Monopoly Round-Up: Obamacare Is Cooked. What's Next?

The monopoly round-up is out. Lots of news, as Argentines voted for Trump’s bailout by picking Javier Milei’s party in a midterm election, newspapers are reporting a comprehensive China deal, and Michael Jordan openly laughed at NASCAR in an antitrust hearing.

But first, I want to discuss the news that health care premiums are going to skyrocket next year, after two years of already significant increases.

These hikes are throwing both political parties, and the health care system, into turmoil. The ACA marketplaces may collapse, which means the intellectual promise of Obamacare is over, even though Democrats wish it weren’t so. But the Republicans have very little to offer, except on the edges, beyond pretending that all problems with health care started with Obamacare, and offering some snazzy but unimportant programs, like TrumpRx. So the politics of health care is paralyzed, even as the system is falling apart.

The reason for this paralysis is simple.

Like all of neoliberalism, the last five decades of health care debate was a deal between the right and left to have social goods distributed through increasingly powerful corporations instead of directly through the state. Progressives got something close to universal health insurance “coverage,” while the right got a privatized system with no limits on corporate power and no price transparency. There have been some uncomfortable moments attempting to disrupt this framework, like Medicare for All, but the main thrust of that argument was “for All” rather than the state provisioning care instead of corporations. It was still an access to insurance argument.

But that deal in health care is over. We just can’t afford it anymore.

Crazy Rich Hospitals

The news kicking off this essay is data coming out about the forthcoming changes in the price of health insurance premiums. And the numbers are jaw-dropping. Here’s the Wall Street Journal, which wrote the cost is now $27,000 for a family plan, according to a KFF study that came out last Wednesday. That’s a jump of 6%. And health care costs were up 7% for the two preceding years. Another major report of health care costs, the Milliman Medical index, indicated with slightly different methodology that the cost for an average family of four in 2025 is $35,000, three times what it was in 2005.

There are other indications of much higher costs. For the last three weeks, the government has been in a ...