The Affordable Health Care Act has proven to be wildly unpopular. Conservatives don't like it because they believe that health care is not a government responsibility. Liberals don't like it because it doesn't go far enough. Nobody likes it because of the way it was conceived.
In its place, conservatives advocate medical savings accounts, claiming that competition would reduce health care costs. Their argument is flawed, for competition requires perfect information.
The market for wheat is competitive, since both buyer and seller are aware of all the relevant facts: Drought in Australia; increased demand coming from China, things like that.
The market for medical services is different. A physician knows whether a procedure will save the patient's life, or whether it is being undertaken to avoid a lawsuit. The patient does not. A patient might refuse to pay for a $100 procedure, and need a $10,000 operation two years later as a result. To reduce health care costs you need tort reform, which would eliminate the need to practice defensive medicine.
The Democrats have only themselves to blame for the law's unpopularity. In 2008 they captured the White House, the House and the Senate. President Obama appeared content to leave things to a completely unprepared Congress, and a bill was cobbled together in a fashion that would be unacceptable in a third-world backwater.
I was living in England when the post-war Labor Government brought the National Health Service into being. Even before it came to power, it had been planning for it and had a bill ready for submission to Parliament as soon as they assumed office. It went through the full legislative procedure: committee stage, a thorough debate in the House, and a careful review by the House of Lords.
The debate featured clashes between Sir Winston Churchill and Anuran Bevan, Labor's minister of health, one of the few Labor MPs who could debate the wartime prime minister on an equal footing. Sir Winston later dubbed Bevan "Mr. Thrombosis," thrombosis defined as "a bloody clot which undermines the constitution." Almost 70 years later the NHS meets with widespread approval. A surefire way to commit political suicide would be to advocate eliminating it.
After jobs and the deficit, health care is shaping up to be an important issue in the forthcoming election. Both parties need to rethink their positions.