Tuesday, February 1, 2011

More Florida

Ezra Klein has aggregated a variety of takes on the ruling of the Federal Judge from Florida here. I don't have anything enlightening to add to the legal questions, but leave all this here:
  • If the ACA is repealed in its entirety, then the status quo health care system will bankrupt our country.
  • If the ACA is implemented in its entirety, we will still have to do more on costs to develop a sustainable health care system, which is a necessary but not sufficient condition for a sustainable federal budget.
Regardless of what the Honorables say, we need to work the policy problems and there is much to do. It will take both sides to achieve success.

Update: and a short history of the individual mandate for health insurance, here, via NPR from last February. Another update: Health Affairs blog on the judicial opinion.


  1. I agree with you. The more I have learned about ACA the more I became convinced that the problem with health care reform in the United States is our unwillingness to reform comprehensive health care plans. If the big ideas behind ACA are going to work, they should be driving down health care costs in Massachusetts. Arguably Massachusetts received a bonanza when it convinced the uninsured to start overpaying for their health insurance and yet their lowest cost health care plan is $1000 per month more expensive that one in Ohio. Obviously the uninsured are not the problem with health cost growth in Massachusetts. The problem is our "double or nothing" bet that the comprehensive health care model is the solution. Comprehensive health care plans have been good to us over the years but they never have been good about cost control. Around 85% of the country is covered by comprehensive health care plans. Our health cost growth problem started with comprehensive health care plans and it will end with them. The time for these plans has come and gone. The more we try to save and extend comprehensive health care, the bigger the spending hole we dig. I don't think we can tweak ACA to make it work. Unfortunately I think the political model for handling this situation is the same model we are using to resolve "bankruptcy" issues with the states and cities.

  2. I can see multiple routes to dealing with costs via implementation of the ACA and changing/improving the law. If it were repealed fully, I don't see a way forward. I don't have any confidence based on the Republican's past record on health reform (which is to be vehement in opposition and silent in power) that they will ever get around to the replace part.

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