Wishful Thinking

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The ACA (Obamacare) was passed in 2010 and some of its provisions have been implemented without fanfare. More young adults can get coverage on their parents’ policies. Employer plans now cover those with pre-existing conditions. About half the states, including a few red states such as Ohio, accepted the offer to expand their Medicaid plans and hundreds of thousands of families have become insured this way.

Oct. 1 was the date individuals who aren’t covered by employer or government plans could begin to select from the array of privately run insurance plans. The decision to keep private companies in the system rather than go to a government run universal plan was a concession to the GOP. It was modeled after Romneycare in Massachusetts and proposals from the conservative Heritage Foundation.

The private insurers deserve some blame for the current chaos. Of the top five insurers, only Blue Cross has made a concerted effort through ads to help buyers navigate the process. It can be argued that all of them have tried to use the confusion to unload some higher risk buyers by cancelling their policies.

That said, the Obama Administration screwed up the implementation in terrible fashion and will pay for it in the 2014 election. Contrary to many suspicions, their web site was not supposed to put folks into a government run plan. It was supposed to channel individual buyers to the private sellers of insurance. Congress will now hold endless hearings to assign blame for the mess, but the real question is where do we go from here?

Some of you might want to go back to where we were five, 10, or 15 years ago. You can forget it. That model no longer exists. We may remember it fondly, but the truth is it was flawed. It didn’t cover millions of households. Costs were out of control. The insurers were pushing us all into managed care plans that lots of us didn’t like.

The Obama Administration’s alternative is to fix the computer, push forward with this uncomfortable marriage of public and private systems, and try to fine tune it as we go.

The conservatives in Congress want to repeal Obamacare but have no alternative to put in its place. And do you really trust Cong. Dana Rohrabacher and friends to fix anything this complicated?

My warning is “Beware of What You Wish For.” The real alternative is probably government run universal healthcare. Maybe expand Medicare to younger age cohorts a decade at a time.

 

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