The U.S healthcare fiasco

Healthcare was a mess before the ACA? TOTAL BS
Before the ACA my wife had her own plan. It cost $250 a month with a $2,000 deductible.
When they passed ACA she lost her plan and her doctor. The cost (with the subsidy included) jumped to $460 a month with a $6,000 deductible.

Which "mess" would you rather have?

 

Medicare Part A covers only a minority of average healthcare cost. And Medicare will be bankrupt in a few years.

 

It works well for most, poorly for many. As I noted, "There were serious problems with the US healthcare system before the Affordable Care Act; there are serious problems with the US healthcare system under the Affordable Care Act; there will be serious problems with the US healthcare system after the Affordable Care Act."

Anyone who expects "Something terrific!" is going to be very disappointed.

 

Medicare Part A only covers hospital charges, you must also have part B to cover physician and other medical services. The increase in health spending starts in the 50 year age bracket and older since chronic conditions begin to emerge when people reach 50 and over. Actually health spending is concentrated among people with dual coverage that have Medicare and Medicaid and the higher income brackets population.

 

Medicare will not go bankrupt, this fund during the productive years of the baby boomers enjoyed triple digit surpluses (surpluses is the same as profit). It is now double digit surpluses since the baby boomers are retiring. If the government were not allowed to spend those surpluses for other than healthcare, we would not be in the mess we are in.

 

everyone should have access to affordable healthcare when they most need it, it is NOT the same as owning a car, a yacht, a mansion... This is where you are dead wrong. In your opinion, it is perfectly fine for insurance companies to treat sick people as nonprofitable business (just as a car or yacht that doesn't sell) and eliminate them (dropping them off plan) or increasing their premiums to unaffordable levels. This is just amoral and shame on you for supporting such practices.

The problem here is that people are caught up on either socialism or capitalism - it has to be one of the other across the board. Why are americans so extreme in their thinking? Why not have a capitalist society where free markets are supported but have some exceptions - healthcare. When it comes to healthcare, it should not be viewed as running a bank or a car manufacturer, it should be socialized to a degree. We can have socialized insurance (single payer) without socialized medicine so that healthcare remains largely private but insurance is not for profit and more cost effective. It is absurd that free market capitalists think it is perfectly ok to discriminate against sick people because they are unprofitable, tax payers should pick up the tab here.

 

Without the mandate, how many people would chose a $460 a month premium and a $6,000 deductible? I would guess hardly anyone and the insurance companies knows this. They took advantage of the mandate and are all charging way too much for health coverage while shifting more of the cost to the consumer.
The only thing that the insurance companies hate is having to provide coverage for people with pre-existing conditions and having to pay for preventive care. They love the Medicaid expansion as they are getting premiums for all adults on Medicaid from the government.

 

Obama didn't oversell it. He fraudulently deliberately lied about it to convince us stupid people -- in the words of his architect.

Prior to ACA about 80% of the population was covered in a group plan (which seldom if ever refuses coverage for pre-existing conditions) and 90% of those were fully satisfied. And you call that terrible compared to ACA? Under ACA best estimates are that 2 to 4 million who really wanted insurance but couldn't afford it got insurance plus another 4 or 5 million or so dependents got an additional 3 or 4 years of coverage. (Actually that number is probably somewhat higher because it does not include the college students that went on their parents' plan after the universities had to cancel their cheap coverage for being incompatible.) This compares to the estimated 15 to 20 million who had their insurance cancelled, but very unfavorably, and to the tens of millions more who saw their costs of insurance skyrocket. Not to mention the $1 trillion taxpayers will have to pay between 2012 and 2022 to subsidize ACA, compared to the estimate of saving us a few $ million a year that Obama told us (with a straight face and fingers crossed) in 2011..

You make the same mistake that most people make: thinking ACA was about healthcare and not about increased central government control of the people.

 

did you know that ACA is largely a republican idea that republicans tried to sell many years ago when democrats were pushing for single payer? Now they claim it's a disaster, what credibility do we have here if any? look it up, do your research. Republicans would've jumped on ACA if Obama would've proposed single payer, just as they did many years ago. It's amazing...

and as far as costs, healthcare costs were rising at a higher rate before ACA so you want to go back to what we had beforehand? It was worse, by most accounts.

 

It would be funny if it wasn't so sad, the legions of poor folks who will lose their insurance after voting for trump. The right has become so focused on repeal that a solution to replace doesn't matter anymore. They've come to understand through right wing propaganda funded by the insurance and pharma industries, that the ACA is an unmitigated disaster. It's typical of the short term thinking of what passes for the contemporary political right. No thought is ever given to the greater good, or the benefits outside of those that occupy the space 2 inches from one's nose.

Healthcare for profit will never be fair, just, or equitable. We've decided in this country that the profit motive has more value than human life. Ironically, these same people who don't want to provide healthcare think they can control what a woman does with her body. It's also ironic that the party who touts themselves the party of business wants to keep the expensive burden of providing subsidized insurance to their employee's.

I suspect ACA will be repealed, and nothing will take it's place. Perhaps when those coal miners with black lung who voted trump realize that their jobs are not coming back, and that trump took away their health insurance, they'll understand how wrong they are. However, that's not likely and people will continue to vote against their interests.

 

What I expect is for the federal government to quit destroying markets(housing, healthcare, higher ed). And, let states and the market deal with these issues.

