An Open Letter on Health Care Delivered to Representative Lynn Jenkins of Kansas
Here is the text of my letter:
February 28, 2017
Dear Representative Jenkins,
The Affordable Care Act, also known as
"Obamacare", is one of the best steps forward in American health care
in the last half-century, expanding access to health insurance and requiring
that insurers cover actual medical costs much more consistently and comprehensively
than ever before. It's true that health insurance costs and health care costs
have continued to rise, but at lower rates than before the ACA was in force.
It's true that some administrative aspects of the law have been complicated,
but any business in which for-profit entities are required to pay for services
is going to face resistance. It's also true that a majority of Americans
believe that the law needs to be 'fixed' but only a small minority actually
believe that repeal and return to pre-ACA conditions is necessary; many more
people believe that health care needs to be more
widely available, more affordable,
and that the way to achieve that is by expanding
the reach of the law, not retracting it.
The biggest barrier to full access and reasonable costs that
the American health care system faces is profits. Insurance company profits
come from shortchanging customers, and health care profits come from
overcharging customers. Neither of those are going to change without legal
protections for health care consumers, which is to say, people. Those
protections must come in two forms: legal requirements that insurance cover the
full range of health care issues, and accountability for both insurance
companies and health care providers. I'm not talking about price comparisons:
health care isn't a television or car, but a fundamental necessity; people
can't be required to know more than doctors and accountants to navigate the
system. Having local officials makes the system more responsive to local needs:
this is why state-level regulation needs to be maintained.
Medicare and Medicaid are very efficient systems for
providing health insurance, and Americans deserve the widest possible access to
those services. Spending on non-profit insurance and health care systems has a
massive stimulating effect on the economy, supporting jobs, helping people to
maintain their employment, shifting spending away from administrative excesses
towards productive services and consumption. Expanding health insurance access so
that it's portable and reliable and affordable also has a stimulating effect on
the economy, empowering entrepreneurship, business creation, artistic ambition.
Expanding health insurance access so that people with existing medical
conditions can maintain health care access saves money in the long run, and
saves lives.
Health care is like education: it's a social good that looks
like a private good, and an expensive thing that pays for itself in economic
growth and social success. Health care spending is a lot like education
spending: comprehensive systems run by serious professionals who are dedicated
to the success of their patients/students work better than systems seeking
profit. There are ways in which both education and health care could be improved,
but making them better for investors and speculators is not one of them.
Respectfully,
Jonathan and Anna Dresner