Unsatisfied by the poor quality of the conversation about the Affordable Care Act, AI board member Tyler Cowen lays out five metrics that we should use to analyze its progress. A taste:
3. Given that prices in the individual insurance market already seem to have gone up 14-28 percent, and may go up more once political scrutiny of insurance companies lessens, what is the overall individual welfare calculation from this policy change? I mean using actual economic policy analysis, of the CBA sort, not just noting that more people have health insurance.4. Given supply side constraints, how much did ACA increase the consumption of health services in the United States? (I take the near-universal bafflement over the first quarter gdp revision a sign of how poorly we understand what is going on.) And how good or bad a thing is the ongoing but accelerated shift to narrow provider networks?
Ross Douthat wrote a similar post in April with a different list of three standards, which we also recommend. There is a lot of overlap between Cowen’s five and Douthat’s three metrics, as well as some differences, but these sorts of lists are sorely needed to ground the debate over the ACA. When the ACA was front and center of the national conversation, both sides shifted the grounds of the debate to frame each new event as evidence of the ACA’s success or failure. Both sides would declare victory because one or another metric seemed to be going their way, without taking a more comprehensive perspective.The ACA debate is bound to flare up again at some point, if only during the next presidential election. When it does, lists like Cowen’s will be incredibly helpful in focusing the debate around a stable set of metrics.