Progressive supporters of health reform wanted a public plan option to compete with private insurers offering insurance in the state and federal health exchanges. To draw support from progressives, proponents of the Patient Protection and Affordable Care Act (ACA) created a type of nonprofit health insurance cooperative that would compete with established health insurers. Consumer Operated and Oriented Plans, or health insurance COOPs, as they are commonly known, were a political compromise for those who supported allowing non-seniors to buy their way into Medicare or a similar public program.

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Health jobs grew more than two thirds faster than non-health jobs in March, they comprised 37,000 (17 percent) of nonfarm civilian jobs added (215,000).

There is significant increase in health services jobs under Obamacare. It is unlikely we will bend the curve of health spending as long as we keep adding relatively unproductive health services jobs.

Earlier this year a report from the University of Pennsylvania found all but the most heavily subsidized ObamaCare enrollees would generally be better off financially if they forgo coverage and pay for their own medical care out of pocket. The group whose incomes fall between 1.38 and 1.75 times the poverty level will spend about three times the amount on premiums for a Silver plan as their out of pocket health care spending had they remained uninsured. For those earning more than 250 percent of poverty, most will be worse off financially compared to having remained uninsured. By design Obamacare is a bad deal for most people! Basically, except for the unlucky few who experience catastrophic health complaints, the vast majority of ObamaCare enrollees would be better off uninsured.

It is common sense that people take care of their own property better than community property, often times referred to as “commons.” Because community resources are finite (say, grazing land in a pastoral society), overgrazing (and too little maintenance) is bound to occur absent any collaborative agreements. Moreover, one person’s conservation efforts cannot overcome all the other self-interested parties’ perverse incentives. Economists call this the tragedy of the commons. Unfortunately, ObamaCare proponents (and LBJ for that matter) did not understand how the tragedy of the commons would boost health care spending. Medicare, Medicaid and Obamacare plans are all examples of attempts by government to expand the health care commons — rather than encourage individuals to sustainably manage their own health care resources with appropriate incentives.


In a survey of non-seniors, a New York Times/Kaiser poll found about one-in-five people struggle with medical bills even though they have insurance. Among insured people who reported crushing medical debts, about three-quarters reported putting off vacations, major purchases and cutting back on household spending.

Nearly two-thirds used up all or most of their savings. Far fewer had to resort to second jobs, take on more hours or ask family members for funds (42% to 37%).

Released on December 22, 2015, the third estimate of Gross Domestic Product (GDP) for the third quarter indicates growth in health services spending is maintaining a disproportionate share of still slow GDP growth.

Spending on health services grew faster (4.8%, annualized, in current dollars) than spending on non-health services (3.9%) The growth in health services spending ($24.8 billion, annualized) accounted for 17% of all GDP growth ($146.5 billion), just under one fifth of personal consumption expenditure ($130.6 billion) ), and 29% of all services spending ($84.7 billion).

The evidence continues to indicate Obamacare is not bending the cost curve.