Should health-care reform be repealed?

Many Republicans want to repeal the health-care legislation President Obama and Democrats passed earlier this year.

Yes: ObamaCare = higher costs and lower quality

The new health-care law’s mandates are already causing health insurance premiums to rise 3 to 9 percent more than they otherwise would. Its price controls are pushing insurers to abandon the market for child-only coverage and will soon begin rationing care to Medicare patients, partly by driving nearly 1 in 6 hospitals and other providers out of the program.

Starting in 2014, when the full law takes effect, things will get really ugly. ObamaCare’s “individual mandate” will drive premiums even higher – assuming the courts have not declared it unconstitutional, as they should. Because the penalty for violating the mandate is a fraction of those premiums, healthy people will wait until they are sick to buy coverage, driving premiums higher still. This is already happening in Massachusetts, which enacted a nearly identical law in 2006. ObamaCare’s price controls will force insurers to cover sick patients at artificially low premiums, guaranteeing that insurers will avoid, mistreat, and dump the sick, because that’s what the price controls reward. ObamaCare’s private health-insurance subsidies will expose low-wage workers to implicit tax rates higher than 100 percent, potentially trapping millions in poverty.

With real reforms like Medicare vouchers and large health savings accounts, and letting consumers purchase health insurance across state lines, a free market would reduce costs and improve quality through innovations such as integrated health systems, nurse-practitioner-staffed primary care clinics, telemedicine, and insurance that offers even sick patients a total satisfaction guarantee.

But until Congress or the courts discard ObamaCare’s mandates, price controls, and new entitlement spending, there is literally nothing that can arrest this downward spiral of rising costs and deteriorating quality.

– Michael F. Cannon, director of Health Policy Studies, Cato Institute

No: we need reform more than ever

With a sluggish economy and double-digit unemployment in some parts of the country, we can’t afford to allow millions of Americans to go without much-needed health care.

Health-care reform finally creates a level playing field where Americans will have access to health care that values quality of care, not quantity of care. It also puts into place much-needed regulations and limits on the private insurance industry. Patients will no longer be denied care simply because they had a preexisting condition. Patients who are not employed or have jobs that do not offer health insurance will not be left at the mercy of the individual health insurance market, where people purchase health insurance that does little more than provide catastrophic coverage. They will finally have choices that are affordable and easy to understand.

Health reform is also investing resources in creating jobs, training nurses and doctors, and making sure that for every dollar spent on health care, no more than 20 cents go to administrative expenses. With health reform, we are finally moving away from using paper and illegible handwriting to make our most precious health decisions.

Yet there are still those who cry for repeal. They say that health reform takes choice away and doesn’t do anything to improve health care. They want to make us succumb to an artificial fear that providing health care is somehow anti-American or anticapitalist. Somewhere in the midst of all this outrage, we are moving forward with reforms that finally benefit the people who really matter: patients and their families.

– Kavita K. Patel, director of the Health Policy Program, New America Foundation