I'm no Tea Partier, but I tend to believe in limited government and lower taxes. Still, after several years of on-again, off-again thought, I've decided that health care has become a public good. Public goods require government regulation and so I've decided that I'm in favor of Obamacare. Here's why:
If you show up with a broken arm at a hospital emergency room, a doctor will fix your arm. If you don't have insurance, you'll pay out of pocket. If you can't afford to pay cash, what happens? I'll be honest, I'm no expert on health care. In fact, I totally botched my FSA savings account set-up in 2011 and accidentally gave away $400 hard-earned dollars to that great big FSA account in the sky. (Use-this-or-lose-this, jerks!) But I do know that someone pays. There's no such thing as a free cast. If not the patient or her health care insurance company, someone is paying for the doctor's time, the x-ray, the cast.
I suspect the hospital is footing the bill. To stay in business, the hospital (or health insurers or whoever is paying) must therefore charge paying customers more. This is one reason health care is expensive. (Other reasons include our insanely expensive high-tech approach to health care, the fact that we too often treat the symptom (diabetes) instead of the cause (bad diet, obesity, lack of exercise), and the fact that too many of us are a bunch of non-exercising chemical-laced lard eaters.)
It's undeniable that those with insurance are subsidizing those who can't pay their bills. That's unfair. Everyone should have health insurance so I don't have to pay for the health care of others. The only way this will happen is through an act of the government, hence Obamacare.
What about the uninsured unpoor, those who have no insurance yet can cover individual health care expenses? What happens to them in a health disaster, like a car accident or disease? If Obamacare reduces the cost of healthcare insurance*, the uninsured unpoor win twice. For them, insurance will cover routine care and disaster care at less cost than today's premium rates.
What about the rich who have insurance? Well, they have insurance, so there will be no penalty under Obamacare.
*Will Obamacare make health insurance less expensive? I think it will and here's why:
1. Obamacare makes health insurance more like a public utility. The act limits how much insurers can spend on things other than health care. It also restricts how quickly insurers can raise rates (no more than 10% a year without regulatory approval), which sounds like awfully good news to me. I believe my family's monthly insurance payment grew around 30% last year. Electricity and water are cheap and, in time, I think health care costs will fall as well. In fact, pretty much anything that becomes broadly adopted becomes more affordable.
2. Supply and demand. The supply and demand effect requires a little more thought. Sure, more customers means more demand. There are a limited number of insurers. More demand, same supply = higher prices. However! The service of health insurance is not really the same as a good, i.e. there is not a limited supply of insurance. In fact, more insured customers should actually increase the amount of insurance available. More people are healthy than unhealthy. More people are paying more than they cost.
3. Obamacare will increase competition among insurers. Okay, okay, if everyone's required to have insurance, then won't insurers make out like bandits not having to compete for customers? I don't think so. There are so many uninsured or underinsured Americans -- and so many people unsatisfied with their insurers -- that the state-run health care exchanges will give consumers the power to change insurers -- for the first time! With the option of affordable health care that's not tied to an employer, consumers will eventually be able to treat health care like car insurance. And let me tell how you excited I would be to get rid of "open season" in exchange for lizard-inspired ad campaigns.
Finally, Obamacare could mean huge savings for small businesses. As this Yale- and Harvard-educated foreign policy expert notes in this article in TIME magazine, affordable health care from exchanges may mean that employers will be able to stop offering health care coverage to employees.
I get that conservatives object to Obamacare because it's an expansion of government. That's true. It is an expansion of government. But you know what? We spend 12% of our nation's GDP on health care right now, far more than any modern industrialized nation that has some variety of national health care, and it's not like we're healthier than similar countries that spend far less.
Health care has become a public good and public goods require regulation. Obamacare means no more freeloaders, everyone paying a fair share, and a more thoughtful way to run health care.
