Re: U.S. Rep. Mike Coffman’s December column:
Mr. Coffman, I share the concerns expressed by your constituents regarding the ACA. I agree that in the wealthiest country in the world, it is reprehensible that hard-working citizens (like my sister and 2 million others) have to make a choice between financial ruin and life itself.
That being said, I find your conclusions to be disingenuous and poorly reasoned. Healthcare costs have been going through the roof for decades, way before the advent of the ACA. And the rate of increase has actually leveled since the ACA. So to allude that the ACA is somehow responsible for high costs flies in the face of the evidence. But frankly, all of this misses the point.
It’s important to ask the fundamental question, why is our healthcare so expensive and less effective than elsewhere in the world? At its root, it’s because of the perverse incentives that emerge as a result of taking the “patient-centered, market-based approach,” using your words.
These incentives emerge as a result of making the assumption that healthcare is the same as any other commodity when it comes to supply and demand. But healthcare is what economists call “price inelastic,” which means that price doesn’t drive demand. This is fundamentally because healthcare lacks the most basic characteristic of an efficient economic model: choice. When you’re faced with death or disability, choice goes out the window.
We also agree that Obamacare is not the answer, but I contend that it’s because the ACA doesn’t directly address the fundamental problem of incentives. What the ACA will do is expose the willful opacity so expertly institutionalized by a set of industries that profits mightily from such opacity. As a society we have (rightly) concluded that we’re not going to leave people to die in the street. In essence this means that healthcare is a fundamental human right as opposed to a privilege. As a society we also agree that we have the right to national security, and we all know that rights come with obligations. We live up to our national obligations by each and every one of us (who is able) pitching in for the universal good. We have a name for this: taxes.
For all these reasons and more, it is inevitable that any sustainable delivery system must preserve healthcare as a fundamental human right in a manner that rewards cost-effective outcomes.
I only hope that we collectively come to this conclusion before we throw the baby out with the bathwater.