A story from The Hill this morning describes how the markets are segmented in America, mostly driven by demographics, largely urban and smaller rural states and communities. Those facts reveal what Republicans might describe as market-driven dynamics. More insurers will compete for the larger markets, and fewer will address the smaller segments. That results in significant cost differences and more or less choices.
Cost disparity is why government intervenes with laws and regulations that distribute costs more evenly. We see that all of the time in the utility market, for instance.
Progressives argue that since profit-motivated capitalists will never attend social responsibility without intervention, that health care should be addressed as a public utility service instead. Conservatives will argue that creating a government bureaucracy to provide and administer healthcare is socialistic and will lead to excess and inefficiency.
The world is filled with successful examples where democratic nations have chosen to provide health care as a government service. Until or unless the American health care insurers can reach a compromise to control costs while maintaining quality, the trend to socialized medicine might pick up a head of steam that is unstoppable. That may be what progressives want.
Americans are driving the market and the outcome and will answer the question at the polls in November by delivering a President and Congress that they want to solve the problem.
"How ObamaCare is splitting in two
Increasingly, there are two ObamaCares.
There’s the one in coastal and northern areas, where the marketplaces include multiple insurers and plans. And there’s the one in southern and rural areas, where there is often little competition, a situation that can lead to higher premiums."
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