systems and more efficiently allocate
resources.
Our healthcare market
is augmented by the practice of employer provided or subsidized healthcare
plans, which theoretically serves to partially defray the cost of healthcare to
the individual.[2] Corporations and other business have been
providing the bulk of Americans healthcare coverage since the advent of price
freezes enacted during World War II.
With millions of men under military service and government price and
wage freezes imposed by the United States government for the war effort,
business needed a way to attract and retain workers beyond the usual peacetime
practice of raising wages. The most
effective way they found was offering fringe benefits to employees, which were
not subject to limitations by the US government. One of the most popular and effective
benefits was the offering of healthcare coverage to workers. The duration of the war and the relative
strength of the United States economy which produced tremendous financial gains
for American firms[3],
made this practice ingrained in the American corporate structure and worker
expectations. This practice of employer
provided or subsidized healthcare has endured to our present day. Objectively this practice of employer
provided healthcare seems to be inefficient for corporations, workers, and
insurance providers. Providing healthcare
for workers, especially in a time period when healthcare costs are increasing
at over twice the rate of inflation, is a growing and burdensome cost for
employers, that isn’t abundantly transparent to the casual surveyor. It makes employing American workers more
costly, for example wages for the average Canadian worker are higher than wages
for the average American worker, but Canadian workers are less costly to employ
than American workers. The main culprit
for this cost differential between Canadian and American workers is the
healthcare costs associated with employing Americans. Healthcare costs are also a variable cost
largely beyond the control of employers, wage costs are much easier to plan for
and give employers total control over that expense. Adding in the historically difficult to
predict long-term cost of providing subsidizing healthcare for retired
employees, healthcare costs can become a major expenditure for employers. Providing healthcare coverage for employees
is burdensome cost for employers that make American business less competitive
in comparison to international competition who do not have to provide
healthcare for their employees.
The
employer provided healthcare system also decreases mobility within the labor
market hurting the efficiency of the American labor market by tying employees
to their current forms of employment.
Workers are less likely to take risks and leave their current jobs as
well as staying longer than is optimal because of worries about obtaining
health insurance, especially if an opportunity does not work out. Workers flexibility within the labor market
is decreased by the employer provided healthcare system as well as creating a
less dynamic labor market for employers.
Another consideration of the employer provided healthcare system
dependent on workers leaving their current jobs, affects one of the United
States great strengths, our entrepreneurs.
The prospect of losing your healthcare coverage may be a factor that
makes the decision to leave one’s current job and start a new company that much
more difficult. It may also dissuade
workers from quitting their current jobs and joining a startup company,
therefore depriving the next Google of talented employees. In short, removing the connection between
employer and healthcare will make the US labor market more dynamic and fluid,
producing a better result for employers, workers, and entrepreneurship in the
United States.
The
current[4]
healthcare market in the United States has created a bureaucratic triangle
between insurance providers, employers, and individuals which has produced an
unnecessary middle man, the employer.
Instead of a direct relationship between the average citizen and their
health insurance provider, the citizen must obtain health insurance from their
employer and negotiate through their employer.
The employer as the middle man between citizen and health insurance
provider creates more bureaucracy in an industry that is already rife with
bureaucracy and paperwork. On any level,
an extra middle man complicates the health insurance process for hard working
Americans and slows down the ability of health insurance providers to quickly
respond to the needs of the citizens they cover. To put it simply, by placing the American
business as an unnecessary middle man in our healthcare system, the United
States has made a less efficient healthcare system. A more efficient system that has a direct
relationship between insurance provider and individual reduces a middle man,
creates less bureaucracy, paper work, and makes interaction between individual
and insurance provider much easier.
Given all of this, we
are left at an impasse, do we want to keep the employer provided healthcare
system and work within it towards a solution or do we want to create a new
system independent of employers. The
authors of the Affordable Healthcare Act have clearly chosen the former path.
While containing many
significant flaws, the Affordable Healthcare Act does have several effective
functional changes worth keeping in one form or another. The advent of health insurance exchanges,
allowing young adults to stay on their parents medical insurance plans until
the age of 26, and banning health insurance providers from charging higher
premiums for those with adverse pre-existing health conditions are examples of
effective structural changes to the state of the healthcare environment in the
United States before the advent of the Affordable Healthcare Act.
