The Affordable Care Act was sold as a way to solve both problems. What it really does, though, is extend, sloppily and expensively, a right to health insurance to all. It’s a law that deals with the universality problem, not the spending problem. The cost-cutting measures it does contain are mainly experiments that will take years to evaluate. Yes, the rate of growth in health care costs has remained stable for the last three years. But that is more likely the result of the recession, and of experiments in private networks, which began before Obama-care. Most of Obama-care has yet to take effect. The problem of rising health costs remains.
And liberals are noticing. In January, David Goldhill, a Democratic business executive, published a book-length treatment of American health care that concludes, “Nothing in the [Affordable Care Act] changes the fundamental incentives that have so warped our health care system.” In late February, CNN pundit and Democratic strategist Donna Brazile tweeted: “Just got off the phone with my health care provider asking them to explain why my premium jumped up. No good answer!” Later that month, journalist Steven Brill published an article in Time magazine investigating the high price of health care and criticizing the Affordable Care Act.
Expect the grumbling to become more pronounced as the administration struggles to implement Obama-care. The 2014 deadline for the individual mandate and state- and federal-based health insurance exchanges is looming, and there is no guarantee the government will meet it. We may be better off if it doesn’t. What might happen, for instance, if universal coverage is not achieved despite the mandate? What might happen if employers slough employees off to the exchanges? If costs rise as demand increases? Imagine what Donna Brazile will be tweeting then.