The Supreme Court today upheld the Affordable Care Act of 2010, otherwise known as Obamacare. Judging from the polls, American public opinion appears to be very sharply divided over the legislation. Some view it as socialism, others as the first success in a half-century of efforts to achieve a sensible national policy on health care.
What explains the wide divergence of views? An economists’ approach - cynical or naïve depending on how you look at it - would be to assume that citizens vote according to their own personal interests. Getting the uninsured onto paid insurance through the individual mandate is very much in some people’s interest, but not necessarily as strongly in others’ interests. Let’s take a look.
Those who have the most to gain from President Obama’s health care legislation are those who have a pre-existing condition or are pre-disposed to illness, for example because they are overweight. They are more likely to need medical care in the future, but can be charged higher rates if they try to buy private insurance, by virtue of their condition. Or they can be excluded completely. (Each obeseAmerican incurs medical costs 42% higher than those of normal weight.)
Figure 1: States with higher obesity rates tend to oppose the Affordable Care Act