The concept of creating
an exchange for healthcare plans is a very effective improvement on the current
listless state of information one finds upon undertaking to identify, let alone
research health insurance plans in our current system. Today, before the implementation of the
Affordable Healthcare Act, a prospective health insurance buyer is confronted
with the polar opposite of information transparency about health insurance
plans. One is left to one’s own devices
and must search in a healthcare world without any guiding or formal structure. The person who seeks to purchase health
insurance must peruse many health insurance company websites, make their own
comparisons, and identify as many health insurance providers as possible in a
completely diffuse, decentralized health insurance market. This daunting task is made possible by the
lack of any formal structure or regulation of the healthcare insurance market. This informal, decentralized market is highly
inefficient for disseminating information about health insurance and providing
timely and effortless connections between prospective health insurance buyers
and health insurance firms. To draw a
comparative example, imagine a world in which stock exchanges do not exist. Now one is tasked with buying stocks for a
diversified portfolio. One must identify
available stocks to buy, ascertain historical stock price movements for each
stock, calculate a rate of return on each stock, and compare stocks to each
other in a comparative analysis, all with the goal of creating a portfolio
which one can earn a return above the market return[5]. Outperforming the market is a difficult task
today even with modern stock exchanges and transparency of information, woe
betide the individual who must attempt the same task in a world without a
centralized hub of information that makes comparative analysis exponentially
easier and substantially less time consumer, i.e. a stock exchange. Given the readily apparent and truly
incredible advantages that stock exchanges provide over the alternative lack
thereof, in terms of increased information accessibility and ease of
comparative analysis, it seems quite odd that we have not utilized exchanges
for other aspect of the United States economy.
Exchanges should be a politically tolerable idea given the overwhelming wide
acceptance and use of stock exchanges. A
healthcare exchange will allow prospective health insurance buyers to more
easily discover and compare health insurance plans, making the process
substantially less time consuming.
Exchanges will bring the full effect of market forces to bear, forcing
health insurers to compete against each other, which is made much easier by the
fact that consumers can more easily compare prices. Without exchanges insurers can exploit the
lack of comparative information available to consumers to charge higher
prices.
While the idea of a
healthcare exchange is an effective one and should be adopted, the affordable
healthcare act employs the idea in such a way that it creates unnecessary and
burdensome complexities for the United States healthcare system, one of the
many flaws of the affordable healthcare act.
It is a great step that the affordable healthcare act employs exchanges
to list health insurance, the benefits have been outlined in the preceding
paragraph, but the affordable healthcare act decentralizes the exchange idea
and allows each state to construct their own exchange. Theoretically there could be 50 healthcare
exchanges across the United States, each operating independently from each
other and potentially each operating with different rules and procedures. This lack of a centralized system creates
asymmetric problems in the aggregate resulting from different policies and
rules across states. This
regionalization of healthcare has detrimental effects for labor market
flexibility and the ability of workers to relocate for new job
opportunities. Policies that apply in
certain states may not apply in other states.
Creating a centralized system for healthcare, for example a single
national exchange, would be incredibly more efficient, uniform, and support
labor market flexibility.
Another flaw keeping
the affordable healthcare act from becoming truly transformative healthcare
legislation is its acceptance and promotion of the employer provided healthcare
system and relationship. As mentioned
earlier, the employer provided healthcare system is rife with inefficiencies
and hurts labor market flexibility. In
addition, the affordable healthcare act has requirements for small business to
cover more employees, creating increased costs for small business owners and
entrepreneurs. Entrepreneurship has been
important to the economic development of the United States, creating many of
the United States’ current largest employers and providing a pathway of social
mobility for hardworking, ingenuous Americans.
The affordable healthcare act is increasing the costs of starting a
company in the United States, especially for the majority of entrepreneurs who
are not backed by millions in venture capital funding. In order to compete in an increasingly
competitive global economy, the United States will need its entrepreneurs and
needs to give them the best chance of succeeding.
The affordable
healthcare act will achieve an increase in the percentage of Americans covered
by health insurance, which is a wonderful accomplishment, but it does not at
all adequately address the increasing and projected to increase costs to the
United States government, especially considering that many of the newly insured
will be insured by and expansion of Medicare and Medicaid. Much of the projected cost savings in the
affordable healthcare act rely on projected efficiency gains in the healthcare
industry. Basing cost saving projections
on efficiency gains is a bit suspect given the historical difficulty in
predicting efficiency gains and that those gains are assumed and outside of any
control by the government. Savings by efficiency
may very well come about, but the large gains projected under the affordable
healthcare act are unreliable and seem the product of wishful thinking. In addition, the affordable healthcare act
does not address in a real way the increasing cost of healthcare to the United
States government. The cost of Medicare
and Medicaid are predicted to increase at similar rates under the affordable
healthcare act as without. The
increasing cost of healthcare entitlements to the United States government is
projected by the congressional budget office to become greater than military
spending and a drastic burden on the United States government, providing less
money to spend on education and infrastructure.
