Health-care reform: Will it improve Americans’ lives?

One in four Americans received a free mammogram, colonoscopy, or flu shot last year, said David J. Lynch in Bloomberg Businessweek. Over 3.6 million Medicare recipients saved an average of $604 each, after the “doughnut hole” drug coverage gap was closed. And 2.5 million young Americans were able to remain on their parents’ insurance plans until their 26th birthday—all “thanks to a federal law many of them despise.” Polls show that 50 percent of Americans oppose the health-care-reform law that “Republicans deride as Obama­care,” but it has already brought benefits to millions of Americans in the two years since it became law. People with pre-existing conditions can no longer be denied health insurance, nor can insurers cut off coverage to the very sick. Doctors, hospitals, and insurers are beginning to respond to the law’s mandate that they “prevent illness rather than treat it,” and costs are already coming down. As the Supreme Court wrangles over the individual mandate at the law’s center this week, said Juan Williams in TheHill.com, it’s worth remembering why the law was passed: It will provide coverage to most of the 50 million people who currently have none. Will the law improve Americans’ lives, and will it reduce the cost of health care? “The indisputable, factual answer to both questions is yes.”

The factual answer is actually no, said Michael Tanner in NationalReview.com. Two years in, Obamacare has proven to be a “monumental failure of policy.” The Congressional Budget Office recently announced that the federal government’s cost of insuring tens of millions of additional people would top $1.76 trillion by 2022. And that’s not counting all the accounting sleights of hand Democrats built into this law. The administration hopes to offset its costs by raising the Medicare payroll tax, levying fines on uninsured individuals, and cutting Medicare payments, said Robert Samuelson in The Washington Post. But with the U.S. already running annual deficits in excess of $1 trillion, was this the time to add another massive, unpredictable, and costly government program? Clearly not. But universal health care was “Obama’s ego trip”—his presumed “path to presidential greatness.”

Whatever his motivation, said Paul Krugman in The New York Times, Obama did finally provide some protection for those who “fall through the cracks” of our current health-care system—the one in six Americans without health insurance. By 2014, insurers and the government will cover nearly everyone, and everyone will be required to buy insurance. That way, both healthy and sick people are “in the risk pool,” driving down insurance premiums for everyone. The law’s reforms are hardly perfect, said Ronald Brownstein in NationalJournal.com. But without reform, the ranks of the uninsured would top 60 million by 2020, placing an extra burden on our overstretched health-care system, which already has to absorb $43 billion in costs every year for treating the uninsured. “Ignoring them doesn’t make them go away.”

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But as with most liberal reforms, Obama­care will have “unintended consequences” that actually hurt the poor, said Avik Roy in Forbes.com. To cut health costs, the bureaucracy set up by the law will cut payments to doctors and hospitals, and punish employers for providing good benefits. As a result, wealthy people will opt out of the system and pay private doctors for “the high-quality care they crave,” while the best doctors will simply stop accepting insurance. We will wind up with a two-tier system in which people with means will buy good medical care, while those stuck in Medicaid, Medicare, and government-regulated insurance exchanges will get rushed, impersonal care based primarily on cost. Americans are right to oppose Obamacare; what we need now is a “free-market” alternative.

“I am a big fan of the free market,” said Fareed Zakaria in CNN.com, but when it comes to health care, the free market doesn’t work. People don’t make rational decisions about buying health-care coverage, since they can’t foresee when they’ll get sick, or how much coverage they’ll need. That’s why “every rich country in the world—and many not-so-rich ones—have decided that every citizen should have access to basic health care.” The single-payer systems in European nations, Taiwan, and Canada “provide universal health care at much, much lower costs than we do,” but America still views “socialized medicine” as foreign. Obama’s health-care reform is a halfway measure. Does it set up a “mixed, messy health-care system” that fixes some problems while preserving some of the flaws of the old system? Yes. Does anyone have a better solution? Not so far.