(See September 20, 2011 post)
1. Because vouchers would cover everyone.
The major purpose of the Affordable Care Act was to get more people covered by health insurance. It employs a number of elaborate measures (with lots of rules and regulations that can't be mentioned here), but it still won't cover everyone.
The Republican plan to replace the ACA would also encourage health insurance. But with no penalties for going without insurance, it wouldn't cover as many as the ACA.
People facing large medical expenses, but who don't have health insurance for whatever reason, have various options (not necessarily considered in this order):
1. Because vouchers would cover everyone.
The major purpose of the Affordable Care Act was to get more people covered by health insurance. It employs a number of elaborate measures (with lots of rules and regulations that can't be mentioned here), but it still won't cover everyone.
The Republican plan to replace the ACA would also encourage health insurance. But with no penalties for going without insurance, it wouldn't cover as many as the ACA.
People facing large medical expenses, but who don't have health insurance for whatever reason, have various options (not necessarily considered in this order):
- Go without medical treatment.
- Use savings, maybe including retirement funds.
- Sell assets -- business property, houses, cars, personal property, anything of value.
- Appeal to charity.
- Go into debt (possibly resulting in bankruptcy).
- Go on Medicaid, after personal resources are depleted.
I think most people would be glad if they had health insurance for themselves, and would be glad if they knew that everyone else had it too.
2. Because vouchers would help control costs.
Vouchers are limited by their nature. They will introduce a lot of effort to get as much value as possible from the funds available. Annual increases will be subject to deliberate controls.
Vouchers would be a big change from the current system where more expensive insurance gets bigger tax breaks and subsidies. Generous insurance coverage results in overpricing of medical services, and in overuse of services, especially those that are more expensive and/or of unproven or marginal value. So medical spending goes up, insurance premiums go up, and tax breaks and subsidies go up, in a vicious cycle.
2. Because vouchers would help control costs.
Vouchers are limited by their nature. They will introduce a lot of effort to get as much value as possible from the funds available. Annual increases will be subject to deliberate controls.
Vouchers would be a big change from the current system where more expensive insurance gets bigger tax breaks and subsidies. Generous insurance coverage results in overpricing of medical services, and in overuse of services, especially those that are more expensive and/or of unproven or marginal value. So medical spending goes up, insurance premiums go up, and tax breaks and subsidies go up, in a vicious cycle.
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