Kevin Drum provides a perfect example of the extremely generous curve by which many Democratic commentaries are grading the Affordable Care Act. After pointing out things didn’t end up as bad as Republicans claimed it would, he concludes:
Yep. It’s time to stop arguing over minutiae. Fundamentally, Obamacare “works.” It’s not perfect, but after nine months we can now say that it does indeed provide health coverage to the poor and the working-class in a reasonably efficient manner, and it does this largely by a combination of taxing and/or reducing payments to the relatively well off.
Unless there is a new definition of “reasonably” I’m not aware of, this is pure nonsense.
The ACA was designed to be mostly just an expansion of our current health insurance system which helped more people buy private coverage. As we just saw, that system costs over twice as much as other countries’ health care systems, countries which have even better health outcomes. Paying over twice as much for a worse product is nowhere near efficient. The government and regular people are dramatically overpaying for insurance on the exchanges compared to any other first world country. In fact, the argument could be made the the exchanges portion of the ACA is one of the least efficient large government programs currently in existence.
One can try to argue the law is a net positive, worth the corrupt compromises needed to secure its passage, or working mostly as it was designed. What you can’t legitimately argue is that it is “reasonably efficient.” At some point the country is going to need to deal with how seriously inefficient our entire health care system is, include the parts aided by the ACA. Pretending the ACA is in any way efficient will just delay the desperately need conversation.
Photo by 401k 2012 under Creative Commons license