Yes, Obamacare creates winners and losers, but any health care system is going to do that.
I got a request the other day to talk about problems associated with Obamacare. And in all fairness there are some problems! For example, the whole website fiasco in the fall really was a problem and certain aspects Obamacare like the CLASS Act portion (covering living assistance for seniors and people with disabilities) of it, have basically been shelved.
But on broader scale this really just illuminates the reality that policy changes always end up creating winners and losers. As Paul Krugman put it the other day on his blog:
So here’s what you need to understand. The Affordable Care Act isn’t magic—it produces losers as well as winners. But it’s not black magic either, turning everyone into a loser. What the Act does is in effect to increase the burden on fortunate people—the healthy and wealthy—to lift some burdens on the less fortunate: people with chronic illnesses or other preexisting conditions, low-income workers.
Krugman is writing about how many of the anecdotes highlighted by conservative political groups have a tendency to not add up, but the broader point is true as well. Any change to the health care system is going to create winners and losers, there’s really no way around that.
Ironically, Obamacare was actually crafted to preserve the status quo as much as possible by largely retaining and building on the preexisting systems of employer based health care and state base markets for individual insurance policies. Other possibilities, like a Canadian style single payer system, would have basically bulldozed those systems and created whole new ones in their place, thus creating even more winners and losers.
Any policy reform is going to involve tradeoffs. In this case some people pay more in taxes and coverage costs while other health care providers get lower payments from the government. And in exchange more people get access to care. I think this tradeoff makes sense and is worth it. Reasonable people may disagree. But it’s silly to argue that the fact that any one person having a negative experience somehow negates the entire reform. Any change is going to produce that.
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