Readers Respond

Fixing Obamacare

Now come claims that health care costs are soaring and thus Obamacare is a failure ("Trump says Obamacare is 'blowing up' after gloomy report," Oct. 25). The claim is that the price of health care insurance will rise 22 percent to 25 percent in the coming year.

So let's do a little research. First, this is a projection. Projections like this have historically been high. Why? Because that helps insurance companies make their case when they go before state Insurance commissioners to request rate hikes.


Next, a little perspective is due. According to the Center for Medicare and Medicaid Services, in the eight years before the Affordable Care Act went into effect, costs were rising 6 percent to 7 percent annually. Since the ACA, the growth rate has been reduced to an average of 3 percent to 4 percent annually. That is a significant bending of that cost curve. I saw those unsustainable rises up close and personal. I sat on a body that reviewed cost of health care for employees. The premiums were rising at least 10 percent every year.

Now let's look at what we are getting for our health care dollars. Of the top 10 industrialized countries in the world, we are spending much more of our gross domestic product on health care than anyone. We spend 17.1 percent of our GDP on health care. The next highest is France at 11.3 percent. We spend 50 percent more of our GDP on health care than the next highest! What do we get? Well, according to Commonwealth Fund research, of those 10 countries we don't do so hot. In safety, we stand seventh. In efficiency, tenth. In effectiveness, we are fifth. And in that old saw about wait time (timeliness), we stand an inglorious fifth. Not much bang for our buck.


Now back to the projected rise in cost for next year. Again, the rise in cost since Obamacare was enacted has slowed significantly. Even noting the reason for why the projection is high coming as it does from insurance companies, let's stipulate that the rise will be higher than in previous years. The question then occurs as to why the costs are rising. The reason is predominantly that not enough younger people have signed up and are opting to pay a tax instead of getting health insurance. That makes the total pool of those insured older and statistically less healthy and in need of medical services.

What to do? Three things. Increase competition among insurers by offering a public option and allow access to insurance across state lines.

But the main and simplest action to take is to change one number in current law. That is to change the age of eligibility for Medicare from 65 to 55. This would simultaneously help Medicare's bottom line as well as that on health care for the rest of the population. Lowering the age of eligibility would add 20 million new premium paying, statistically more healthy subscribers to Medicare rolls. That relatively healthier cohort would require less in services. Thus, more premium dollars into the system and less expenditures out. Voila! Improved solvency! For the rest of the population, removing those 20 million relatively older and thus less healthy from those rolls would mean less services required for that cohort. Voila! Lowered cost for those covered by Obamacare.

It is time for a rational discussion on this, not just the bombast of "repeal and replace" that would mean 20 million people would have their newly-gained health insurance ripped away. You remember those people who before Obamacare could not get insurance at all.

Mel Mintz, Pikesville