High cost for health care in America

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ACA didn’t implement any of their target cost reduction areas
it was a sham written by industry lobbyists
 
Yeah this isn’t a party issue. Its a national issue.

Needs to be scratched and start over from scratch
 
I actually agree with you here. (Lie down and elevate your legs a little; it’s the best First Aid for shock 😉

The ACA had some hope until industry captured it.
 
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Health Insurance premiums were climbing at a rate of 19% a year before ACA went into effect

Healthcare costs are the result of the “For Profit,” healthcare system we have, which is out of control
 
Not just pharma. Hospitals and medical groups are run by people with MBA’s and their job is to make money for the institution that employs them.

So, cutting the number of nurses, charging high costs for treatments and other revenue driven functions are part of their jobs.
 
JimR-OCDS said:
Health Insurance premiums were climbing at a rate of 19% a year before ACA went into effect

Healthcare costs are the result of the “For Profit,” healthcare system we have, which is out of control
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For Profit with appropriate regulation is good, but their lobbyists have turned the regulations in the US in their favor.
 
To give the law (in general) the benefit of the doubt, wasn’t it given a rocky start like some states not expanding (still haven’t) expanded Medicaid, not to mention, President Obama turning into a lame duck after 2010 seemed to kill any effort at tweaking and readjusting the law like boosting premium subsidies?
Not to mention, a relatively weak mandate meant that people wouldn’t opt for insurance which led to the exchanges being stressed (possibly added by Trump cancelling the CSR Subsidies (yes, they weren’t apparently properly appropriated which apparently will drive the deficit slightly higher instead of saving money), that comes to mind though, if we boosted premium subsidies (flooding the exchanges with funding) and tweaked the formula (total OOP can be capped at 5% or 10%), then it would have worked out?
An Economics Professor I had told me that health care spending growth slowed after its passage and while a lot of people found higher premiums/deductibles, what if that was meant to “balance out” the exuberant costs of pre-existing conditions as well as Essential Health Benefits which seems nice to have (like a baseline plan)? I do concede deductibles seem higher (and chances are we still have to pay), it’d be nice if those were lower or even zeroed out, if you’re struggling with premiums, wouldn’t having little to no deductible be a nice to have?
Also, if we look at it, aren’t the Exchanges basically a more open ended High Risk Pool (thanks to pre-existing protections), why go to the trouble of forming a High Risk Pool, if we already “have” one?
 
RCIAGraduate said:
To give the law (in general) the benefit of the doubt,
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Why give it that benefit when it was eventually read and understood.

it didn’t include provisions to reduce the costs of care.​

Bringing up expanded medicaid is a deflection, that could have been done without ACA. Expanding medicaid was maybe the only useful thing he did with the law, and increased protection for preexisting conditions.
 
Bringing up expanded medicaid is a deflection, that could have been done without ACA.
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Yeah, in fact I even read an argument saying that Medicaid Expansion (and extending family benefits to age 26 for adult kids) may have hindered the law since less people would have bought into the exchanges, consequently. Another deflection, could a solution to the Medicaid Gap though be to provide zero premium plans for people up to a certain income thereby offering a baseline plan or not as easy?
Expanding medicaid was maybe the only useful thing he did with the law, and increased protection for preexisting conditions.
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Could the Medicaid Expansion been too modest (like not to 200%, 250% or even 400%) considering the living costs in some areas or is that moving sway from a poverty issue to a cost of living one? That said, isn’t there a case to cover the working class/moderate income under Medicaid considering these may be folks who make too much for social assistance yet aren’t necessarily in a comfortably middle class state, they may be struggling to get by even unable to save (especially in HCOL areas)?

Actually, weren’t the Exchanges promising (and like I said, isn’t it basically a High Risk Pool that people can opt to) and there was the Public Health and Prevention Fund which could or did help, also there was this video (8:48) saying it was promoting innovation including alternative methods of payment like bundled.
 
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The more I think about it the more simple the solution is. I know it is pretty complex but still…

If you add a maximum price to every service/drug/procedure/etc this is what would happen IMO.
Everyone would be on a level playing field charging the maximum. Eventually, the smart providers would realize that if they drop their prices a tad, they would get a lot more business. Everyone else would catch onto this and drop their prices to pick up more business. This cylce would likely happen often but the end result is competition for business instead of competition for highest price per service.
 
No they were not. I had been buying health insurance myself for years prior to ACA. I went back through my records and found that the 10 years prior to ACA they went up at an average annual rate of 5.5%. not good, as that’s double inflation, but no where near 19%. Now since ACA, my rates are twice as high (after only 5 years), with twice the deductible and fewer doctors and hospitals in my network.
ACA has been a disaster. It has made things much worse.
 
tafan2 said:
No they were not. I had been buying health insurance myself for years prior to ACA. I went back through my records and found that the 10 years prior to ACA they went up at an average annual rate of 5.5%. not good, as that’s double inflation, but no where near 19%. Now since ACA, my rates are twice as high (after only 5 years), with twice the deductible and fewer doctors and hospitals in my network.
ACA has been a disaster. It has made things much worse.
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Man what I wouldn’t give to go back to my first year out of college in regards to health care costs. I thought it was outrageous then. A married plan with a $1,000 deductible was around $900/month on premiums. And it went up about 5-10% every year. This was with a company that the average age was 55 years old.

