There’s that word again. Unravels. A very fine title for my next book.
In WSJ, John Cochrane writes about alternatives that we should consider when Obamacare implodes (presuming, I suppose, that this is inevitable).
The unraveling of the Affordable Care Act presents a historic opportunity for change. Its proponents call it “settled law,” but as Prohibition taught us, not even a constitutional amendment is settled law—if it is dysfunctional enough, and if Americans can see a clear alternative.
This fall’s website fiasco and policy cancellations are only the beginning. Next spring the individual mandate is likely to unravel when we see how sick the people are who signed up on exchanges, and if our government really is going to penalize voters for not buying health insurance. The employer mandate and “accountable care organizations” will take their turns in the news. There will be scandals. There will be fraud. This will go on for years.
Yet opponents should not sit back and revel in dysfunction. The Affordable Care Act was enacted in response to genuine problems. Without a clear alternative, we will simply patch more, subsidize more, and ignore frauds and scandals, as we do in Medicare and other programs.
There is an alternative. A much freer market in health care and health insurance can work, can deliver high quality, technically innovative care at much lower cost, and solve the pathologies of the pre-existing system.
He is preempting the common refrain that without Obamacare, we have to go back to the bad status quo:
ObamaCare defenders say we must suffer the dysfunction and patch the law, because there is no alternative. They are wrong. On Nov. 2, for example, New York TimesNYT +0.93% columnist Nicholas Kristof wrote movingly about his friend who lost employer-based insurance and died of colon cancer. Mr. Kristof concluded, “This is why we need Obamacare.” No, this is why we need individual, portable, guaranteed-renewable, inexpensive, catastrophic-coverage insurance.
On Nov. 15, MIT’s Jonathan Gruber, an ObamaCare architect, argued on Realclearpolitics that “we currently have a highly discriminatory system where if you’re sick, if you’ve been sick or you’re going to get sick, you cannot get health insurance.” We do. He concluded that the Affordable Care Act is “the only way to end that discriminatory system.” It is not.
On Dec. 3, President Obama himself said that “the only alternative that Obamacare’s critics have, is, well, let’s just go back to the status quo.” Not so.
In related news, Karl Rove, who is still waiting on the undecided voters in Ohio to surge for Romney, fearlessly predicts that the individual mandate will be lifted in 2014.