The Affordable Care Act (aka Obamacare) is now in place and ruled constitutional in a surprise Supreme Court decision last June. Since it is now officially the law of the land it is important to examine how this will affect the US and it's citizens. Noted economist, Thomas Sowell, often states that the ends that legislation aims for are not as important as the incentives it creates because the change in behavior and restrictions that is creates is the substantive effect.
To examine the law scientifically, you must first state what the goals of the law are, how it affects individual freedom, and what the incentives it creates that could ultimately be the lasting legacy of the law. The endangered species act is a prime example of the dangers of ignoring the unintended consequences of a policy. It shows that land owner commonly killed off endangered species at a higher rate to keep them from using their land as a habitat and thus lowering the land value.
So what are the goals of the ACA? The answer to this question could be different depending on the individual asked. To pinpoint the goals of the ACA, it is best to base it on the aims of the writers of the law and on the law that it was based upon (i.e. the Massachusetts Healthcare Law). the following are the goals of the plan as per the writers of the ACA and the Massachusetts law.
- Affordability of healthcare: The number one issue in the healthcare debate is the affordability of care for everyone and especially the poor and low middle income citizens (and illegal immigrants). It is undeniable that the cost of healthcare has skyrocketed in recent decades and easily outpaced inflation. The costs of purchasing healthcare are an major concern facing Americans and thus should be a central focus of any future policy.
- Access to Healthcare: Access to healthcare can be defined in a couple of ways. First, there are areas where their isn't enough physicians to effectively treat the populations that they serve. This could be a question of the pure number of physicians or a question of the type of care offered. There is also a question that links affordability of healthcare to access. Whether this is the correct framing of the issue is debatable and will be covered in further posts.
- Quality and expediency of Healthcare: The quality of care is directly related to the mechanism that provides the care. This is also a highly subjective measure that can really only be judged by the individual with a historical context of their own care. Everyone has standards for the care that they need and the services they want. A more objective way to measure this would be the effectiveness of care and the cure and survival rates of commonly encountered afflictions. The higher survival rate, the more effective the care must be. This measure must also be used in conjunction with the satisfaction surveys of healthcare professionals and their patients.
- Effect on personal freedom and liberty: Above all, the government must not and can not enact legislation that violates the supreme law of the land, the Constitution. This means that the fundamental rights of an individual can not be infringed upon with out just and due process in response to a violation of the law. The health and security of our free union rests on our ability to protect the individual liberty and freedom of every citizen. The litmus test for this measure is usually the Supreme Court but due to the controversial nature of the challenge of this law, it may not be clear in this situation.
