By Megan McArdle. Excerpts:
"The rate of Americans without health-care insurance is now
within a percentage point
of where it was in the first quarter of 2008, a year before Obama took
office. Yet in 2008, the unemployment rate was more than a full
percentage point higher than it is now. Given how many people use
employer-provided health insurance, the uninsured rate ought to be
markedly lower than it was back then.
Overall, the effect of Obamacare seems to be marginal, or perhaps nonexistent.
You can chalk that up to
Republican interference,
since the uninsured rate has risen substantially in the Trump era. But
Democrats weren’t really making that argument, perhaps because they
realized that a system so vulnerable to Republican interference isn’t
really a very good system.
But even before
January 2017, Obamacare was failing to deliver on many of its key
promises. At its best point, in November 2016, the reduction in the
number of the uninsured was less than the architects of Obamacare had
expected. And the claims that Obamacare would “
bend the cost curve” had proved, let us say, excessively optimistic.
Adjusted for inflation, consumer out-of-pocket expenditures on health care have been
roughly flat
since 2007. Obamacare didn’t make them go up, but it didn’t really
reduce them, either. The rate of growth in health-services spending has
risen substantially since 2013, when Obamacare’s main provisions took
effect. And since someone has to pay for all that new spending,
premiums have also risen at about the same pace as before Obamacare. So much for saving the average American family
$2,500 a year.
Meanwhile, the various proposals that were supposed
to streamline care and improve incentives have produced fairly
underwhelming results.
Accountable-care organizations,
which aimed to reorient the system around paying for health rather than
treatment, have produced, at best, modest benefits.
Meanwhile, a
much-touted program to reduce hospital readmissions
not only failed to save money, but may also have led to thousands of unnecessary deaths."
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