By Kenneth G. Crosby


OBAMACAREObamacare is, as conservatives claim, a bad law--but not for the reason they give: government takeover of health care. It is a bad law for precisely the opposite reason: it relies on free-market capitalism to provide access to health care for everyone, which free-market capitalism cannot do.

Health care insurers in free-market capitalism have only one objective: to make money. Such access to health care as they provide is merely their means of making money. (Providing health care for profit is why such care in the U.S. costs so much more than care in other countries, without producing better results: unnecessary but profitable diagnostic and treatment procedures are used just to make money.)

The niece of a friend has been condemned to death by her health insurance company. The company was interested only in collecting as much as possible in premiums and paying out as little as possible for care. Having reached the point at which her care is costing too much, it refuses to provide the care that she needs to stay alive.

Former U.S. vice president Richard Cheney recently told a TV interviewer that there was nothing unique about the health care, including a heart transplant, that he had received, at an unusually advanced age and at public expense: “anyone can receive it.” That was a lie. News media briefly reported last year the deaths of much younger Medicaid patients in Arizona because the state claimed that it didn’t have the funds to pay for the transplants they needed.

The Speaker of the U.S. House of Representatives recently declared yet again that “the U.S. has the best health care system in the world.” Another lie. Millions of Americans lack the access to health care that insurance provides. The politically conservative American Medical Association estimates that 45,000 Americans die annually because they cannot afford to buy the care that they need.

No country has been able to provide health care to all its citizens under free-market capitalism. Most patients cannot be the informed consumers making rational purchase decisions that free market theory assumes. Advertisements of drugs, doctors, hospitals, and insurers are, like all advertisements, intended not to inform consumers, but to persuade them to buy. Young, healthy, upper- and middle-class people who can afford to buy health insurance refuse to do so, knowing that the premiums others pay will also pay for their care when they need it. That increases the premiums paid by those who do buy insurance.

Obamacare tries to use free-market capitalism by forcing everyone to buy insurance, telling insurance companies the minimum coverage that their policies must provide, and limiting what they can keep for overhead and profit to twenty cents of every dollar of premiums received. The health care insurers went along with that with the promise that there would be no competing non-profit government run-insurance, the so-called “public option,” though some insurers are now claiming that 20% of premiums is insufficient for overhead and profit. (In stark contrast, non-profit, government-run Medicare’s administrative expense is about 2% of benefits paid out,) Health insurance companies now see a way to overturn Obamacare by informing policy holders that their inadequate policies cannot be renewed, because they do not provide the minimum coverage required, and that continuing their coverage will require significantly increased premiums.

Access to health care for all Americans can be provided only if the U.S. adopts a single-payer, publicly-run system like Canada’s or some other country’s in which all citizens are required to pay for health care in the taxes that they pay.

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