- - Thursday, March 31, 2016

Seven years on, the size of the Obamacare disaster is only beginning to emerge. Fixing it won’t be as easy as some of the candidates for president seem to think it will be. The Congressional Budget Office estimated last week that over the next decade Obamacare will add $1.4 trillion to the nation’s debt.

Many of the so-called cures are utterly unrealistic. Hillary Clinton, for example, after proposing new and expensive additions to Obamacare, now suggests a solution concocted of one part fantasy and two parts nonsense. She would impose a 4 percent tax on millionaires to pay for increased costs. But her tax would yield only $150 billion over 10 years, a fraction of what her plan would require. Even millionaires are not what they used to be.

Sylvia Mathews Burwell, the secretary of Health and Human Services, said last year that the Obamacare website, the heart of the president’s scheme, cost $834 million to build. Bloomberg News puts the cost at $2.1 billion. At any price it represents the obstacle to medical progress. The exchanges that were crucial to encouraging the competition that would lower costs, have been another disaster. All but 12 of the original 23 have failed and congressional critics say the $1.2 billion lent to them is unlikely ever to be repaid.

Obamacare’s promise to insure Americans who had no health insurance is increasingly suspect. Of more than 11 million who signed up by the end of the enrollment period last year, 3 million had dropped out by the end of the year. The Heritage Foundation estimates that a full quarter of those eligible either didn’t buy a plan, or later dropped out.

The president’s most memorable promise, that Obamacare would not disrupt existing doctor-patient and health-care insurance arrangements, has long since evaporated. Insurers continue to drastically reduce the choice of doctors and hospitals. The industry, trying to sugarcoat a label on disaster, calls this “narrowing networks.” The Heritage Foundation says even fewer choices lie in wait for consumers in the future.

The critics of Obamacare are challenged to come up with an alternative to the disaster President Obama’s scheme has wrought. But an alternate drawn up with the recklessness of Obamacare would create another and equally crippling disaster. Resolving the complexities of the American medical scene in one comprehensive program has been an invitation to debacle for more than a half-century. Health care costs account for one-sixth of the American economy, and these costs are growing as American medicine demands new and expensive technology. Comparing American medicine to medical programs in other countries, particularly those with single payer systems, ignores the cold statistics that tell the actual story. Survival rates for breast cancer, for example, are much better here than in the most advanced European health systems.

Strenuous efforts to repeal and replace Obamacare must go forward, and this time common sense must be a guide. Prohibitions against crossing state lines to buy insurance must be repealed as a start. Simply removing that obstacle could go a long way toward the competition that would reduce health-care costs. One step at a time, and this time it must be a step forward.

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