The affordable healthcare act only address one side of the healthcare
debate in the United States, increasing coverage, it would be better if it also
addressed the cost of healthcare to the United States government.
Finally, the long-term
societal impacts of the affordable healthcare act may serve to further divide
the United States. Much has been made in
the media of the wealth gap between the wealthiest and least wealthy in
American society, and more importantly the shrinking size proportionally of the
middle class creating greater class divides in the United States. While much attention is hyped for ratings,
there is a very real danger of creating a more divided society and this divide
is increasingly being defined on education lines. In an economy where agriculture and
manufacturing no longer provide a significant proportion of jobs, services and
skills become much more important.
Having a university education is increasingly important. Social scientist have identified educational
attainment as the greatest indicator of economic success, health, and living
standards in the United States. The United
States is moving towards a society that is increasingly being divided by
educational attainment. I believe the
affordable healthcare act will increase this social divide further, primarily
because it keeps the employer provided healthcare system as the primary avenue
for obtaining healthcare in the United States.
Very well educated people have better chances of obtaining jobs with
employers who will pay for high quality healthcare as a benefit. They do not have to seek health insurance
from an exchange. Those without an
education who cannot obtain a highly coveted job with a firm that provides
health insurance will be forced to seek healthcare on an exchange. Healthcare exchanges will be utilities
primarily by the uneducated. Perhaps a
stigma will evolve for those who purchase healthcare from an exchange, I hope
not. There is a real danger in the
affordable healthcare act further defining the socio-economic divide in the
United States. For those who are
concerned with the socio-economic dynamics of American society, they should
consider the social implications of the affordable healthcare act.
Given the state of
congress at the time, politically the affordable healthcare act was surely the
most feasible and less disruptive option, which is amazing given the extreme
lack of support and opposition is entailed.
American citizens, for the most part like, other country’s citizens
around the world, are uncomfortable with drastic change and adapting to a new
societal paradigm. It is unsurprising
that politicians worried about reelection prospects chose the less disruptive
and more comfortable option. The safe
approach would be appropriate if it achieved effective reform, but with the
Affordable Healthcare Act we are left without effective healthcare reform. American elected officials have chosen
comfortable mediocrity over difficult effectiveness. The American people deserve better from their
elected officials.
After highlighting the
inadequacies of the pre-Affordable Healthcare Act environment in the United
States and of the Affordable Healthcare Act in addressing the many demands of
the American healthcare landscape, I will present some ideas and the general
framework for a healthcare system that I believe will better serve the United
States. Again, these are ideas intended
more for thought and rumination than a finalized plan that is ready to be
adopted. They are too general and need
to be worked through further to be immediately actionable. Hopefully they will provide some food for
thought for the existing conversation.
As highlighted
previously, the employer provided healthcare system is inefficient and in the
guise of the affordable healthcare act may actually increase socio-economic
divisions in society. I propose
completely removing the employer provided healthcare system so that no one in
the United States will receive their healthcare from their employers. Removing the implicit obligation of employers
to provide health insurance for their employees will have the same effect as a
tax break for employers and make American workers cheaper to hire. It will make American firms more competitive
around the world because a variable cost much outside the control of the firm
is eliminated and it will make American workers more attractive to hire by
domestic and foreign firms. The benefits
to the economic competitiveness of the United States are real.
In exchange of the
employer provided healthcare system, I believe the United States should adopt a
system that brings the best of the free market and government systems
together. I propose setting up one
national healthcare exchange that every health insurance provider will be required
to list on as well as the United States government creating a government run
insurance agency that will provide multiple insurance options for those who are
priced out of the exchange.
A national healthcare
exchange is superior to collective state exchanges because it brings national market
instead of individual state market forces to bear lowering prices through
greater competition, provides better mobility in the labor market, has a set
rules and regulation system that applies throughout the entire country, and
will have more than enough participants to make the exchange viable. As discussed earlier in regards to the
current pre-affordable healthcare act system, market forces can be utilized to
great effect; competition by insurers lowers prices and markets adjust faster
to shortages or gluts in the industry as with creating higher salaries for
nurses during a time of nurse shortages.