 

Please. There was never a wide spread mainstream movement among republicans to push an ACA like system in the country. That's just like saying Bernie Sander's pure socialist driven agenda is a mainstream "democratic idea" because he ran under the democratic banner. Republicans (and conservatives in general) want free market solutions for healthcare challenges. The ACA is built on coercion. It doesn't fit the criteria.

 

The feds are not about to eliminate the $250 billion annual subsidy that sustains employer-administered healthcare plans, even as it foists the administration of them onto private businesses that could better allocate their resources.

Nor should you expect a president not interfere in private-sector corporate decisions aimed at maximizing profit.

Those who worship the free market in theory need to grasp the reality.


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Rob, exceptional post. In the nutshell, it helps explain part of the reason why Trump will take be taking the oath later this month.....

 

In Britain we've had the NHS (National Health Service) since 1948, it's funded by our taxes which means it's sort of "free", and nobody has to dip into his/her pocket to get medical treatment.
It seems to work okay, so if Britain can do it, why can't America or anywhere else?

 

In America, the only tool about half of us feel comfortable using is private enterprise. Call it a hammer. Thus about half of us see every problem as a nail.

 

I think Trump is not going to be the GOP's puppet. Bernie sanders is sharing Trump tweets where during the campaign, he attacked GOP for wanting to cut social security, medicare and medicaid. Trump is asking both parties to come up with something better than ACA, i see him standing in the way of GOP attempts to repeal without any plan. Trump is not a far right nut, he's more of an independent who disagrees with GOP on some of these aspects. I don't think Trump wants to go down as the present that repealed ACA without having any concrete plan to replace it. GOP will get a rude awakening if the try to use Trump as their puppet to pass whatever they want... you watch.

 

private insurance doesn't work when it comes to reducing costs, it's a lie that more competition and free markets will bring down costs. See, one of the reasons premiums continue to go up even after ACA, is that it's largely left to private insurance companies and medical providers to set the price. The free markets will set a high price for healthcare for very obvious reasons:

1. healthcare is expensive
2. Insurance companies make astronomical profits, our premiums are not just to pay for healthcare, it's also goes towards profits and fat cat's wallets who run insurance companies
3. There is an incredible amount of inefficiency with hospital administrative costs, the amount of waste here is much higher than in nationalized or single payer systems. Administrative costs for hospitals in US amount of a much larger % of their budget when compared to systems like what they have in Canada for instance. This is largely due to the private insurance industry...


so i have yet to hear a good solution to how FREE markets will set a low price when part of the premiums go towards billions in profits, there is so much administrative waste in hospitals and healthcare is expensive to begin with. It simply will never work! The free markets will NEVER set a good price for healthcare.

This is so basic. The free markets see sick people as unprofitable and so how do they seek to tackle this? charge high premiums, set high deductibles, drop them off plans, set lifetime limits. There is no way around it, simple no? Now ACA attempted to improve this by eliminating discriminatory practices against the most in need, the idea was - force everyone to pay for insurance, limit insurance companies power to discriminate against the most in need and it'll all work. The problem here is that the private sector 'free markets' will always seek to make a profit so they found ways to do it by increasing premiums for healthy people and increasing deductibles. Well, there you go - FREE MARKETS.

The only way to solve this is to take the free markets out of the insurance business, medicare of all or single payer would bring down hospital administrative costs tremendously and once profits are eliminated, premiums will come down. This is a no brainer... Of course, if you have the money, you can always get what you want anyway.

 

Free markets can have proper regulation. On one hand, those who choose not to insure should not be forced on insurance companies to insure after they need it. On the other, no one should be charged differently based on age or circumstances beyond their control. We can share the cost of many illness. Yet, those who smoke, are obese or are self-destructive, should be charged higher accordingly.

I'm in favor of mandated HSA's to be used strictly for health issues. I'm for the government incentivizing employer HSA funding, while disincentivizing group plans. This would stimulate market forces and curb unnecessary use. Individuals/families should shop doctors and pay out of pocket/HSA for most needs, while buying high deductible catastrophic insurance for major needs. This allows people to build personal wealth for later years or to pass to heirs, while engaging market forces.

 

Hope your right! I really do.

 

Well, the trustees say it will be broke in 10-15 years without any corrective action.

 

Which has no bearing on the question. ACA is terrible and if there are Republicans who disagree, well, Dems do not have a monopoly on stupid.

Pellosi just ballyhooed that health care cost increases tapered off between 2003 and 2013, nimbly avoiding the ACA spike that began in 2014.

 

Thanks.

 

The ACA actually has very few problems. It's the likes of Paul Ryan who made it a problem by hijacking the program to start with, and sent false messages saying it was a failure. They made it a failure. Obamacare was never a failure; http://newcenturytimes.com/2016/11/...n-by-keeping-billions-from-obamacare-details/ And now millions will be without it because the Right was never going to give Obama credit for something that works.

 

this sounds good but i don't think it will work.... too much goes towards profits, administrative costs. I read a stat that at least 30% of healthcare costs today goes towards profits, paperwork, overhead, CEO and executive comp. You don't see this waste in nationalized or single payer systems, they are much more cost effective.

I don't think any of these HSA ideas and other ideas will be as cost effective as single payer.. it just never will. People think countries like Canada incur more government healthcare costs than US but they are mistaken. The US government spends more on healthcare today and it's not even a nationalized or single payer system! The US spends a greater % of GDP on healthcare than Canada or UK! are you shocked? well, there you go... most of it is spent on private insurance for government employees and tax subsidies. So when people talk about nationalized systems costing govt more, it's not totally true.