Markets and choice

The Republicans have now unveiled the skeleton of their Health plan. It is clear that the guiding principle is not providing decent health care for all of our citizens in the most efficient manner. The guiding principle is conservative political ideology that overrides all other considerations. They continue to promote the fantasy that markets with less or no governmental oversight or participation provide the best solution. They have been saying this from the time that Ronald Reagan said that Medicare would destroy the American healthcare system.

For markets to function efficiently conditions must be met. Knowledge on the part of all participants must be symmetrical, users must be rational maximizer's in the markets cannot be highly concentrated. These are minimal requirements and the market for health care, and for that matter health insurance, do not have these characteristics. The market for health insurance is highly concentrated and is at the least oligopolistic. There is no reason for large insurers to compete. Opening markets across state lines only creates an allusion of more competition. There can be competition at the provider level at least in highly populated areas but the republican proposals do nothing to promote this. The insurance funding model is a dinosaur and only adds an unnecessary additional expense to the healthcare system.

The Republican" Choice "is similarly an illusion. Too many of our citizens cannot" Choose" good healthcare because they will not be able to afford it. The question that the Republicans refuse to address is a simple one." Do we as a country and a society want to commit to providing a reasonable level of healthcare,  including preventative healthcare, for all of our citizens"? The Republican answer is only if they can afford it. If the Republicans wanted our citizens to have a real choice, they would allow those citizens to have the choice between the Republican plans or a participation in what is essentially Medicare by way of the public option. All our citizens would be given the choice between the grim reality of the Republican political ideological approach to healthcare or more Government participation. To prevent this option from being gamed, individuals would have a limited amount of time to choose the public option instead of waiting until they were older and sicker.

As imperfect as it was, the affordable care act accomplish two things. It got rid of the uninsurable's and recognized the need for greater governmental subsidies. The republicans have spent the last six years sabotaging that act by among other things refusing to fund the provisions that would compensate insurance companies for insuring those with preexisting conditions and refusing Medicare expansion at the state level. The Republicans now claim the affordable care act can't work after spending six years doing everything in their power to make that true. The Republicans now want to take a giant step backward. They will disadvantage those who need help the most purely for the promotion of political ideology. A measure of the morality of a political and economic system is how it treats those most vulnerable and unable to fend for themselves. On this basis, what the Republicans are proposing is despicable.