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Last chance
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The Patient Protection and Affordable Care Act should be seen as what it is: One last opportunity for the private health insurance market to prove that it can offer a service that covers the millions of Americans who were previously left out, at a cost that we — as individuals, employers and taxpayers — can afford.

If that is a goal beyond the grasp of the existing system, then it needs to be finally swept aside in favor of something that will meet those needs.

The most valid critique of the law, better known as Obamacare, is that it does not do enough to reduce, or even retard, increases in the cost of health care across the board. That, in furtherance of its humanitarian goal of catching up to every other industrialized nation by providing near-universal health care, it does too much to increase the cost of that coverage to individuals, employers and taxpayers.

This has been illustrated locally, by the Granite School District's decision to duck an expected $14 million jump in costs by reducing the hours of hundreds of part-time workers. That way, the district, and its taxpayers, can avoid the ACA mandate that employees who work 30 or more hours a week have to be included in an employer's health care plan.

And it has been illustrated nationally, by a study that estimates health care insurance claims that are paid may jump by as much as 32 percent per capita as millions more Americans enter that system. Of course, a law that requires health insurance outfits to put actually insuring the health of their customers ahead of their own profits is going to increase the amount of money those companies spend on actual care.

These cost projections, if the ACA works as intended, should be mitigated by other provisions of that act. Health insurance companies should, for example, be limited in how much of the increased cost they can pass along to customers by the provision that at least 80 percent of what an insurance provider spends must be for care, not overhead and profit.

Other factors that could help include increasing access to preventive care now and avoiding more expensive emergency or chronic care later, or moving low-wage workers off their employers' plans and onto subsidized plans or Medicaid.

But this is, or should be, the private health insurance industry's last chance. If Obamacare fails, a return to the cold-hearted free market is not a realistic or humane choice.

An entity with the chops to bargain down the actual cost of care is necessary. At the very least, a robust public option, an idea President Obama bargained away in the creation of the ACA, must be provided. Better still would be a single-payer plan — Medicare for all.

If ACA fails, single payer is next
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