More Americans than name affordability as the most important problem with America’s healthcare system than at any other time in the last decade, according to a new Gallup survey, likely reflecting the impact of decades of cost inflation in healthcare and several years of steep premium hikes in the Obamacare exchanges.
Throughout President Obama’s first term, as the above chart shows, Americans were more worried about access to healthcare than the price tag. The Affordable Care Act mainly addressed the former issue: By expanding Medicaid, subsidizing private healthcare purchases, and mandating that insurance plans offer comprehensive coverage, the law expanded access significantly. But subsidies, mandates, and regulations also reduced competition in the healthcare sector and contributed to rising costs, forcing many middle-class families to pay much more for their coverage. Since 2012, as Obamacare began to take effect and the economy improved, Americans have grown less concerned about healthcare access and increasingly concerned about affordability.
The next administration and Congress should put the access question temporarily on hold and adopt a laser-like focus on bringing healthcare costs down overall. That means opening up competition among insurance companies by allowing them to offer a wider range of plans, arresting or reversing the trend toward hospital consolidation, and making a full-court press to apply the gains of the information revolution to the healthcare sector. Because in the long run, as we like to say, affordability is access, and leveraging the market to slow healthcare inflation so that care is increasingly affordable for a growing middle class is a better approach to health reform than simply expanding ever-more expensive care with a growing array of subsidies and mandates.