Wednesday, November 18, 2015
Megan McArdle hates Obamacare.
That's why I was so gratified today to see her call the ACA "good insurance design" in her column, "Deductibles Are the Price You Pay for Obamacare." (Aha! I told you Obamacare was flawed!)
Let me say that again: the ACA is good insurance design. Ooh, that feels good.
I'll let you read the piece (shorter Ms. McArdle: ACA isn't perfect), but the message I received is what I've been saying all along: the Affordable Care Act was the best health care reform that could actually get passed.
And I still believe it. As far as I can tell, there are really only three choices on health care:
(1) The previous "system," which (almost) everyone agrees was a disaster;
(2) Obamacare, which only die-hard, cranky Republicans truly think is a disaster; or
(3) A single-payer system like Medicare for All, which could never, ever -- ever -- get passed in the United States. Ever.
So, really, in the Real World (the one in which Ms. McArdle and I actually live), the best alternative would be (2) Obamacare: a private insurance-based system in which more people than ever are covered at a lower-than-expected cost. Like Ms. McArdle (she's gotta be somebody's little sister), you could forever point out its flaws (nyah, nyah) or you could suggest ways to tweak it around the margins to make it better.
I hate to be the bearer of bad news for Ms. McArdle and all the other Obamacare haters out there, but the ACA is here to stay. Why? Because it's the best of all the alternatives. (Even Alabama is considering an expansion of the state's Medicaid program -- Alabama!) I've seen the various Republican "replacement" plans. And you know what? They're all like Obamacare, except not as good. And that makes sense, doesn't it? If a better plan could have been passed, it would have. To refresh your memory, the ACA passed by the skin of its teeth. I'll say it one more time: It was the best reform that could actually get passed.
Now deal with it.