Tony LoSasso, DePaul University Professor of Economics, and Kosali Simon, Indiana University Distinguished Professor of Economics, think the problem with Obamacare subsidies is their structure and not their size, and they want a shift to a Centrally Planned scheme akin to the government-approved form of competition that is the Federal Employees Health Benefits Program, wherein Government decides (still) what is a suitable subsidy and peg[s it] to a lower-cost, benchmark plan. Under this, the coverage who selects a higher-cost plan must pay the cost increment himself. That this is all too similar to Obamacare and its Bronze plan subsidization, with consumers choosing pricier options paying the difference isn’t particularly relevant here.
LoSasso and Simon are missing the beam in one eye for the mote in the other. The problem with Obamacare subsidies isn’t their size, nor is it to whom they should be sent, as some on the right are starting to propose.
The problem with Obamacare subsidies is their existence. This broad government coverage scheme of Obamacare, advertised—still!—as the Affordable Care Act, is not, never has been, and never was intended to be affordable. The Act was intended from the outset to nationalize our nation’s health care coverage industry.
The only real solution, the only one with long-term durability, is to move our health care coverage industry back to its actual health insurance roots, and then to go a few steps further. Make insurance plans entirely salable across State boundaries. What began that century or more ago in a nascent health provision and health insurance process as wholly local and completely intrastate has long since grown to nation-wide production and market facilities, and that’s readily regulable under our Constitution’s Commerce Clause. Make health insurance policies available in one State available to prospective insurees in all States. That alone will let policy costs to the insuree (premiums, co-pays/out-of-pocket caps, deductibles) go down since the insurer will have only one set of rules with which to comply rather than 51 (the States plus the Feds).
In addition, it’s necessary to take the shackles off what insurers (not government coverage purveyors) are allowed to sell and what customers, insurees, are allowed to buy. These salable policies would range, under true, unfettered by Government, competition, from the full-up policies of pre-Obamacare that covered a broad range of ails and potential ails to policies that would cover only specific or closely related ails and potential ails to everything in between, including the sale and purchase of customer-selected bundles of policies covering specific closely related ails and potential ails.
A freely competitive market with far more limited government involvement is what will drive health insurance costs down and policy quality up. And that will have an important sequela: doctor availability, even for those on the bottom economic rungs, will go up.
All of that will take taxpayers out of the business of paying for coverages that don’t apply to them, especially including those taxpayers who otherwise would eschew health insurance altogether.