The Affordable Care Act, better known as Obamacare, is also well-known for the trouble it keeps getting into. The most recent chapter could be the next to last.
Big insurance companies, thinking there are better ways to make necessary profits than by losing money, are saying goodbye to the program’s exchanges. This and others departing could make the program collapse, and some of the remedies being floated about could make it even less sustainable.
In a way, all this should be no surprise. The overriding issue plaguing these companies, the exchanges and those in the program has been there from the start. It is the idea of an all-encompassing, enormous, comprehensive project making sure all of us are in health care heaven.
What President Barack Obama and the other founders wanted was not some cautious outing in which particular problems were cautiously but reliably solved on an individual basis. They wanted to revamp pretty much everything in a hurry, and there is a problem.
The human intellect is not up to it.
It is difficult to know the consequences of any act we undertake, even something simple, such as driving home from a movie. There could be an accident or a heart attack or a road could be closed and on and on. When you decide to reframe virtually the whole works in a system constituting a sixth of the economy in a continental nation of 300 million people, you are dealing with something complex almost beyond imagining.
Central-planning hubris was nonetheless riding high in hatching the plan, and lawmakers and bureaucrats didn’t think there was a detail they could not manage. Thus we got 2,000 pages of law and 10,000 pages of regulations and one mistake after another, from computer confusion to language that apparently did not mean what it said to reinventions of the free market system that were not free and did not work.
As an instance of big brains doing dumb things, our D.C. superiors redefined insurance from a guarantee of money if something goes awry with one’s health to a guarantee of money if something is already awry. If they were working on fire insurance, they would have said you can buy it and cash it in after your house had already burned to the ground.
Yes, we needed to find a way to help the uninsured with threatening preconditions. Unfortunately, the way the Democrats did it made insurance companies depend on unusually huge numbers of young, healthy individuals signing up for Obamacare to compensate for all those who were already sick. It has not worked out so well. Despite penalties, too many of the healthy are staying away from insurance policies irksome in a host of ways.
What this means is that, even with government subsidies, the insurance companies dish out more money than they take in and turn to sky-high deductibles and ever heftier premiums that do still more to keep the healthy at bay. Finally, opting for survival, they skedaddle from the program.
Defending the program as a whole, some say it was, after all, a huge accomplishment to finally insure 20 million of a planned 50 million uninsured Americans. But given the flimsy structure, that could mean now you see it, now you don’t.
A favored remedy of the left amounts to assisted suicide for the economy. These folks cheer for a single-payer system — something like Medicare for everyone — that would cost the government trillions on top of entitlement programs that are already set to crush us in not too many more years minus readjustments.
Other plans have issues, too, and what is needed is gradual repeal and replacement by means of legislative prudence — one small step at a time, building on what works and discarding what doesn’t. A comprehensive, all-at-once junking of Obamacare could be as bad as its comprehensive creation. There are lots of good ideas around, but Congress should proceed slowly and carefully.
Jay Ambrose is an op-ed columnist for Tribune News Service. Readers may email him at [email protected].
