The problems with the ACA (Obamacare) website illustrate our convoluted, fragmented, overly expensive, and unequal health insurance system. The ACA has some long overdue reforms — the elimination of pre-existing conditions and very large deductibles and setting an annual cap of out-of-pocket costs. However, this is still an inefficient and cumbersome private insurance-based system that will still leave millions without coverage.
The simplest and most efficient way to cover all Americans would have been to extend Medicare to everyone. Not only are Medicare’s administrative costs negligible compared to the private health insurance industry, the risk factor per capita would have been greatly reduced by including a younger and healthier portion of the population. Further savings would include elimination of huge hospital billing departments and allow doctors in private practice to see more patients instead of interfacing with insurance companies.
Thanks to the health insurance industry lobby and its congressional allies, such as Rep. Paul Ryan of Wisconsin, this simple fix, essentially a single-payer system, was never going to happen. At least here in Vermont, we have a chance to have such a universal plan with Act 48 in 2017.
JERRY KILCOURSE
Montpelier