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