Sara’s smarter and funnier husband, Loren, will be writing this column today.  He is also better than her at board games.

Since the election I have spent a lot of time trying to figure out why so many people voted for a man who is so obviously a con artist.  Statements like this 299 word doozy make it tough to imagine someone thinking “yeah, that sounds like a reasonable thing for a US president to say.”  While I now have a good picture of why people voted for him, I don’t yet understand the hatred for the Patient Protection and Affordable Care Act, AKA the PPACA, AKA the ACA, AKA Obamacare.  First, a bit of background.

America spends way more than other countries on health care.  Take a look at the chart below, which includes all money spent on health care, including costs reimbursed through insurance.  This means we have less money for burritos, sorry losers and haters!

us_spends_much_more_on_health_than_what_might_be_expected_1_slideshow

Perhaps a better way to look at things are to examine the costs of individual procedures, which again are much higher in the US.  Here are two charts I picked at random from the article linked in the last sentence, one for a surgery (appendectomy) and one for a service (hospital stay).  There were compiled by the International Federation of Health Plans, a global insurance trade association that includes more than 100 insurers in 25 countries.  Why are the other countries’ prices uniform? Because their governments set prices centrally so everyone pays essentially the same amount.  We are losing to Chile and South Africa.  Sad!

appendectomy-800x567hospital-day-800x564

Why are things more expensive in the US?  The biggest reason is that US providers of health care charge more, because insurers lack negotiating power.  In other civilized countries, the government negotiates on behalf of all citizens, or owns the hospitals outright.  This is called “single-payer.”

The ideal situation would be for the US government to copy the dozens of such systems from around the world, and to provide universal government health insurance through higher taxes to individuals, which would give the government negotiating power to dramatically reduce health care spending overall.  We actually have a government system that while not universal, does have significant cost savings over private insurance (Medicare).  Since dozens of other countries have already run this experiment, we know that it would work in the US.  This was apparently Obama’s original plan for the ACA, but Republicans and conservative democrats tend to hate such plans.

Instead, the ACA mandates that everyone must have private insurance, provides government subsidies based on your income in an effort to make this private insurance affordable, and implements a number of cost-saving and patent protection rules.  While I have focused on the financials here, these patient protections are themselves a big deal.  Late last night when we were all in bed, the Senate voted on a budget resolution to de-fund the ACA.  More on what the ACA actually is and the impacts of repealing it at a later date.

So, folks, get ready to act. Because this is actually pretty darn reasonable and it has helped millions! (More on that later…)