The State of the Union Address: What the President Got Right on Healthcare


January 30, 2014

In This Article

What the ACA Is and Isn't

Obamacare is NOT government or socialized medicine. It is a hybrid of multiple diverse components designed to make a bad system a little less bad. Considering the ideologic dysfunction of our government, it was the "best we could do" at the time.

What does big government do well? Collect money and dispense money. Witness Social Security. What does big government do poorly? Manage large operations with efficiency and accountability. Witness the Pentagon; it can't even do an audit.

Since my scoring system began in 1992, what part of the American healthcare system has always scored high? Medicare. In fact, an improved "Medicare for All" system scores 80 -- not perfect but a huge improvement over all other plans considered. Privately run medicine with government funding. And the ability for individuals or companies to opt out if they wish to use their own money to buy business-class or boutique care outside of the Medicare system of basic care.

Obviously, that is what the US should do. Almost as obvious, that is what the US will do. We just can't predict the date quite yet.

I personally agree with the President's earlier statements that basic healthcare is a human right, not a privilege or a commodity available only to those able to pay whatever price is charged. We are not quite there yet, but we are getting closer.

That's my opinion. I'm Dr. George Lundberg, at large for Medscape.


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