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Evaluating the state of the U.S. healthcare system

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George Washington University

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Evaluating the state of the U.S. healthcare system

An discussion on Obamacare with columnist Ramesh Ponnuru

Matthew Fuzi

11.15.17

With the floundering of efforts to repeal and replace Obamacare earlier this year, the public healthcare debate has taken a backseat to more pressing issues in recent months, especially foreign policy and immigration. Given the uncertainties surrounding the future of the U.S. healthcare system, the GW Young American for Liberty (YAL) and GW College Republicans collaborated to bring acclaimed author and National Review columnist Ramesh Ponnuru to GW in order to discuss implications and potential solutions to the liminal state of the American healthcare debate. The event, which was held in Marvin 302 on Thursday, Nov. 9, attracted a modest yet enthusiastic crowd of about 35 people.

“It is an issue that was glossed over during the campaign, and having been so contentious in previous elections, we feel that it is important to cast a more pragmatic light on the current state of U.S. healthcare policy.” stated Dominic Conoshenti, co-president of GW YAL.

"The conception that markets do not operate accordingly with health insurance, and that governments inherently do, is not entirely valid. Competition is what keeps insurance prices low."

During his oration, Ponnuru discussed the rationale behind hostilities toward Obamacare from a conservative point-of-view before expressing a need for a supply-side, market-driven solution. According to Ponnuru, "The conception that markets do not operate accordingly with health insurance, and that governments inherently do, is not entirely valid. Competition is what keeps insurance prices low." In other words, by limiting the number of providers in that market, prices become more demand-inelastic, allowing a smaller amount of healthcare providers to inflate prices with impunity.

Instead of dabbling in principle and ethics like many other critics of Obamacare, Ponnuru provided a refreshingly-academic, empirical critique of Obamacare. Noting that more than 12 million Americans still could not afford health insurance under Obamacare, and with millions more remaining uninsured, one of his primary points of contention involved the sheer unsustainability of single-payer universal healthcare policy, in which healthy individuals would lack the incentive to purchase health insurance with the higher deductibles under Obamacare. Obamacare sought to avert this by implementing an individual mandate; something President Barack Obama had initially campaigned against in 2008, legally obligating healthy individuals to purchase a policy that they did not necessarily need.

"If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what."

Furthermore, Ponnuru evaluated the shortcomings of Obamacare itself. In particular, even with the individual mandate, Obamacare could not prevent the cancellation of numerous plans and the skyrocketing of deductibles for many more, a defection from Obama's campaign promise that "If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what."

This broken pledge is supplemented by the transactional design of Obamacare; A high-deductible policy with lower co-pays and premiums like Obamacare departs from the traditional definition of insurance by theoretically providing a more effective plan for routine medical expenses such as medications, physicals, and regular appointments, which Ponnuru admits is beneficial for those with pre-exisiting conditions. However, Ponnuru argued that this type of policy often fails to cover large, unexpected medical expenditures, such as major surgeries and other costly, unforeseen treatments.

As such, relatively fit individuals are much better off purchasing a higher premium, lower deductible insurance plan, which under Obamacare, they are not permitted to do.

"Their public health muscles have atrophied, if you will."

Nonetheless, Ponnuru was cognizant to give credit where credit was due, conceding that an expansion in the number of insured Americans under President Obama was a welcome sign, and that Obamacare was successful in facilitating "a consistent, substantial growth in the healthcare coverage" despite his reservations. Additionally, Ponnuru admitted that many Republicans in the U.S. federal government today are ineffective at resolving this policy issue, noting that "most are poorly-versed and often clueless on the subject of healthcare... Their public health muscles have atrophied, if you will."

Considering that Congress and the Trump administration, which has continually reiterated how much of a "disaster" Obamacare was, have both failed to even agree upon a new national healthcare plan, it seems as if Ramesh Ponnuru is fairly justified in reaching that conclusion.

This is an opinion piece and does not reflect the views of The Rival.