The Picture of Good Health

Ensuring Health through Family-Friendly Reform of Medical Insurance When the Obama Administration and its Democratic supporters pushed through the radical 2010 reform of medical insurance known officially as the “Patient Protection and Affordable Care Act” and unofficially as “Obamacare,” they justified their one-party revolution in insurance as a way to rein in runaway health-care costs. To be sure, health-care costs have skyrocketed in recent decades, so dramatically in fact that no clear-eyed policymaker could deny the need to address the problem. Available evidence, however, indicates that the ACA has utterly failed to contain costs.[1] But then that failure should surprise no one, for most policymakers simply do not know what good health looks like. Their ignorance reflects their overly narrow focus. The architects of the ACA can see only two fundamental realities: the individual needing health care and the government (usually the Federal government) guaranteeing that care. Everyone else—including physicians, hospitals, and private insurance companies—must bend to these two realities. These ACA designers, assert Republican critics, have failed to see how the economics of the marketplace affect health care, and in their economic blindness these designers have actually exacerbated the crisis in health-care costs while dramatically enlarging the size of government. These critics are right about how Obama and his supporters have expanded the Leviathan State. They are right, too, about the need to let the free market work. Yet Republicans have offered no satisfactory replacement. To be sure, they do advocate measures—such as block grants to the states and wider consumer choice—which would improve the health-care picture, but only at the margin.[2] But what is most inadequate about Republican criticism is that those advancing it seem generally to share with the architects of the ACA a fundamental blindness. They see, rightly enough, that O
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