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Managed care: What Obamacare produces

Obamacare was supposed to usher in a glorious new era in which health insurers would offer more choices to more people for less money. In New Hampshire it is shaping up to look a lot like a previous health care reform it was supposed to replace: managed care.

As our State House reporter Garry Rayno explained on Sunday, Anthem, the only insurer to offer coverage on the Obamacare “exchange,” will offer essentially a managed care plan in which costs are kept in check by limiting access to providers, as HMOs, PPOs and other reforms of the 1980s and ’90s did.

Anthem says it chose to lower prices by limiting provider options because a poll it conducted showed that people overwhelmingly preferred lower prices to greater access. Surely that is true. Alas, politicians over the decades have opted to expand access rather than pursue policies that lower prices.

By and large, political “reforms” of the health insurance marketplace have consisted of mandating greater access to insurance. From coverage mandates (forcing everyone to buy coverage for gastric bypass surgery, for instance) to community rating laws to Obamacare’s individual mandate, the focus is on providing more coverage to more people.

But the people want insurance that costs less and comes with more choices. That happens through competition, which states and the federal government have spent decades constraining. Even when states have tried to lower costs, they have done it in dumb ways, such as Certificate of Need laws, which stifle competition, thus having the opposite of the intended effect.

If Anthem’s plan actually brings costs down, Obama- care backers will say it proves the law a success. But Obamacare was supposed to lower costs while letting us keep our doctors and our current insurance plans. It was not supposed to give us a super-sized managed care plan. The people would be better served by laws that let them buy exactly the insurance plan they need, not the one politicians have decreed that they must have.

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