I believe the supply side of the market can accommodate a large increase in the number of insured, but only if we give them the freedom to meet the new demand efficiently.
Third, in Massachusetts we adopted the same model of managed competition that is in HillaryCare and in ObamaCare. I like the idea of people choosing among competing health plans. But under managed competition, the premium is the same for everyone, regardless of expected health care costs. That means insurers try to attract the healthy and avoid the sick. After enrollment, the health plans face perverse incentives to overprovide to the healthy (to keep the ones they have and encourage the enrollment of more just like them) and underprovide to the sick (to encourage their departure and discourage enrollment by any more of them).
A better model is the Medicare Advantage program, where seniors also have choice and competition. But in that system, the federal government goes to great lengths to try to ensure that the premium paid for each person matches as closely as possible that person's expected costs. Because the amount the government pays for each senior can differ by ten-to-one or more, insurers compete just as aggressively to enroll a cancer patient as they do to enroll a healthy patient. I believe we can do something similar for the nonelderly population.
Finally, you cannot allow people to game the system. In Massachusetts, some folks remain uninsured while they are healthy, obtain insurance after they get sick, and then drop their insurance again after they get their medical bills paid. We call these folks "jumpers and dumpers." Under ObamaCare we are about to repeat this mistake nationwide. We do not allow people to game the insurance system with impunity in other federal programs. It's not allowed in Medicare Part B, in Medigap insurance or in the Medicare drug coverage program.
Were I president of the United States, I would take these lessons to heart. I would replace ObamaCare with a workable health system — copying what works and avoiding what doesn't work, based on my experience in Massachusetts.
I believe I am the only candidate who actually knows how to do that.
John C. Goodman is President and CEO of the National Center for Policy Analysis, Senior Fellow at The Independent Institute, and author of the acclaimed book, Priceless: Curing the Healthcare Crisis. The Wall Street Journal and National Journal, among other media, have called him the "Father of Health Savings Accounts." He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system.
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