As I have written before, Obamacare is not about health care but all about expanding the scope and power of government. The reason why most Americans rejected Obamacare is not because they don't favor reform. They do. They are just smart enough to realize that the government mismanages all its enterprises. They all lose money. Why turn one's health care over to the folks who lose $7 b a year on the post office, who lose on Amtrack, Medicaid and have bankrupted social security. No Americans realize that the government will turn what some think is a bad system to one that is worse and costs more. Americans did not oppose adding 30 million more people to the insured rolls. However, they were opposed to having to pay for the insurance of those 30 million people. So what can be done to improve the system? There is a role for the Federal government. The first is to do something akin to the Reigel-Neal interstate banking act, which removed the barriers erected by the states on interstate bank branching and acquisitions. Removing the barriers erected by the states to prevent competition in health care insurance would mean that policies could be transported across state lines when a person moves, It would mean that a person in one state could buy a policy offered in another state. States should remove all mandates from health insurance policies. That would allow persons and families to craft a policy suitable for them rather than being forced into higher cost one size fits all policies. There should be a nationwide tort reform law. Texas has shown that when there is tort reform, then doctors move in to provide services and costs are lowered. There should be a nationwide pool for those with pre-existing conditions. Those in the pool sould be able to purchase insurance and the pool policies should be subsidized by the federal government. Lastly, one item that is the elephant in the room is that no one address the problem of emergency room use and nonpayment. Lets be blunt. Health care is a good and going to the emergency room and not paying is nothing more than stealing. One would not be allowed to walk away with a TV without paying for it. The same should be true with health care. Since the Feds will go after you like a junk yard dog if you don't pay your income taxes, it should go after health care scofflaws with the same vigor. Just like with delinquent taxes, the terms of repayment would be worked out. Do all of this and costs will come down. Since this makes so much sense there is no hope that any of it will take place.
Harold A. Black is professor emeritus in the Department of Finance, University of Tennessee, Knoxville having retired after 24 years of service. He has served on the faculties of American University, Howard University, the University of North Carolina - Chapel Hill and the University of Florida. His government service includes the Office of the Comptroller of the Currency and as a Board Member of the National Credit Union Administration. He also has served on the boards of directors Home Savings of America and its parent company, H. F. Ahmanson & Co., Irwindale, California prior to its merger with Washington Mutual Savings Bank, on the board of New Century Financial Corporation, Irvine, California, then the nation’s largest real estate investment trust and as director and later chairman of the Nashville Branch of the Federal Reserve Bank of Atlanta. He writes an occasional article for the Knoxville News-Sentinel at http://www.knoxnews.com/staff/dr-harold-black/. His web page is haroldablackphd.com