Question

Regarding the US health care program, the Affordable Care Act and current suggestions for a single payer system, please provide two ways the current system may be altered to either reduce adverse selection or moral hazard.?

Answer 1

Answer :

Congressional Republicans have been trying to replace the Affordable Care Act, the ACA’s popularity is at an all-time high, and the majority of Americans now believe that it is the federal government’s responsibility to provide health care for all Americans. This shift in sentiment suggests that a single-payer system a “Medicare for all” may soon be a politically viable solution to America’s health care woes.

This system has long been an aspiration of the far left, yet even the right now seems to acknowledge its growing likelihood. Following his decision not to support the Better Care Reconciliation Act (BCRA), the Senate Republican leadership’s latest attempt to replace the ACA, Senator Jerry Moran, Republican of Kansas, warned in a statement: “If we leave the federal government in control of everyday health care decisions, it is more likely that our health care system will devolve into a single-payer system, which would require a massive federal spending increase.”
While there may be openings for bipartisan compromise to address the weaknesses of the ACA, the core of the ACA framework is unstable a hostage to the market and political fortune. By contrast, a single-payer model stands to be much more durable and provides a chance to build a health care system around the well-being of patients rather than the profits of providers and insurers. Thirty-three percent of the American public now support a single-payer system a 5% increase since January.
To be sure, some important players remain opposed to a single-payer system. One is the American Medical Association. It favors an ACA-like structure that subsidizes insurance for low-income individuals and families, and argues that a single-payer system would stymie private-sector innovation, create long waiting periods, and offer less patient choice. However, the AMA is far from a disinterested party. Indeed, it was an early resister of alternatives to our current fee-for-service system, fearing a more progressive model could diminish the independence and entrepreneurial capacity of its members.
But are these concerns warranted? Doctors who fear losing their autonomy need only look north to see how a single-payer system can work without encroaching on the independence of physicians. Canada has had a single-payer model for decades, and there’s no government takeover of its health care system in sight. Most services are still provided by the private sector, and most physicians are still self-employed. While health expenditures remain high, Canadians nevertheless enjoy better health outcomes at lower cost than the United States, whose population’s health is mediocre despite ever-higher spending on medical care.
If implemented correctly, a centralized payment structure can create a health care system that is genuinely organized around health. It may seem counterintuitive to suggest that the U.S. system is not organized around health, but this truth has long been obvious to anyone who follows this issue or to anyone who has ever had to seek care in a time of need. Over and over, we have seen how the U.S. health care system produces a vast array of increasingly expensive drugs and treatments that few can access without high-quality insurance.

A single-payer model could change this not by nationalizing health care outright but by incentivizing new payment structures such as bundled payments, accountable care organizations, and other population-based models.
While such innovative payment models are possible within the current fragmented payer system indeed, the Centers for Medicare and Medicaid Services has been a leader in innovating a single-payer system immediately creates an opportunity for wide-scale adoption of new approaches that can transform health in the United States. With a health system reoriented toward stopping disease before it starts, rather than treating it once it strikes, we may even start to see more health investments go beyond health care, targeting the social, economic, and environmental factors that create the conditions for disease in society.