The Problem With Obamacare Is Obamacare

[Why_Yes_I_Do]

Originally Posted by adav8s28

...we are seeing large rate increases getting approved on the government exchanges due to UNBALANCED Risk Pools. It's as simple as that...

Sure, Socialism is simple enough. Make people buy something they do not need or want. You know. The thing. More of Other People's Money. Come on man!

[farmstud60]

Originally Posted by Yssup Rider

Stud, you are describing ACA marketplace insurance, which is what Farm Bureau sells.

There’s no bigger group than that.

nope

[txdot-guy]

Originally Posted by Why_Yes_I_Do

Sure, Socialism is simple enough. Make people buy something they do not need or want. You know. The thing. More of Other People's Money. Come on man!

Who’s the simpleton here? The truth is that eventually everyone will both need and want healthcare. And the older you become the need will become more acute.

That’s what makes this discussion different than a traditional capitalist response. If everyone is going to both need and want healthcare then the way to make it economically viable is to make everyone participate. For everyone to have a stake in the system.

[Mort Watt]

^^^^^^^^^^^^^^^^

Perfectly said.

[adav8s28]

Originally Posted by txdot-guy

Who’s the simpleton here? The truth is that eventually everyone will both need and want healthcare. And the older you become the need will become more acute.

That’s what makes this discussion different than a traditional capitalist response. If everyone is going to both need and want healthcare then the way to make it economically viable is to make everyone participate. For everyone to have a stake in the system.

+1

Outstanding reply!!!

[adav8s28]

Originally Posted by Why_Yes_I_Do

Make people buy something they do not need or want. You know. The thing. More of Other People's Money. Come on man!

Republican congresswoman MTG has relatives on Obamacare. During the government shutdown she was calling for the GOP to extend those extra Obamacare tax credits that Biden put in during CoVid. Do you think Republican MTG is a socialist?

Question for you. For the person who is 30 years old, healthy and doesn't want health insurance. This person comes down with a serious illness and needs to be admitted to the hospital. This person ends up with a bill of $20,000. The person can't afford to pay. Who is suppose to pay the hospital and doctors that treated him/her?

[Tiny]

Originally Posted by adav8s28

Question for you. For the person who is 30 years old, healthy and doesn't want health insurance. This person comes down with a serious illness and needs to be admitted to the hospital. This person ends up with a bill of $20,000. The person can't afford to pay. Who is suppose to pay the hospital and doctors that treated him/her?

Most hospitals are nonprofits that don't pursue collection of unpaid bills from indigents.

That's not to say that the USA shouldn't have universal health care. Most here probably believe it should. The question is how are you going to get there. And lower costs and improve outcomes. I believe free market solutions with some help from government, or even a single payer system favored by TxDot, would work better than doubling down on what we've got now, which is what Obamacare did.

[Texas Contrarian]

The thread title is certainly apropos, since the fiasco that answers to the name of "Obamacare" doesn't even make any attempt to address the most fundamental issues.

The actual name of the legislation, of course, is the Patient Protection and Affordable Care Act. (A misnomer if there ever was one, as was the infamous "Inflation Reduction Act" of three years ago.)

My take on a few key points:

The total all-in cost of health care for Americans has increased at a far faster pace over the last 15 years than all the other major necessities of life. Why is that? Well, because the health care industry (including insurance companies, hospital chains, pharmacies, and physicians' practices), is a giant MINO (market in name only). There's virtually nothing in the way of pricing transparency or available information to individuals regarding what they're really getting when they shop for insurance, or even whether they're at risk of being bankrupted in the event of serious illness that exceeds coverage caps or is subject to numerous exclusions.

Then there are the "pharmacy benefit managers" (PBMs). Originally, 50+ years ago, they were intended to manage costs by negotiating prescription prices with the larger insurers and and other entities. Now, in the aftermath of vertical integration resulting in the largest PBMs being formed or acquired by large insurance companies and pharmacy chains like CVS, the pricing incentives are perverse; driving up costs for patients. The result is an edifice built on a foundation of rent-seeking and crony capitalism that's virtually without peers in the American economy.

By contrast, compare all this with the marketplace for two other necessities of American life: Paying for a home (or apartment) and buying a car. Prospective tenants shopping for an apartment can pretty easily determine, within just a percentage point or two, what they should be paying for the unit and the amenities they're getting. The same goes for buyers of new or used vehicles. These are transparent and easy-to-navigate markets where no one has to buy a "pig in a poke."

Is the answer really to stuff more subsidy cash down the gullet of this obese turkey?

(I think not! There are better answers!)

For instance, Germany and Switzerland achieve universal or near-universal healthcare coverage at a cost of five or six less percentage points of GDP than in the US. There's no reason that we couldn't do that with properly design reform, regulation, and efficiency. Instead, we allow the bank accounts of politicians (of both parties) to be lubricated with a flood of lobbyists' and PACs' cash, meaning that many of them continually make every effort to avoid solving the very problems that some of them publicly fulminate over.

Perhaps worst of all, this acts as a heavy tax burdening working-class and middle-class America. If we could reduce all-in health care costs by six percentage points of GDP, as we obviously could if we simply followed the examples set by the Germans or the Swiss, costs per household could be reduced by about $11K to $13K annually.

Some might say, "Well, that's not a problem for me. I have a good job and my employer pays for my health coverage," my answer is this: No, they do not! That's part of your compensation, and every employer that pays for coverage "figures it in" when deciding on your total compensation package.

As many have noted, coupling of HSAs or similar structures with well-designed catastrophic coverage would allow much greater price transparency and place decision-making power in the hands of better-informed patients, and if properly engineered could save massive amounts of money.

Sadly, though, no one in a position of power is likely to do a damn thing in the way of properly addressing the most pertinent issues.