I hesitate to call the Affordable Care Act rollout “botched,” mostly because even Apple, that sterling example of private enterprise, has yet to have an iPhone launch that was free of bugs and glitches in the ordering process. Why we would expect a more complex product rollout intended to reach a wider audience than Apple does to be smoother than the iPhone 5s release (which is still experiencing significant delays) I don’t know. However, it is clear that HealthCare.gov does have problems.
Most of these problems are not the result of that website’s design, but rather in the need for the Obamacare system to pull customer data from other agencies’ servers. For example, some experts have blamed the IRS’ outdated system for bottlenecking the subsidy calculation process. In a USA Today article, John Engates, chief technology officer at cloud computing firm Rackspace, said he believed that “most of the problems” with the rollout stem from integration with other agencies, the IRS in particular. Outright hostility for the insurance exchanges from GOP-governed states has not helped streamline these systems. These are just a few of the many issues plaguing Obamacare’s technical side, but they could all be solved if we do as the Republicans want and repeal the whole thing – as long as we replace it with a truly universal single-payer healthcare system. There would be no need to calculate subsidy eligibility, we could completely bypass intransigent Republican state governments, and payment for healthcare could be centralized within a single federal agency.
But the benefits go far beyond fixing rollout issues. All Americans who currently own health insurance pay monthly premiums on that insurance. Under a single-payer system, these premiums would be replaced by a progressive tax that would allow the government to pay for everyone’s healthcare. Given the established way in which actual medical care is provided in this country, the government would most likely reimburse hospitals and doctors for the treatments they perform (as Canada does) rather than employing healthcare professionals directly (as England does). Under this plan, we would realize the same savings to be provided by the ACA that result from wider accessibility to preventive care, but the true reduction in cost would be far greater than Obamacare could ever provide.
Liberals considered it a major victory that the Affordable Care Act requires insurance providers to spend 80 percent of their premium revenue on healthcare and reimburse subscribers up to that point if they don’t meet it paying for treatments. Of course, what this also means is that Obamacare guarantees to insurance companies that they will be allowed to keep 20 percent of revenues for operating costs and profit. Our current system of health insurance providers essentially constitutes a middleman between patients and doctors that saps up 20 percent of the money changing hands. Obamacare codifies this system in the law. A single payer system would eliminate much of this inefficiency (administrative costs would persist), providing Americans with healthcare savings potentially equal to current insurance company profits. In a multi-trillion dollar industry, that’s nothing to sneeze at.