Holman Jenkins writes in the Wall Street Journal, ObamaCare- Upheld and Doomed, 6/29/12


The solution is a tweak. Republicans already are lip-committed to a national health-insurance charter that allows insurers to design their own policies and market them across state lines. Republicans are also lip-committed to a tax reform to equalize the tax treatment of health care whether purchased by individuals or by employers on behalf of individuals.

Now just modify the Affordable Care Act so buying any health policy authorized by the new charter, no matter how minimalist, satisfies the employer and individual mandate.

What would follow is a boom in low-cost, high-deductible plans that leave individuals in charge of managing most their ordinary health-care costs out of pocket. Because it would be cheap, millions who would opt not to buy coverage will buy coverage. Because it will be cheap, companies will direct their low-wage and entry-level employees to this coverage.

Now these workers will be covered for serious illness or injury, getting the rest of us off the hook. As they grow older, wealthier and start families, they will choose more extensive but still rationally limited coverage. Meanwhile, the giant subsidies ObamaCare would dish out to help the middle class afford ObamaCare’s gold-plated mandatory coverage would be unneeded.

With consumers shouldering a bigger share of health expenses directly, hospital and doctors would discover the advantages of competing on price and quality. This way lies salvation. In the long run, whatever share of GDP society decides to allocate to health care, it will get its money’s worth—the fundamental problem today.

HKO comments:

In other words:

1. Allow insurance companies to compete (across state lines).

2. Remove the tax disincentives that distorts insurance creating incentives to cover non catastrophic events.

3. Allow consumers to buy the insurance they actually want (kill the mandated  overages).

That would eliminate about 2,999 pages of a 3,000 page bill.

I think it is a bit of a stretch to think this bill can be modified to fill these wishes.  Modifying this bill to reflect true free market choices would be like modifying a Ferrari to get the gas mileage of a Prius.  I am not saying it can’t be done but nobody would want the final product.  You would either have a shitty Ferrari or a a grossly overpriced Prius.  It would be far cheaper just to buy the Prius.