A national healthcare exchange brings the benefits of market forces to
work in the healthcare industry. With
the majority of Americans buying their health insurance on a national exchange
instead of through their employers, market forces can still provide their
positive benefits to consumers in the healthcare industry. Also with the majority of Americans buying their
health insurance from a national exchange, it provides a much deeper pool for
the exchange than any individual state exchange could ever produce. This much much deeper pool for the national
exchange will alleviate any fears that currently exist about enough people
buying from exchanges to make them viable, after all, they will not have any
other choice but to buy from the national exchange. Also with every insurance company forced to
list on a national exchange, greater competition will be more effective in prices
than a state exchange’s capacity to lower prices.
A single national
exchange will produce the result of anyone who purchases health insurance from
the exchange operating under the same rules and regulations regardless of where
in the United States they are living when purchasing their health
insurance. This makes it much easier for
Americans to move between states when they do not have to worry about meeting
requirements or regulations for a particular state. In addition to a general uniform set of
regulations, removing the employer provided healthcare system for an exchange
will provide an environment where workers are more likely to leave existing
jobs for new ones, creating a more efficient labor market. In the current employer provided healthcare
system, employees may be reticent about quitting their jobs for new ones with
the worry of losing their health insurance. (The dilemma of paying for health
insurance when in between jobs is a real challenge and will be addressed later
in this essay) Taking a job that also includes a degree of quality of health
insurance will no longer be a consideration.
Entrepreneurs will no longer have to factor in the cost of employees
health coverage when starting the next Google or Nike and they may leave their
current occupations to start their new firms without worrying about losing
their employer provided healthcare.
(Again the dilemma of paying for their health insurance in between will
be addressed later in this essay) The
multiple benefits of utilizing a national exchange are very persuasive.
Another benefit of a
national health insurance exchange, without employer provided health insurance,
is that it does not create the necessity of requiring all citizens to have
health insurance or to fine those citizens who choose not have health insurance. Even with maintaining an employer provided health
insurance system, a national health insurance exchange will have the numbers
necessary to make it viable without fining those who choose not to have health
insurance. And with all those who previously
received their health insurance from their employers, purchasing health
insurance from the national exchange, the national exchange is further
augmented and is made even more viable.
Americans, like many in other nations, do not like to be told what to do
or to have restrictions placed on their behavior. I suspect most hostility to restrictions is
mostly philosophical in nature and not actually derived from any physical
discomfort these restrictions cause in the routine of daily life. Nonetheless, removing the requirement of
obtaining health insurance will ease opposition to healthcare reform by
removing a philosophical rallying point for the opposition.
A national health
insurance exchange will most likely succeed in lowering the prices paid by consumers
out of competition, but prices may not be low enough for every American. A person’s healthcare is too important to
leave to the market alone. Having a
healthy workforce is important to the productivity of the American
economy. I propose the United States
government create a government run health insurance company, which will offer
multiple plans, to provide health insurance for those few who are priced out of
the national healthcare exchange.
Non-government health insurance firms do not have the ability to operate
at a reduced profit or at a loss as can the United States government. The United States government can utilize
economic demographic data as well as historical price analysis of the national
health insurance exchange to set prices properly for those priced out of the
national health insurance. To qualify
for the different government health insurance plans, one will have to meet
certain income criteria, so those earning below designated income levels will
qualify for different government health insurance plans. The government will determine these income
levels from economic demographic data.
I propose the United
States government health insurance company provide at least three different
options for paid health insurance and one option that is free. The free option will be open to those earning
below a certain income threshold in order to allow only those who need it to
have access and diminish the cost to the United States government. This free option will only provide the bare
essentials of health coverage, it will not be nearly as high quality as what
one could purchase on the national health insurance exchange. This will be achieved by reducing choices. One on free government health insurance will
be able to see a doctor and get all the treatments they need, but they will not
have a choice in which doctor they are able to see. They will be assigned a doctor by their
insurance and that will be their only option, same with seeing
specialists. The free government health
insurance option will provide all the necessary care one needs, but without
choice. I liken the free option to a
used Toyota corolla. It is not flashy at
all and without creature comforts, but it is more than capable of getting one
from point A to point B. Using economic
demographic information, the United States government will price the three paid
government health insurance options and the income thresholds for each
accordingly so that they accommodate the needs of those who cannot afford to
purchase a private plan from the national health insurance exchange but earn
too much for the free government insurance options. The government insurance options are meant to
augment the health insurance exchanges and fill in the gaps at the bottom for
those priced out of the exchange.
