Yes, the ACA was a compromise—but it may have been a compromise of the wrong kind. Instead of combining the best elements of public and private care the way other developed nations have done, it may have combined some of the most incompatible. For instance, most countries with functioning universal care do not fund their systems by raising premiums on specific demographics. Instead, they use a combination of funds from personal and corporate income taxes, sales tax, lottery proceeds and other sources. In this country, however, citizens are still required to purchase private insurance. What’s more, there are limited options available to buyers depending on their location and economic position, which often results in middle-class earners being saddled with higher premiums to help subsidize care for other demographics.
Since the government is unlikely to make the sweeping reforms necessary for a truly workable universal care system anytime soon, it may be more productive to focus on incremental changes that can be accomplished with relative ease. One such change that could mitigate the rising premiums faced by middle-class earners is insurance reform. Allowing people to purchase their insurance across state lines could expand the number of options available to them, preventing them from being forced into premiums that subsidize others at their own expense. It raises an obvious question though: if middle-class earners no longer must subsidize groups like retirees, how will members of those groups receive adequate care?
