The Right Answer: on Health Care

John Delaney: Let 55-year-olds buy into Medicare

The second good part of the ACA consists of adjustments that were made to improve coverage and change incentives. One excellent example is the rule that people with preexisting conditions can no longer be excluded from coverage.

The crucial mistake was the way the health care exchanges were structured. If you're individually insured, or uninsured, and you don't qualify for Medicaid, you can buy insurance on the exchange. But in an effort to protect people between the ages of 55 and 65, the ACA mandated that the exchanges could charge them only up to three times the cost of the cheapest policy on offer. Did someone forget to do the math? Health care costs for people in that age range are, on average, six times what they are for young, healthy people. My solution would be to let people over 55 buy into Medicare.

John Delaney: Allow Medicare to negotiate pharmaceutical pricing

This scandalous arrangement is unacceptable, and the sooner we change it, the better. We should add more "pay for results only" regimes for newly innovative, very expensive drugs. This would allow a handsome payment if a drug worked on a patient, and nothing if it didn't.

John Delaney: Costs would rise too quickly in a single-payer system

I took a few minutes to explain my concerns about a single-payer system--in my view, costs would rise too quickly, and such a system might actually result in patients having worse care than they would have otherwise. I went on to describe my fix for the health care system, which begins with allowing Americans over the age of 55 to get Medicare.

"There's no question every single person in America should have health care," I told her. "That should be the uncompromising values statement of the Democratic Party, but we need to have a really thoughtful debate about how we get there." This point had exactly zero impact. For her, single-payer was a litmus test, These kinds of litmus tests are a real impediment to progress.

Mitt Romney: Idea for opt-in health exchanges adopted by ObamaCare

Here's the problem, though: in an effort to protect people between the ages of fifty-five and sixty-five, the ACA mandated that the exchanges could charge them only up to three times the cost of the cheapest policy on offer. Did someone forget to do the math? Health care costs for people in that age range are, on average, six times what they are for young, healthy people.