Megan McArdle advises Republicans to do nothing yet with regards to Obamacare, and neatly captures America's conflicting desires on health care. McArdle outlines a fairly simple replacement plan and then explains why it can't happen.
However, this is completely politically infeasible, because voters don't want genuine insurance, by which I mean a pool that provides financial assistance for genuinely unforeseeable and unmanageable expenses. Voters want comprehensive coverage that kicks in at close to the first dollar of spending, no restrictions on treatments or their ability to see a doctor, nice American-style facilities, and so forth. They are also fond of their health-care professionals and do not wish to see provider incomes slashed and hospitals closed, nor do they want their taxes to go up, or to pay 10 percent of their annual income in premiums. This conflicting set of deeply held views is one major reason that Obamacare -- and American health-care policy more generally -- has the problems it does.
Your car insurance doesn't pay for your gas or oil changes. Your homeowners insurance doesn't pay for termite treatments or new paint. Why do you want your health insurance to pay for annual check-ups and ear infections? It can be done, but when you add a bunch of fixed expenses to an insurance plan, premiums go up in direct proportion plus management costs.
