I announced back in February that I will be debating Yale University's Ted Marmor on health care, with emphasis on the Affordable Care Act, aka Obamacare. I asked you for proposed questions because the debate isn't structured as a traditional debate. Rather, the moderator will ask questions that we will each answer. Each of us can propose questions. The debate will be on the evening of Wednesday, March 19. The public is welcome.
Many of you were very helpful. I've taken the best of the questions you proposed and tweaked some of them. I've also added a few of my own. I plan to send my list tomorrow and so am asking for comments on these. Many of you will recognize your own questions in the list. Here it is:
1. A large part of the Affordable Care Act is based on the idea that health insurance is the best way to finance health care. Do you think that requiring health insurance to cover routine, expected or elective health care expenditures will increase or decrease the cost of such services? Explain.
2. Is there a tension between the public-sector health care trend of "Comparative Effectiveness Research" and the private-sector medical science trend of "Personalized Genetic Medicine?" Does this imply a tension between cutting-edge medical science and cutting-edge health care delivery systems?
3. When the government has a great deal of control over both health insurance and health care, as it does under the Affordable Care Act, will change in line with new technologies be easier or more difficult than when government has less control? [This is a more general version of #2 above.]
4. When the government wants to make it easier for poor and low-income people to buy food, it provides food stamps so that people can buy their own food in line with their own preferences. If the government wants more health care for people, why not provide subsidies for people to buy either health care or health insurance, so that people can choose their own? Why regulate in detail the structure and coverages of health insurance, not just for poor people, but also for everyone?
5. The price of medical care has been rising faster than inflation at the same time 3rd party payments (private insurance, Medicare, Medicaid) have been increasing. Health care expenditures that do not generally accept third party payments (Lasik, plastic surgery) have at the same time been decreasing in price and increasing in quality. Do you believe there is a causal link between these factors?
6. Of the many attributes of the US health system (before ACA) that led to its high costs and inefficiencies, which ones were improved by ACA, which ones made worse, and which ones were left relatively untouched?
7. Is the ACA affordable? If so, why are businesses cutting hours and employees to hedge against the rising costs of the ACA and why are unions asking for and getting exemptions to the ACA?
8. What is the difference between health care and health care insurance, and why are those terms so often confused in health care discussions?
9. What, in your view, would a completely free market in health care look like? Be specific about coverages, cost, competition, etc.