The Affordable Care Act

Considering the acrimony over Obama Care, it may be time to look at health care from a different angle. In its present form as a free enterprise model even under the ACA, the US stands way below nearly all of the developed countries in both perinatal mortality, longevity and other metrics of health and at the highest cost of any of them.

When legislators and healthcare planners decided that modern industrial practices and competition would lower HC costs and improve quality, they opened a Pandora's box of greed. For one, HC is a monopoly, even if there are x number of other competitors available. The price is not quoted and the bill comes after the service. Furthermore every new corporate and administrative layer added to the delivery of a service costs as much as the service provided. For a solution to make sense, one must acknowledge that healthcare is a vital public infrastructure necessary for our country to have a sufficiently healthy human resource to survive and compete in todays crowded world.

The simplest solution would be to eliminate all insurance and to pay the providers and institutions a fair budgeted income. Eliminating the burden of pay for service would reduce cost to a fraction of the present burden. Some administration will be necessary but the required leadership, education and accounting can be done through existing state universities and medical schools with a far greater tilt towards excellence and patient care.

Insurance companies and the Hospital Association will scream, and that may be a problem because of the amount of financial power that insurance companies can focus on retaining the status quo. High paid specialists and surgeons will resist as well.

If the ACA disappoints, there  may be an opportunity for such a revolutionary solution.