Real Problems With Healthcare Are Getting Lost In The Shuffle

Healthcare Shuffle

 
No one really knows how the Supreme Court will rule on the Affordable Care Act (Obamacare) later this year and the consequent affects this ruling will have on healthcare. Three days of oral arguments does demonstrate the significance of healthcare problems in the United States. The Supreme Court Justices certainly recognize this problem and devoted time to sifting through the major legal questions of Obamacare.
 
There was a lot of discussion inside and outside of the Court regarding the Commerce Clause and how Congress could potentially regulate individual behavior should the healthcare law be upheld as Constitutional. Many of the arguments took regulatory oversight to extreme examples, such as a legal mandate to buy broccoli. Additionally, a great deal of time was devoted to whether the entire healthcare law or just portions of it should be overturned and/or upheld.
 
It’s amazing that very little discussion centered around the major issues that actually matter to Americans when it comes to healthcare. Americans want lower costs and improved quality in healthcare.
 
Will the Affordable Care Act actually reduce costs? How will it improve the quality of healthcare? The focus became more about providing healthcare for more people, but that doesn’t really do much to address cost and quality. More people using something in no way guarantees it will become cheaper, nor does it automatically lead to improved quality. Healthcare is no different from gasoline consumption in this regard.
 
A strong argument could be made (although it hasn’t been put forward by too many people lately) that an individual mandate for healthcare could reduce costs much the same way that a mandate to have automobile insurance has reduced costs.
 
Of course this argument fails to recognize the differences in regulation between healthcare and automobile insurance. Each market is regulated differently. Automobile insurance providers have a much greater ability to provide coverage options across individual states and consumers can freely choose between a multitude of providers all over the United States.
 

Unresolved Healthcare Questions

Individual state requirements and standards for healthcare are much more varied. To add an additional level of complexity, there are numerous federal requirements relating to Medicare and Medicaid as well. It remains to be seen how healthcare insurance providers would negotiate state and federal requirements across state lines. Would a person living in New Jersey, for example, be able to easily compare healthcare options provided by companies operating out of California or Florida?
 
What about quality? Quality has a very close relationship to choice. Healthcare is no exception. If people were required by an individual mandate to purchase healthcare insurance would they also be able to choose their actual providers of healthcare as well? What sort of specific relationships would be established between healthcare insurance providers and hospitals, doctor’s offices and other medical service providers?
 
If the goal of reducing costs is finally met the problem of getting quality healthcare could still remain. More federal mandates and regulation rarely leads to greater efficiency. Of course quality and efficiency are not always the same thing. In this case, however, quality and efficiency relate to choice very strongly.
 

Healthcare Problems Will Still Remain

It may well turn out that only medical facilities and healthcare insurance providers that are able to meet all federal and state regulations would be eligible to provide healthcare options. The list of eligible healthcare providers could grow very small at this point. This situation would lead to a bottleneck of providers faced with serving a very large number of people needing healthcare. How long would waiting lists become at that point? How would medical providers and government officials negotiate prioritizing of healthcare services?
 
Few, if any, of these questions have been seriously discussed recently. Regardless of how the Supreme Court rules, the problem of healthcare will be far from solved.