What Comes After Obamacare Fails

"The unraveling of the Affordable Care Act presents a historic opportunity for change," writes John H. Cochrane. "Its proponents call it 'settled law', but as Prohibition taught us, not even a constitutional amendment is settled law—if it is dysfunctional enough, and if Americans can see a clear alternative."

The Affordable Care bets ... that more regulation, price controls, effectiveness panels, and "accountable care" organizations will force efficiency, innovation, quality and service from the top down. Has this ever worked? Did we get smartphones by government pressure on the 1960s AT&T phone monopoly? Did effectiveness panels force United Airlines and American Airlines to cut costs, and push TWA and Pan Am out of business? Did the post office invent FedEx,UPS and email? How about public schools or the last 20 or more health-care "cost control" ideas?

Cochrane argues that the clear alternative is a free market solution in which health insurance is:

• individual [i.e., individually-purchased rather than employer-purchased];
• portable across jobs, states and providers;
• lifelong and guaranteed-renewable, meaning you have the right to continue with no unexpected increase in premiums if you get sick;
• a wealth protection against large, unforeseen, necessary expenses, rather than a wildly inefficient payment plan for routine expenses; and
• vouchers for charity care for the very poor.

We are seeing just the beginning of debacles, scandals and fraud in the news that will go on for years ... unless the American public understands that there is an alternative and demands it.

No other country has a free health market, you may object. The rest of the world is closer to single payer, and spends less.

Sure. We can have a single government-run airline too. We can ban FedEx and UPS, and have a single-payer post office. We can have government-run telephones and TV. Thirty years ago every other country had all of these, and worthies said that markets couldn't work for travel, package delivery, the "natural monopoly" of telephones and TV. Until we tried it. That the rest of the world spends less just shows how dysfunctional our current system is, not how a free market would work.