The Pyro wrote on Nov 10, 2016, 09:56:
The Affordable Care Act is failing the middle class because it has done nothing to address the root of the issue: costs are out of control. Instead, the ACA just spreads the same outrageous prices around and allows the inflation to continue unabated.
Consider a medical procedure like having a baby. The cost of a routine vaginal delivery can exceed $20,000 in San Fransisco this year (and a C-section is twice that). The same service in other developed countries costs half or less. This is the problem that we desperately need to fix. The cost increases are unsustainable no matter how we try to pay for them.
Premiums have skyrocketed because people are using more health care - but we haven't brought the costs down at all.
It's true that the ACA was supposed to reduce costs, and for the first couple of years it did, but the last couple, they've gone way up again. The main problem IMO is using a bunch of private insurers. Profit is always a motive.
There are 3 models that the rest of the industrial world uses to control health care costs:
1. Single payer (Canada, Sweden) - by having a massive single pool, costs are distributed and massive bulk purchasing power is in play
2. A public option (Japan) - provides a baseline low with which everyone else must compete.
3. Private, but heavily regulated and high competition (Swiss) - Have a lot of smart regs controlling how healthcare companies can operate, require everyone into the free market, and have the system be national. Still, Swiss healthcare costs are second only to the USA.
The USA has several problems:
1. Each state can have its own healthcare regs, which any carrier is required to follow. This increases costs.
2. Often, like ISPs or the phone company, there are only one or two healthcare options to choose from. You end up with ISP/Phone company pricing.
3. You'll never get a national single payer or a public option past congress. There are too many insurance lobbyists.
Interestingly, the most efficient healthcare in the USA is Medicare. It's a shame we couldn't extend that to everyone as a sort of public option.
I know the Repubs are going to repeal the ACA, but they probably won't right away. The private healthcare system is making too much money from the 20M people that have swelled their ranks over the past 5 years, so the lobbyists will oppose it. Until the Repubs can field their own plan (which they've yet to show an ability to do) it will stay in place.
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