The polls don’t lie: Things in the U.S. health care system are really bad and getting worse in at least several important ways. In a recent New York Times piece, Elisabeth Rosenthal collects data from a national NYT survey on health care costs. The results confirm what we already knew: average Americans report that their out-of-pocket expenses have gone up; they’re forced to put off doctors visits and prescription refills; they struggle with maddening amounts of paperwork; and wish doctors would tell them upfront how much their services will cost. Buried in the litany of complaints is this eyebrow-raiser:
The poll bore out readers’ experiences: Nearly half of respondents described the affordability of basic medical care as a hardship for them and their family, up 10 points from a year ago. While the Affordable Care Act has expanded insurance to millions of Americans, including those with existing conditions, it does not directly address cost. And cost is becoming increasingly problematic.
Of course, this is true. The ACA makes little provision for measures that could help bring down costs. But that is not what any advocates of the law said at the time of its passage. The law is called the Affordable Care Act, as Nancy Pelosi has reminded us, and that is not a coincidence. On the campaign trail, President Obama said, “I have made a solemn pledge that I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family’s premiums by up to $2,500 a year.” Gruber, however, has let the cat out of the bag, and now, it seems, the line is that Obamacare is only about coverage and was never about cost.This is a case of revisionism, pure and simple—and bad revisionism, at that, because even regarding coverage alone, the ACA has serious problems. But it could also very well be revisionism on a mission, because it lays the groundwork for the single-payer pivot: The ACA fixed coverage, now we need single-payer to fix costs. Here’s how the piece concludes:
There seems to be widespread agreement that medical prices are burdensome for American patients, and new solutions are needed. But will the answer be a market-based approach involving greater price transparency? More regulation, focusing on price? A government-sponsored single-payer health system, like that in Canada? Or allowing younger people to join Medicare, the popular health insurance program for seniors? Many readers surprised me by saying they could not wait to turn 65. As one reader from Texas said: “I bought medicine in Mexico for 23 years before I became eligible for the promised land of Medicare.”
Single-payer, however, failed in Vermont, and it would likely fail nationally too. We need a better health care conversation than one that recapitulates bad history in support of bad policy.