President Obama reacts to the passage of ACA.

In the old game by this name, participants are first asked if they want to agree to “tell the truth” about what they will be asked (usually something embarrassing), or if not, if they will “do a dare” instead (again, usually something embarrassing). When you Google “Truth or Dare” you find a link to an entry in Wikipedia which says, “The game is particularly popular among adolescents and children.” One would hope the adults are in charge of American public policy, but it certainly doesn’t appear that way in regard to health-care policy.

Having been fully in effect since January 1, 2014, ObamaCare is experiencing a “crunch time” of Truth or Dare alternatives. Supporters of the new system appear unwilling to tell the truth about the growing costs of ObamaCare and how it has an unsustainable design. People who had never paid anything into the system prior to signing up are now undergoing organ transplants, bypass surgeries, and other very expensive procedures. Overall costs are going up – not down as promised – and this will result in everyone’s premiums going up in the future.

Supporters hope that opponents won’t “dare” to let so many people lose their health insurance and will be forced to set up state-run exchanges to replace the federal ones, which don’t qualify for the subsidies. Opponents of ObamaCare are “daring” supporters to admit its flaws and fundamentally reform the system by keeping popular features like “no exclusion for prior conditions,” but adding new features designed to actually contain costs and make health insurance affordable for all Americans.

These new features include restrictions on malpractice suits, allowing insurance to be sold across state lines, allowing people to keep existing policies they like when they change jobs or move, giving comparable tax incentives to those who buy individual policies instead of getting insurance through their employers, providing incentives to allow a range of providers of health-care and thus increase supply and hold down costs, and mandating transparency in medical-care costs.

Other ideas which have been suggested include making Health Savings Accounts easier to buy and use, allowing small businesses to pool together to increase their “purchasing power” in dealing with insurance companies, and allowing individuals to pool together through churches, alumni associations, and other civic groups.

More broadly, let’s “Dare to tell the Truth” that letting the market provide a multitude of solutions instead of mandating a “one size fits all” government plan will best serve the American public and especially those who were not previously receiving coverage for a variety of differing reasons.

Reprinted by permission from INSTITUTE BRIEF, a publication of Public Interest Institute.

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