It is important not to confuse opposition to the Affordable Care Act with general dismissal of the legislation's centrally stated goals. To be clear, both opponents and supporters of the bill agree with its intentions - to expand health care coverage and access to those who are currently uninsured, to lower costs and to increase the overall quality of care. The point here is not about who cares for the poor and elderly the most, but about how we as a nation can best go about solving the problem.
It is undeniable that the president's health care law expands coverage to 30 million previously uninsured Americans. But is the president's prescription sustainable? The ACA's fundamental problem is that it seeks to apply the Band-Aid of bigger government to what is a complex and interconnected web of economic decision-makers. The government mandates in the ACA do nothing to prevent the covered patient from going to see a physician whenever they so much as sneeze, and they do nothing to finance the ballooning costs that these decisions perpetuate. Unless we repeal the ACA and retool our approach to develop a fundamental overhaul of the system, we risk leaving ourselves with a costly piecemeal quick fix to problems that cannot simply be bought off or solved through more taxes.
So, what does a better approach look like? For starters, it involves admitting the that the health care system functions largely as a market. A sensible and more sustainable alternative to the ACA should focus on altering the incentives within this system and solving its structural ills, rather than taking it over entirely. Transparent health exchanges and performance-based metrics for hospitals and insurance companies would be steps to better inform patients and drive down costs. Cost-sharing mechanisms can encourage patients to only seek care when they are certain they need it. Finally, tort reform in the area of medical malpractice would limit the incidence of defensive medicine. Unless we focus on the incentives people face, we will be stuck putting an expensive Band-Aid on a broken arm.
