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From the ObamaCare Dilemma to Single-player Healthcare

Healthcare issues have long been heatedly debated in Congress since 2008, when the prospect of ObamaCare (or the Affordable Care and Patient Protection Act) was first brought up to public attention. Frenzies of debates follow as policy makers argue for the better health coverage of the lower-income groups while worrying over the prospects of a dual system in which the government competes with the private enterprises in the healthcare market. The worriers are right. Such a dual system further reinforces the previous status quo of the public instead of narrowing the gap between the rich and the poor, as the plan seeks to accomplish.

We can clearly see this dilemma by viewing the poor and rich’s choices between ObamaCare and private health insurance as a game theory model. Both the poor and the rich can choose between ObamaCare and private health insurance. Since the poor most likely do not have the financial ability to choose private health insurance, they would opt to choose Medicare, which is their dominant strategy in this case. The rich has the financial freedom to choose either Medicare or private health insurance. Since Medicare most likely do not have as broad a coverage and as many benefits as the more expensive private health insurance, the rich will most likely opt to choose private health insurance, which is their dominant strategy. Both the rich and the poor have a dominant strategy in this game, but the net result of both sides opting for the dominant strategies is worse off for society, as status quo is kept and there was no societal development.

Also, one of the main problems with ObamaCare is its complexity and amount of freedom given to insurance companies to charge customers based on their age and health condition. This allows companies to discriminate against the older and more ill customers by charging them more than the younger and healthier customers in order to maximize their payoffs. As the sample data from below shows, the disparity between different premium rates based on customer conditions are huge. Such discrimination further reinforce societal status quo.

Sample Data of ObamaCare Insurers

While ObamaCare certainly helped many to finally receive healthcare coverage, it simply isn’t enough to truly improve the gap of inequality between rich and poor. Another option was called for by Bernie Sanders in his campaign, where he pushed for a Medicare-for-all system, or single-player healthcare. Without a choice between government-provided insurance and private health insurance, there would not be the existence of a polarization of dominant strategies between the rich and poor, and the static status quo as a result of it.


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October 2015