Obamacare is a continuation of the business model for insurance

By Joseph Jarvis, M.D.
Deseret News (Salt Lake City), Oct. 4, 2013

I agree with Dan Liljenquist that the cost of Obamacare has been grossly underestimated ("Obamacare will lead to single-payer health care," Sept. 26). It is also likely that many more employees than originally predicted by the smoke and mirrors estimates offered at the time of passage of the Affordable Care Act will lose their employment-based health benefits, thus the now increasingly strident opposition of organized labor to the implementation of this legislation.

Obamacare is neither affordable nor about care. But it is also not a stepping stone to single payer, nor was it ever intended to be. Dan Liljenquist offers no facts in support of his conspiracy theory that the end goal of Obamacare is to create "single-payer, socialized health care" in this country.

Rather than taking us halfway to single payer, Obamacare is a continuation of many decades of government preference for the most wasteful health care financing scheme ever invented: the private, for-profit health insurance business model.

Both parties are responsible for the continuing dominance of this useless business model. Federal tax policies and state regulations with bipartisan support over many decades have locked Americans into buying health insurance, despite the well documented fact that the health insurance business model features $400 billion per year excess administrative costs and still fails to hold down health care price inflation.

Despite all of the incredibly wasteful claims reviews, American health insurers cannot effectively discriminate between high and low quality care. The perverse incentives of the American health care system occur because providers of care can make better margins by being reimbursed from health insurers for mediocre care. Obamacare is just one more governmental intervention on the side of the health insurers and against patients and taxpayers.

During its deliberations preceding the passage of Obamacare, Congress explicitly excluded single-payer advocates from participating in hearings. Some single-payer activists were arrested when they tried to provide testimony at a Senate Finance Committee hearing. The public option, contrary to Liljenquist’s conspiracy theory, was explicitly voted down by Congress.

Obamacare is the fruit of Obama’s deal with American health insurance interests, according to Frontline. Far from being the pathway to single payer, Obamacare is a guarantee to American health insurance that despite the massive wastefulness of its business model, American patients and taxpayers will be mandated to purchase its useless product in perpetuity.

Ultimately, the ridiculous cost of this bipartisan worship of private, for-profit health insurance will undermine Obamacare. We cannot afford to continue to outspend the rest of the industrialized world on health care nearly two to one. What cannot be, therefore, will not be.

It remains to be seen, however, whether we Americans will have the sense to ignore voices like Dan Liljenquist and stop fearing single payer soon enough to avoid a health system breakdown and the consequential economic meltdown.

Obamacare is not a halfway house to single payer. It is the full realization of the bipartisan American government support of the private, for-profit health insurance business model over many decades. Without this political support, now including a mandate to purchase this worthless product, American health insurance would not survive. No one needs health insurance.

It is time for Americans to stop fearing real change in how we do health care business. Let’s go to work replacing Obamacare with something that we really can afford. Start by looking at the solution proposed by the Utah Healthcare Initiative.

Dr. Joseph Jarvis is chairman of the Utah Healthcare Initiative.