Maryland’s ACA exchange paid $65 million to a contractor outside of the normal procurement process and it is deemed a huge failure. While they are only at half of the goal of 77,600 enrolled by the end of the month only 20,000 of the 38,070 enrolled have actually made a premium payment. With a cost of $200 million that is about $10,000 per paid enrollee just for the cost of the exchange.

A Failed Exchange

Proponents of single payer centrally controlled health care often criticize the current system because of the inherent cost of the profit which they contend has no place in the health care market. But to contend that profit serves the market for health care poorly while it serves the delivery of almost every other product and service well is to misunderstand the nature of profit and its function.

In a competitive world profits drive costs down. In the absence of profits there is little to control the costs that become the tool of political self-interests and enlightened elites. If there is not room for profits in health care where is the room for obscene ineffective administrative bloat, and the damage to the health care market done by this arrogant and disastrous plan. Now a whole other level of expense is added to the cost of insurance and the cost of health care itself.

Moving economic decisions to a central authority does not remove the tough economic decisions; it just puts them in the hands of someone you do not get to choose. It removes the consumer’s voice.

While Maryland may be worse than other state exchanges it does illustrate that exchanging profit for cronyism and elitist arrogance does not reduce cost and likely increases it while delivering an inferior product for most of the consumers.

There were and are problems in the health care market, and there are also big problems in the government controlled portion of this market. The question is not whether the government or the market will make bigger or more frequent mistakes, but which one will correct mistakes and market dislocations quicker, and which one will be held more accountable.

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