Jeb Bush interrupted a riff Thursday on Obamacare — unsurprisingly, the Republican former governor of Florida thinks it ought to be repealed — to discuss how the Apple Watch could revolutionize health care. In particular, he talked about the idea of patients taking care into their own hands:
Someone will, because of my blood sugar, someone will send me a signal, I’ll get a double beep saying, you just ate a butter scotch sundae, you're diabetic, you can’t do that, whatever, we’ll be able to guide our decisions in a way that will make us healthier.
Some in the media read this as Bush suggesting that Apple Watches should replace Obamacare altogether. I watched the clip and think that's a stretch. It seems more like Bush interrupted his thoughts when someone in the audience pointed out that he was sporting an Apple Watch. So he moved away from talking about Obamacare repeal, and shared his thoughts about why the watch could matter for health care.
Still, there's something a bit weird about Bush's suggestion in the context of his desire to repeal Obamacare — namely, that his idea of how Apple Watches will improve health care specifically relies on people having insurance. And repealing Obamacare would mean reducing the number of Americans with coverage.
Bush endorses the idea of "someone" sending him a signal on his Apple Watch when his blood sugar is low. I like that idea, too! It would help diabetic patients, like Bush, better manage their care.
But here's the challenge: there is not some army of benevolent people out there monitoring blood sugar. There are health-care providers who do this, and to get signed up for their blood sugar monitoring programs, you typically need health insurance. In this way, the type of consumer-powered health market that Bush describes is one that relies on Americans having access to health services — and using that access to make better decisions about their health care.
All the best data we have right now strongly suggests that repealing Obamacare would reduce access to health care in the United States. There are an estimated 16.9 million Americans who have gained coverage under the health-care law — and who would lose health plans, blood sugar monitoring programs and all, if the law disappeared. The vision that Bush outlines isn't one where the Apple Watch replaces Obamacare. It's one where the Apple Watch relies on Obamacare existing to empower consumers in the first place.