The Patient Protection and Affordable Care Act: A Dissenting Opinion
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POLICY DEBATE
The Patient Protection and Affordable Care Act: A Dissenting Opinion Michael Tanner
Published online: 3 February 2013 Springer Science+Business Media New York 2013
Abstract This paper asks whether the Patient Protection and Affordable Care Act achieves its goals of significantly expanding health insurance coverage, while reducing costs and increasing the quality of the care provided. An examination of the early results and current future projections suggests that while PPACA will increase the number of Americans with health insurance, it will fall significantly short of universal coverage. In addition, PPACA fails to control health care costs, and will likely result in higher costs for government, as well as many businesses, and individuals. The author concludes that PPACA is not the most effective vehicle for achieving US health care reform, and that a more market-oriented approach offers a better alternative. Keywords PPACA Health Care Reform Patient Protection and Affordable Care Act
The US Supreme Court has now upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). But, constitutional does not mean wise public policy. As Chief Justice John Roberts noted in his decision (National Federation v. Sebelius 2012, p. 2), the Court did ‘‘not consider whether the Act embodies sound policies.’’ The larger debate over whether PPACA represents the best approach to US health care reform remains as important as it was before the court’s decision. PPACA was intended to accomplish three things: (1) provide health insurance coverage for all, (2) reduce insurance costs for individuals, businesses, and government, and (3) increase the quality of health care and the M. Tanner (&) Cato Institute, Washington, DC, USA e-mail: [email protected]
value received for each dollar of health care spending. At the same time, the President and the law’s supporters in Congress also promised that the legislation would not increase the federal budget deficit or unduly burden the economy. And it would do all these things while letting those of us who are happy with our current health insurance to keep it unchanged. Three years in, there are serious questions about each of these, issues which critics of the legislation would suggest pose serious problems for taxpayers, providers, and patients. The remainder of the paper is organized as follows. First, I reflect on the failure of PPACA to include serious cost-control measures. Second, I look at the effects on insurance premiums and current coverage. I argue that a large number of American families will end-up paying more in insurance premiums than now, and note that, despite the underlying initial promises, millions of Americans will not be able to keep their current health insurance coverage. I then consider the likelihood that PPACA will slow the economic growth and, thus, increase unemployment in the future. I go on to show that the law will not come close to achieving universal coverage, which was one of its original intents, and discuss a b
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