The Affordable Care Act isn't a great bill. It's not a good bill. But the best parts of it are those that don't rely on market mechanisms. The Medicaid expansion has already provided insurance to millions of poor Americans and the cost-saving provisions have helped stall health care cost inflation.
We have seen the future in the UK, Canada, France and Germany, and it works. Although the systems vary in complexity, all reject market mechanisms for distributing health care in favor of government-directed system.
Even the radical Margaret Thatcher has left the National Health Service untouched. She was right to: it produces better results than the U.S. system for half the cost. Meanwhile, the Institute of Medicine estimates that the U.S. system wastes 750 billion dollars each year. Kenneth Arrow argued in 1963 that a market system simply can’t work for health care.
Our uniquely “market-oriented” health care system is the blight of the developed world. Keep markets out of health care.