dollarshcThere have been dozens if not hundreds of news articles about Aetna leaving the Affordable Health Care Act’s online marketplaces in 11 states, and whether this signals serious problems for Obamacare down the road.

But none of them have truly explained that what’s happening with Aetna is the consequence of a flaw built into Obamacare from the start: It permits insurance companies to make a profit on the basic health care package Americans are now legally required to purchase.

This makes Obamacare fundamentally different from essentially all systems of universal health care on earth. (There is one tiny exception, the Netherlands, but of the four insurance companies that cover 90 percent of Dutch citizens, just one is for profit.)

Why does this matter? The answer is complicated but extremely important if Obamacare is going to avoid collapsing.

Insurance companies like Aetna complain that fewer young people than anticipated are buying insurance on the exchanges. The Obama administration was aiming at over 38 percent of the exchange pool being between 18 and 35 years old, but right now that number is just 28 percent. That means insurers have to pay more in health costs […]

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