The Objectives of Obamacare

Ezra Klein follows up on his post from yesterday with this one. In it he argues that no one to the right of Obama has suggested an alternative. But what he means to say, is that no one on the right has suggested an alternative that meets his objectives.

He describes Obamacare as "a policy to make sure most every legal resident of the United States has access to comprehensive, affordable health care. In order to achieve that goal, it helps poorer Americans pay for insurance and regulates the products offered by insurers to make sure they’re worth paying for." I imagine that's what he (and liberals) want any alternative to do.

The problem is that this is not how non-liberals would describe Obamacare, and though that may be the goal, Obamacare does so much more than that.  I think people of all philosophies can agree on a policy to make sure most every legal resident of the United States can afford basic healthcare.  The only difference with my wording and Ezra's is that I've reduced comprehensive to basic.  Of course, this goal had already been achieved before Obamacare since anyone can get treatment in an emergency room.  That's why the Republicans haven't really proposed much in the way of alternatives, because they believed this is the important objective, and it has already been achieved.

The difference, I suppose, is that Democrats wanted to exchange basic for comprehensive. Admittedly, I'm not really sure what comprehensive means. This was something lost in the debate, as happens. It's hard for people like me to argue when we don't know exactly what we're arguing about. I would welcome a debate as to what level of care everyone should have but they're not getting.

What I gather this means for liberals is that everyone should have access to an affordable insurance plan that covers preventative medicine and any reason you may want to go to the doctor. Now, if this is really the goal, then all that has to be done is give people the subsidy to afford it. That accomplishes the access goal. But, of course, that's not where the Democrats stopped. In addition, they had to mandate a whole slew of benefits that insurance had to cover and mandated how much insurance companies could charge. If the objective was just granting access, why are regulations necessary?

Because the objective is not "granting access," the objective is remaking the health insurance industry into an industry that liberals approve of.  That industry can't charge seniors more even though they're more costly, can't charge other groups more if they're more costly, can't spend too much on administrative costs. These are all bad practices.

So the goal wasn't only to provide access, but to root out distasteful practices.  To achieve the goal stated above should be relatively simple. All Republicans would need to propose would be to keep the subsidies and cut everything else. (Guaranteed Issue would also need to be addressed, and I think state pools or national pools expressly for the uninsurable is the way to go).