MICHEL MARTIN, HOST:
At the heart of the government shutdown is a fight over health insurance, specifically how much it should cost buyers who use the government-run marketplace set up under the Affordable Care Act. Along with the lawmakers who have been fighting about this, we've been talking to health policy experts about whether the ACA has been a good way to get people access to health insurance, but also why is health care so expensive in the U.S. anyway?
Last week, we heard from Dr. Ezekiel Emanuel. He's considered one of the architects of the ACA, who said it has fixed the main problem it was designed to solve - getting more people access to coverage. Today, we hear a different perspective from Michael Cannon. He says the ACA has failed, and it's time for something different. He's the director of health policy studies at the Cato Institute. That's a libertarian think tank based in Washington, D.C., and he's with us now. Good morning. Thank you so much for joining us.
MICHAEL CANNON: Good morning.
MARTIN: You know, many advanced countries have solved the issue of access with single-payer systems. What's wrong with single-payer systems from your perspective?
CANNON: Well, first, they take away your right to make your own health decisions by saying, you've got to give your money to the government and keep giving your money to the government even if the government's doing a lousy job. The second problem is, the government is doing a lousy job. No country has solved the problem of making health care more universal. Many of them have issued a blanket guarantee of access to care, but that's not the same as actually delivering access to care.
If what we want to make health care more universal, then what we need are innovations that drive down the price so that more people can afford it by themselves. And Congress has shown over and over again that it is completely incapable of eliminating wasteful health spending. We have the most expensive health sector in the world. And every time someone identifies a problem with it, like Obamacare premiums rising at 26%, people say, well, the only solution is to throw another half trillion dollars at it.
MARTIN: OK, you've told us what's wrong with the system as you see it. What is your better idea?
CANNON: The biggest problem with the U.S. health sector right now is that we're spending 5 or 6 trillion dollars per year, but the wrong people are controlling the money. It's the government and employers, and if we took that money and gave it to consumers, we would see prices falling, health care becoming more universal. There are experiments that show this. Let them choose a health plan that stays with them between jobs because then people will have seamless coverage throughout life changes.
MARTIN: You know, one person's unhelpful, burdensome, regulatory requirement is another person's essential - right? - like contraceptive care, assisted reproductive technologies, preventive care, cancer screenings.
CANNON: The question is not whether there should be access to effective screenings. The question is, what is the best process for identifying what the cost-effective screenings are and then getting the price down as far as we can so that it's most widely available, most universal. I think that if we did what I suggested - just let consumers control their health insurance dollars and choose their on health plan - you would have health plans competing to do both of those things.
MARTIN: Before we let you go, we've been talking to Democrats and Republicans, as I said. We've spoken to a number of Republicans over the course of this, and many of them have diagnosed the problem in the same way that you have. They haven't really put forward any specific solutions. So why is it that the Republicans have not produced a coherent strategy, including things that one would think that they would support that lean on free market solutions?
CANNON: There just are no - there's no Bernie Sanders of free market health care. There's no AOC of free market health care. I think it's because health care in the United States government has already socialized it so much that making any effort to limit government's involvement is easy to demagogue as taking health care away from grandma or something like that. And Republicans haven't invested the time to get their heads around exactly why that's wrong and why reducing the government's role would actually make health care more universal and higher quality.
MARTIN: That is Michael Cannon. He is the director of health policy studies at the Cato Institute. That's a libertarian think tank based in Washington, D.C. Michael Cannon, thank you so much.
CANNON: Thank you. Transcript provided by NPR, Copyright NPR.
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