Addressing health care after the Affordable Care Act

Tevi D. Troy, PhD

Synesis: A Journal of Science, Technology, Ethics, and Policy 2011; 2:G39-43

Upon taking office, President Obama sought to address the myriad problems of the American health care system: an increasing percentage of GDP spent on health care, an inefficient market, and equity concerns. The issues raised have led to increased discussion of whether access to health care is a right, and what should be done about it. While health care may be a right in the sense that one cannot survive without it, it may be better described as a good, and public policy should address distribution of that good in the best possible way(s). While markets provide a viable distribution system, a variety of distortions in the US system, including heavy governmental involvement, create market failures that impede fitting health care into a traditional economic model. The new Health Care law goes beyond this concession, employing a mandate for all individuals to purchase health coverage, as well as imposing taxes upon employers who do not provide coverage for their employees, pharmaceutical and medical device companies, and tanning services, among other things. One significant problem with the new law is that companies may actually save more by choosing not to provide health coverage for their employees and incurring the specified fine. This essay posits that a different approach may be needed that provides more incentives for individuals to make smart health care choices, the decreases of defensive medicine practice allows cross-border purchase of insurance, and provides greater access to information.

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Key words: health care reform, health insurance, Patient Protection and Affordable Care Act, market failure