That is a great deal by today’s standards. BAck then, it was nuts. Now I have friends that pay $2k/month for a $10k deductible.
 
Some observations:
  1. Any debate has to define terms and people here are mishmoshing them. Are you all debating the high cost of health care? Or health insurance? Those are 2 totally different things. Some of you appear to be debating the former; most others, the latter.
  2. As to health care, or insurance, either is exceedingly complex - in neither case is high costs caused by, solely. lobbyists; “big pharma,” greedy doctors; or whatever.
  3. As to health care, I would posit that the “system” isn’t broken at all, because the USA has the best health care in the entire world, bar none:
    –Where do the world’s richest people come for treatment? The USA.
    –Where do the world’s best physicians, or physicians in training, come for training? Medical schools in the USA. Many medical schools in other countries, by contrast, can’t have their graduates even become physicians in the USA.
    –Where is the highest-echelon medical research being done? The USA.
    –Would you rather have drugs pass the rigorous quality control of the FDA and US drugmakers? Or would you rather get your drugs from, oh, I dunno, China?
    –Where do you wait for months for a doctor? Places like Europe. Where can you likely get a doctor in any of 10 million specialties, essentially on demand? Major metro areas of the USA.
All of these things will be factored into the cost of health care. Want free health care? You’ll get what you pay for? Want the best? You’ll pay for it, but that’s not “healthcare,” so much as it’s life.

IMHO, what is the single biggest factor in high US health care costs? Probably managed care, perhaps with defensive medicine (largely fueled by lawsuit costs and hence malpractice costs) second, but I am not qualified to render a comprehensive opinion as to that.
 
RCIAGraduate said:
Yeah, in fact I even read an argument saying that Medicaid Expansion (and extending family benefits to age 26 for adult kids) may have hindered the law since less people would have bought into the exchanges, consequently.
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I can’t see this since Medicaid is means tested. Expanding medicaid helped the exchanges succeed by moving the people qualifying for the largest subsidies off the exchanges.

ACA failed because two reasons:
  • they overestimated the number of wealthy and health people that would join up and pay the subsidies.
  • They also grossly underestimated the cost of people with pre-existing conditions.
 
VonDerTann said:
  1. As to health care , I would posit that the “system” isn’t broken at all, because the USA has the best health care in the entire world, bar none:
    –Where do the world’s richest people come for treatment? The USA.
    –Where do the world’s best physicians, or physicians in training, come for training? Medical schools in the USA. Many medical schools in other countries, by contrast, can’t have their graduates even become physicians in the USA.
    –Where is the highest-echelon medical research being done? The USA.
    –Would you rather have drugs pass the rigorous quality control of the FDA and US drugmakers? Or would you rather get your drugs from, oh, I dunno, China?
    –Where do you wait for months for a doctor? Places like Europe. Where can you likely get a doctor in any of 10 million specialties, essentially on demand? Major metro areas of the USA.
All of these things will be factored into the cost of health care. Want free health care? You’ll get what you pay for? Want the best? You’ll pay for it, but that’s not “healthcare,” so much as it’s life
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And could you quote a few stats showing the impact of these services to the rich on overall US people’s health? Do they live longer? Have less pain? Remain mobile longer?
 
VonDerTann said:
Some observations:
  1. Any debate has to define terms and people here are mishmoshing them. Are you all debating the high cost of health care? Or health insurance? Those are 2 totally different things. Some of you appear to be debating the former; most others, the latter.
  2. As to health care, or insurance, either is exceedingly complex - in neither case is high costs caused by, solely. lobbyists; “big pharma,” greedy doctors; or whatever.
  3. As to health care, I would posit that the “system” isn’t broken at all, because the USA has the best health care in the entire world, bar none:
    –Where do the world’s richest people come for treatment? The USA.
    –Where do the world’s best physicians, or physicians in training, come for training? Medical schools in the USA. Many medical schools in other countries, by contrast, can’t have their graduates even become physicians in the USA.
    –Where is the highest-echelon medical research being done? The USA.
    –Would you rather have drugs pass the rigorous quality control of the FDA and US drugmakers? Or would you rather get your drugs from, oh, I dunno, China?
    –Where do you wait for months for a doctor? Places like Europe. Where can you likely get a doctor in any of 10 million specialties, essentially on demand? Major metro areas of the USA.
All of these things will be factored into the cost of health care. Want free health care? You’ll get what you pay for? Want the best? You’ll pay for it, but that’s not “healthcare,” so much as it’s life.

IMHO, what is the single biggest factor in high US health care costs? Probably managed care, perhaps with defensive medicine (largely fueled by lawsuit costs and hence malpractice costs) second, but I am not qualified to render a comprehensive opinion as to that.
Click to expand...
I understand where you are coming from but from what I’ve read, studies show that Americans, health wise, are not better off than other countries.

So I don’t think that “you get what you pay for” is applicable. We aren’t healthier, we aren’t living longer, etc.
 
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