Don't get me wrong. I'm glad we have Obamacare. A lot of people, millions of us, have some kind of health insurance thanks to the Affordable Care Act (ACA). Nobody has proved that people are any healthier because of this, but the best study shows that the newly insured are more likely to get medical care when they are sick and far less likely to be bankrupted by a sudden illness. That's all to the good.
But that does not mean that by succumbing to the political and economic pressures to preserve our cruel and wasteful private market health system, Obamacare isn't a jerry-built Rube Goldberg edifice. Margot Sanger-Katz explains that the Department of Health and Human Services is proposing a regulation to "encourage" people who buy coverage through the insurance exchanges to go through the laborious process of re-evaluating which plan will be cheapest and will give them the medical access they want every year.
Now cheap is good. But changing insurance companies can often mean changing doctors, hospitals, relationships, maybe medications -- why would we want people to have to go through all that every year?
That is, unless individual citizens are willing to unsettle their medical arrangements annually, there will be less competition between insurers. If people are loath to change insurers, they'll settle in with one that more or less suits them and only change if they have to.
Because Obamacare seeks to use competition between insurers to keep prices down while upholding basic quality, without churn in the market the exchanges will become uncompetitive. If people find a plan that works for them and just stick with it, there goes competition between insurers. So to keep this private marketplace working, users have to be pushed to jump between insurers. The job of keeping the insurance market healthy is to be pushed off onto individuals, many of whom are poor or sick.
Sick people are not consumers making choices like which new electronic widget to buy. When serious illness hits, our lives are at stake. As was the case before Obamacare, what chance we have of receiving good care should not be determined by how good we are at jumping through bureaucratic hoops. Health care really is a human right; preserving the health of a dysfunctional profit-seeking market is just the detritus of an anti-human social system.