What is the best way to make sure that Americans with chronic medical conditions — those most likely to need costly or frequent health care — can afford the insurance they need to meet their bills? The conventional answer, reflected in Mitt Romney’s 2006 health care reform law in Massachusetts and the federal overhaul signed by Barack Obama in 2010, contains these ingredients:
■ Require everyone to have health insurance, with subsidized plans for low-income citizens.
■ Compel insurers to accept anybody who applies for coverage and to charge roughly the same premium for everyone, regardless of health status.
■ Make all health plans cover a fixed array of medical treatments, providers, and conditions — coverage that many customers may not need or want.
In short, the orthodox view is that to shield people with serious medical needs from undue financial hardship, we must suppress the normal workings of a free market — supply and demand, competition, flexible prices. There’s just one problem with this approach: It doesn’t work.
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