That’s the conclusion Steffie Woolhandler, Benjamin Day, and David Himmelstein have reached. Why? Because Romneycare expanded coverage to everyone while making no serious adjustments to the other dynamics that affect cost. The inevitable result was a fiscal runaway train:
In sum, neither government, nor employers, nor the uninsured themselves have pockets deep enough to sustain coverage expansion in the face of rising costs.
Being single-payer zealots (they are founding members of the advocacy group PNHP), Woolhandler, Day, and Himmelstein offer a predictable solution—-a wholesale government takeover of the health care finance system:
We remain convinced that more radical reforms can simultaneously expand coverage and control costs. A shift from our complex and fragmented payment system to a simple single-payer approach could save about 14.3% of total health spending …
Anyone who deals with our proto-single-payer system, Medicare, knows that it is anything but “simple.” In fact, its rules are so Byzantine that they fill 120,000 largely undeciperable pages.
Arnold Kling has a much more sensible idea. Try the Woolhandler single-payer approach in a few states while simultaneously trying the free market approach in other states.
I would like to see [single-payer] tried, but only in some states. I would like to see other states try radical health reform of the opposite kind, with health insurance deregulated and major rollbacks of licensing requirements. Then we’ll see which performs better over the long term.
My bet is that Kling’s model would beat the stuffings out of the Woolhandler model. Meanwhile, it will be interesting to see if the “news” media and the “progressive” blogosphere continue to pretend Romneycare is a success.
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