Obamacare was a rather bad way of trying to deal with whatever ails the American health care system. Perhaps the most cogent criticism is that it’s hugely complicated, complication being something that doesn’t work when trying to deal with the interactions of 320 million people. That system of what people do to whom and when is just so chaotic that only the simplest of rules and pointers actually works. Works well enough that is – there will always be some level of failure at such a scale.
There are other critiques to be made. The idea that contraception should be dealt with under an insurance model is simply ludicrous – insurance is just entirely wrong as an economic structure for a perhaps $10 a month expense that half the population might use for half their lives. Assurance could work, making it free might, leaving it out of pocket could be sensible, but insurance is just silly. That’s actually, writ small, the basic American problem in fact, that they’re using insurance for things which simply aren’t insurable. Full government health care or proper insurance, catastrophic insurance plus health care savings accounts, either structure, would have been better than Obamacare. And yes, economists of both right and left have made the same point, Scott Sumner and Brad Delong come to mind there. Both having said either, not splitting to one or t’other as biases dictate.
We now can add a third problem, it appears that Obamacare is unconstitutional:
A US federal judge in Texas ruled on Friday that the Affordable Care Act, commonly known as Obamacare, is unconstitutional, a decision that was likely to be appealed to the supreme court. US district judge Reed O’Connor in Fort Worth agreed with a coalition of 20 states that a change in tax law last year eliminating a penalty for not having health insurance invalidated the entire Obamacare law.
How this pans out, well, that will be interesting. But this latest ruling is that it’s unconstitutional and given that that’s the latest word from the Federal judicial system that’s what the state of play is right now.