Monday’s op-ed by former Senator Jim DeMint, now the president of the Heritage Foundation, likening The Affordable Care Act to the Titanic, is the height of hypocrisy. What became the ACA began its life as a market-based health insurance proposal from the Heritage Foundation itself. DeMint’s column is the equivalent of a father declaring his own child to be ugly.
My entire 37-year professional career has involved working with, for, and around the health insurance business. In all but two of those years, health care provider costs have increased, and those underlying costs have pushed up the cost of health insurance. Before the ACA, insurers could affect their profitability by carefully choosing who could buy their products. Selling only to the healthiest helped reduce the risk of claims.
Now that the ACA prohibits insurers from refusing coverage to buyers with pre-existing conditions, those insurers must look for other ways to manage their risks. Unfortunately, the solution they seem to favor is to buy each other up to reduce the competition in the market.
As most industrialized countries have learned, treating health care as a business doesn’t work because the laws of supply and demand do not apply. No one can put off treatment for an accident or serious illness until the price of the treatment comes down. When both demand and supply are inelastic, there is no market-based reason for price to come down.
The ACA is far from perfect, but it is far from being the sole cause of increased premiums and reduced coverage. Killing the ACA is the equivalent of sending a new car to the junkyard because the oil is a quart low.