Obamacare - a stunning legacy

The future of Obamacare.

n engl j med 367;23 nejm.org december 6, 2012 2165 it passed Congress without a sin­ gle Republican vote, and the GOP subsequently mounted legal and legislative challenges to Obama­ care, vowing to repeal and re­ place it. The Supreme Court decision in June 2012 upholding the ACA’s constitutionality dealt a serious blow to the law’s opponents. Now, in the aftermath of the 2012 elections, with P...

Obamacare, Medicare, and baseball's greatest pitchers.

Obamacare and the Theory of the Firm

The fragmented nature of the U.S. healthcare system is quite anomalous. A hilarious video on YouTube makes the point well, asking what it would be like if air travel worked like healthcare.1 In this alternative world, we see an unfortunate consumer trying to book a crosscountry fl ight to Oregon. He discovers he needs to book separately with an East Coast specialist to get him to Chicago and a ...

Look Who Opposes Obamacare, by Fat Margins

Those who have the most to gain from President Obama’s health care legislation are those who have a pre-existing condition or are pre-disposed to illness, for example because they are overweight. They are more likely to need medical care in the future, but can be charged higher rates if they try to buy private insurance, by virtue of their condition. Or they can be excluded completely. (Each ob...

Federalism and the End of Obamacare

Federalism has become a watchword in the acrimonious debate over a possible replacement for the Affordable Care Act (ACA). Missing from that debate, however, is a theoretically grounded and empirically informed understanding of how best to allocate power between the federal government and the states. For health reform, the conventional arguments in favor of a national solution have little reson...