Congress basically has a healthcare decision to make in four areas:
- Social welfare programs. Is government funding to be increased or decreased for Medicare (for the poor) or other “free” healthcare programs?
- Federal regulation of commerce. Is the government going to continue to mandate coverage and benefits or make coverage optional and plan design discretionary? (Congress needs to keep in mind that the Supreme Court decided that the individual mandate is an unconstitutional regulation of commerce, yet it was “saved” (arguably incorrectly) as a law of the land representing a “tax” on non-compliant inactivity or indecision.)
- Health plan design. Should health plans have high deductibles across the board so that premiums can be dedicated to high-dollar catastrophic care incurred by the sickest few? Or should high-cost benefits of the sickest few be dramatically cut to dedicate more premiums to lower-cost routine care and lower deductibles of the majority? Or should consumers decide what benefits they want?
- Prices charged for care. Should measures be taken to stimulate price competition among care providers (leading to free-market price reductions)?
It seems the best answer is to stimulate price competition. If the prices for care can be lowered to levels more in line with the rest of the world, then the problems of costly social programs and costly premiums begin to diminish automatically.
Health plans in any free-market cannot cover 100% of everyone’s cost of care. In fact, Obamacare’s bronze and silver plans are designed to cover only 60% and 70% of the population’s medical costs, respectively. Obamacare does not allow annual and lifetime benefit caps and mandates full coverage of high-cost benefits incurred by the sickest few. As a result, the 40% and 30% not covered by the above plans have to be paid out-of-pocket in the form of significantly increased deductibles for everyone. Before Obamacare, health plans limited high-cost benefits of the few which allowed deductibles to be lower for all.