Why the US Makes No Progress with Accessible, Affordable Health Care (legal, drugs)
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All of the 30+ other OECD countries cover all their citizens, and medical bankruptcy is unheard of. The USA has a patchwork of coverage and millions without access still.
The two most common reasons given here, and many other sources, seem to be:
If government would stay out of health care, and let the private sector handle it, we'd all be better off.
It seems #2 above proves that to be false?
It's corporate greed by insurance companies that are causing all the problems. I'd contend that's only a small part of the problem.
IMO we can't be paying twice as much on average than all other developed countries (who cover all the citizens) simply due to insurance company greed.
So what are ALL the reasons the USA has the highest costs by far, significantly poorer health outcomes, while leaving millions without?
Here's what I gather just as a place to start, in no particular order, but please add as you see fit.
lifestyle (obesity, smoking, drugs)
high cost and profit for intermediaries (insurance)
excessive profit for some product and service providers - medical devices, pharma, hospital groups, doctors & other medical professionals
administrative burden (millions of microplans)
high charges for specialized services
forced use of expensive specialized facilities for routine medical needs (emergency room)
multiple regulations around the country
punitive legal awards
diagnostic overuse (expensive tests even for routine matters)
treatment overuse (especially end of life)
excessive unproductive labor vs technology
plus significantly/ironically, excessive usage by patients who have no idea how much the services are actually costing them
almost none of us ever asks "what does it cost?" or makes any attempt to be selective - there is little else we buy without considering the price
The fact there are so many causes is probably the reason we can't seem to get from where we are to something better for all concerned. And special interests/campaign contributions greatly inhibit any meaningful change on top of all the causes. We've created a campaign finance system that makes it almost impossible for a candidate to get (re)elected without special interest money.
Hopefully there will be some thoughtful posts, including some from the health care sector, between all the overly simplified responses.
Our motto is bigger and more is better. Break it down. Drs to Drs. Who makes more. - surgery, medicine , testing? And the Drs a nurses training, schools etc. less expensive?
If it was cheaper, more would take better care of themselves.
There are smokers -fat people- and unprotected sex everywhere ...
And in other countries, is health care and/ or insurance for profit??
The big pharmaceutical companies do not want a single entity being able to negotiate down the high-markup prices for the entire market. When that happens in other countries drug prices fall like a rock!
The American Medical Association has long had a policy of restricting the number of medical professionals as much as possible. The objective here is to maintain a very nice standard of living for themselves and high return on minutes spent with customers. A powerful health system would undoubtedly see the expansion of the MD pool (through grants and scholarships) as another way of bringing the cost of health care into line.
The insurance companies would much prefer to have a lucrative portion of the vast market with it's high rates of return than none at all ...
Altogether these three groups are the sources of an incredible fountain of dark money to pollute our electoral process and shut down any meaningful reform of the health care industry. They are in this racket like mobsters, each gets it's 'skim'..
It was affordable before ACA....
No deductible to be met.
Premiums weren't killer...
Many different insurance companies and policies to choose from.
Was optional to have... Not mandatory. Not a fine or taxable offense if you chose not to have it...
It was affordable before ACA....
No deductible to be met.
Premiums weren't killer...
Many different insurance companies and policies to choose from.
Was optional to have... Not mandatory. Not a fine or taxable offense if you chose not to have it...
So why can't it go back to that?
Because a lot of people didn't have any health insurance at all. You probably did and so you don't care about anyone else. Insurance was not affordable before the ACA.
With ACA at least people could buy health insurance when it wasn't offered through their jobs or when they had to work two or three part time jobs, none of which offered health insurance. No, not everyone can get a great full time job with benefits.
For a lot of people, it was not affordable before ACA.
Costs were rising to the point that many small businesses, including medical practices, dropped their group policy.
I've read several analysis of how average cost increases during 6 years of ACA were actually less than during 6 years of the Bush administration. It was around $4K for each.
So the cost of health insurance is not going to go back to what it was prior to Obamacare.
People may be able to get cheap policies that don't include things like ER visits or hospitalizations, but I don't see that as a step forward.
Because a lot of people didn't have any health insurance at all. You probably did and so you don't care about anyone else. Insurance was not affordable before the ACA.
With ACA at least people could buy health insurance when it wasn't offered through their jobs or when they had to work two or three part time jobs, none of which offered health insurance. No, not everyone can get a great full time job with benefits.
Was a Ford mechanic for years. Wouldn't call that a great job or claim the benefits were outstanding...
So because someone cant afford health insurance. You want to fine/tax someone for not having it... And make it mandatory or else... A product. Forced into the citizen.
Do you not see the hypocrisy there?
You're right. I don't care and didn't. I don't expect someone else to be responsible for my well being. Thats my call. Not yours. Not uncle sams. Surely not the tax payers. So why should anyone be responsible for others?
Imagine the outrage if the government mandated AR15s be mandatory in every household for that is a constitutionally granted right? A product forced onto the people... That not everyone can afford? And if they refused, just fine them for it...
It was affordable before ACA....
No deductible to be met.
Premiums weren't killer...
Many different insurance companies and policies to choose from.
Was optional to have... Not mandatory. Not a fine or taxable offense if you chose not to have it...
So why can't it go back to that?
No it was not affordable before the ACA. Employer subsidized insurance was good, but if you had to buy your own, it was still not affordable.
Our pre-reform system was also hindering our entrepreneurialism. That’s because hundreds of thousands if not millions of our best and brightest were victims of job lock, afraid to leave their corporate jobs to start their own businesses because doing so would usually mean walking away from affordable health insurance. And in a system in which insurance companies could refuse to sell you coverage if you had a pre-existing condition, many would-be entrepreneurs gave up their dreams of starting their own businesses.
Premiums were rising before and after the ACA.
If it goes back to the previous system, insurance companies can and will deny you coverage when you get very sick. If you have a pre-existing condition, the rates will be much higher for you than for others.
Insurance companies could charge people more if they had cancer, for example, or deny them coverage entirely. Insurers were partly able to keep costs down just by keeping sick people off their plans. Under the ACA, insurers can’t do that anymore.
Quote:
In the years since the ACA was implemented, individual-market premiums haven’t been rising as fast as they were before, according to Jonathan Gruber, an economist at the Massachusetts Institute of Technology.
And of course, all those who did not have any health insurance would be back to that condition and using the emergency room for their care which is much more expensive than going to a doctor with a deductible.
Is it bad with the ACA? Yes. Would it be better without the ACA? Nope.
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