Nancy Cummings thinks that the Affordable Care Act provides a brighter future for our health care system (Maine Voices, July 15), but her enthusiasm is misguided.

In health care, as in every area of public policy, it is important to consider both ends and means.

Constitutional or not, the ACA is filled with examples of bad economics and perverse incentives that almost always create bad policy. It provides free care to millions of individuals and generous insurance subsidies to millions more, but the cost of doing so is exorbitant and will eventually result in one of the most expensive entitlement programs in the country’s history.

The legislation embeds more deeply the third-party payment system, which shields consumers from the costs of their health decisions and gives them little incentive to seek value and providers little incentive to create it. Dr. Cummings and other ACA advocates may be oblivious to economic reality, but there are no free lunches, or free checkups.

Chief Justice John Roberts made the ACA constitutional by the ingenious transformation of a penalty into a permissible tax. That dismayed conservatives, but the court’s decision has done them a favor by putting the fate of the legislation back where it belongs, in the hands of voters and their elected representatives.

If Americans can get past the attraction of yet more government largess they will recognize how expensive and harmful the ACA is. It isn’t too late to replace it with something better, but the task will be difficult and time is short.

Martin Jones is a resident of Freeport.

 

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