Under this new
scenario, Medicare and Medicaid will cease to exist and their previous users
will enroll in either an insurance plan from the national health insurance
exchange or one of the government health insurance plans. The United States government forming a health
insurance company provides the government with the same negotiation power with
hospitals, doctors, and pharmaceutical providers that private health insurance
companies currently enjoy. The United
States government, backed by the taxpayers, will be able to leverage a higher
financial security rating and a nationwide pool of participants, comprised of those
utilizing government insurance plans, to negotiate great rates and conditions
for itself and its participants. By
entering the market as an insurance company, the United States government will
be able to negotiate and gain an offensive power in controlling costs that the
United States government currently does not enjoy with Medicare and
Medicaid. Within the context of
government provided healthcare, a government insurance firm operating in the
market place provides the government with the greatest ability to control
costs. We must not be under any
illusions though, creating a government health insurance company will require
the recruitment of qualified staff and the nationwide infrastructure to serve
participants and fulfill obligations and operations.
It is important to note
that there is a precedent of the United States government operating firms in
the general market place already. The
United States government operates banks and insurance firms serving military
veterans and their families. They
provide many much needed services to military veterans, from mortgages to auto
insurance. A viable precedent has been
established in the United States already.
While I believe the
general framework described above is the most efficient system for creating a
comprehensive healthcare system in the United States, it is not without its
faults. Requiring most people to
purchase their insurance from a national exchange, even with less expensive
health insurance costs as a result of the exchange, is asking most people to
pay more for their health insurance from the employer provided system. Given that firms can no longer offer health
insurance as a fringe benefit, it seems reasonable that firms would raise wages
to attract top talent and that hopefully wage increases offset the new cost of
health insurance purchased from an exchange.
This may not happen however, wage increases could not be consummate with
new health insurance costs. In all
likelihood adopting the healthcare system advocated for in this essay will
require an additional cost to most Americans.
Ideas designed to save the government in healthcare cost may actually
turn out to be more expansive than previously thought. Many who opt for government health insurance
plans may be dissatisfied with the extent of their coverage in comparison to plans
available on the national health insurance exchange. From a political feasibly standpoint,
creating a government health insurance firm may not be possible. Given the current extreme partisanship
enjoyed by both main political parties and the republican opposition to the
relatively benign affordable healthcare act, it is more likely than not that a
healthcare law with a provision for a government health insurance firm will not
come close to passing. Under any
national healthcare system there will most assuredly be very passionate and
vocal detractors, as the current pre-affordable healthcare act system and the
affordable healthcare system have experienced, but passionate dissent should
not be automatically confused with well thought out identified systemic flaws.
I believe the
national healthcare system I have outlined in this essay to be the best, most
efficient system in general that the United States could employ. I believe that it combines the best of a
market system with the best of a government provided system. Hopefully this essay will encourage
discussion on the topic of healthcare reform beyond a mere debate on the
affordable healthcare act or nothing new at all. The affordable healthcare act is an admirable
effort at healthcare reform, but I believe the United States can and must do
better.
[1] I
will endeavor to refer to the healthcare law signed into law by President Obama
in 2010 by its abbreviated title, The Affordable Healthcare Act. I will endeavor to not refer to the
Affordable Healthcare Act as ‘Obamacare.’
I will do this in order to avoid any built in hostility or admiration
the term may bring to the table. Also
because I would like to see politics become more civil and pragmatic, and less
dependent on emotive appeal, political spin, and demagoguery. When discussing the Affordable Healthcare Act
we must discuss the law on its merits from its text, not on the author or our
opinions of the author and/or the author’s political ideology, lest those
outside influences corrupt our interpretations and we become beholden to
them.
[2]
Theoretically this benefit is taken out of wages and can be used as an excuse
for not increasing wages if healthcare costs have accelerated faster than wage
growth. Under a theoretical situation,
if healthcare costs were no longer required of employers, wages would rise to
reflect this change.
[3]Especially
in comparison to war torn Europe and Japan.
There was virtually no economic rival to the immediate post United
States.
[4]
‘Current’ defined as pre-Affordable Healthcare Act implementation
[5]
Provided one can gather enough data in this neo-world without a stock exchange
to calculate the market return.
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