Obamacare Survives Court Challenge--Will US Life Expectancy Improve?

The big news this morning was that the US Supreme Court rejected the latest challenge to the Affordable Care Act. This means that people living in states that have not set up a health care exchange, and thus use the US Government exchange, will still have their health care subsidized. Does that mean that we will now have better health care than before? Probably not. This does really change the health care system. Obamacare mainly brings more people into the market where they can buy health insurance, but of course it is not free for them, and it is still too early to tell exactly where the federal money will ultimately come from to pay for the subsidies. There is no free lunch and when it comes to health care Americans have the most expensive lunch on the planet. Yet, we have life expectancy that is lower than any northern or western European country and Canada. Why? There are four reasons: (1) the health insurance industry, which profits as a broker of health care services; (2) physicians who are the highest paid in the world; (3) lawyers who depend upon medical malpractice for their livelihood; and (4) drug companies who charge more in the US than elsewhere in the world.

My main objection to Obamacare when it was first proposed was that it did not go nearly far enough. Although health as a social movement has had a long history in the US, the fact that it spun off into a fee-for-service program instead of a universal health care program is, in my estimation, the sole reason for the country lagging behind others in life expectancy. And, of course, the four reasons I listed above are the reasons why we don't have universal health care. There are too many people making lots of money from healthcare and, quite naturally, they don't want that to change. One of the more positive things coming from the Affordable Care Act, however, is the idea that health providers should be reimbursed on the basis of quality of care, not on quantity. In particular, people in the public health field have known forever that prevention is the best medicine--it just doesn't pay as well...