5/7/15

House of Representatives passed the American Health Care Act—the first leg in the long road to “repeal and replace” the infamous ACA, AKA ObamaCare.

I am often driven to despair due to the shallowness of the public discourse on all matters in American politics, but the debate surrounding the AHCA takes the cake.

Starting from politicians, to reporters, to pundits to academics the discussion about issues of policy and politics is always shallow, full of sound bites, 90% of the time misses the point and most of the times pure wrong. Simply put, it drives me nuts!

In most cases there are one or two rays of light amongst the discourse that do a good job of providing facts, figures and proper analysis. More often than not it is the Wall Street Journal or one or two pundits (closer to one …), such as Charles Krauthammer, that provide this ray of light with good reporting by the WSJ, excellent analysis by their editorial board and interesting, correct and profound (in the good sense of the word) comments from Krauthammer.

Unfortunately, during the debate on the ACA v AHCA even these two sources disappointed.

We kept hearing analysis of the political road to passage or failure, the number of people insured, the costs of the premiums and on and on. Not once, not even a single comment was made about the fact that the AHCA (or, come to that, the ACA that it supposed to replace) is NOT about health care. Both these acts are about health EFFING INSURANCE!!!!

Now, I will concede that in order to provide good health care one has to have a good, effective health insurance market, but I will NOT concede that the measurement of whether or not the ACA or the AHCA are working to achieve this goal is in the number of people insured and/or the cost of the premiums.

If these were the correct measurements then I have a solution to the problem: let the Federal Government issue a health insurance policy to each and every person in the US for ZERO premium. Some of you may ask how this will be funded and I can assure you that is not a problem. Every policy will have an NCPA clause (to the uninitiated, NCPA stands for “No Claims Payable Absolutely.”)

There you go—everyone has coverage, it is as cheap as you can get at zero premium and it costs the government no money as it pays no claims; success, right?

This is, of course, a stupid notion, but not more stupid than measuring the success or failure of the ACA or the AHCA by measuring the number of people insured or the premiums they pay.

The ONLY relevant measurement is whether we are getting better health CARE as a result of the framework for health insurance provided by this or that Act.

I do not know the answer to this question as far as the AHCA is concerned and I have heard or read ZERO discussion on that point which is why it is so frustrating.

My view as to the effectiveness of the ACA was discussed in detail in my post “The Final Nail in Obama’s Legacy and in ObamaCare.”

In spite of an increase in the number of people insured during the period the ACA prevailed, health care during that period has deteriorated as evidenced by the decline in life expectancy during the same period.

As I said there, I may be wrong in concluding that the ACA was an abject failure. I am not a health care expert and I do not have the research resources that academics and other such people have. But do we not deserve an intelligent discussion, discourse and analysis on the status of health care in this country and the contribution that the AHCA as opposed to the ACA will make towards the goal of better health care as opposed to the continuing meaningless blabbering about the number of people insured versus the premium etc. etc.?