7 ms·

I know I can say it. Married, two kids. Everybody reasonably healthy, have a decent job. Healthcare costs have become expensive as shit because of the ACA.

I know I can say it. Married, two kids. Everybody reasonably healthy, have a decent job. Healthcare costs have become expensive as shit because of the ACA. That's not a partisan talking-point: that's the bottom line in our household budget. The happy-face anecdotes the ACA's advocates trot out are lovely, but there are far more people in my position.

colemickens 10y ago
How could you possibly just assert there are far more people in your position? There are tens of millions of people who had no access to health care that now have it. And can you explain exactly how the ACA has made healthcare unaffordable for tens of millions, since you assert more are disaffected by it than helped?
- kobeya 10y ago
  And there are hundreds of millions of people who have seen their premiums and health care costs go up.
  - ceejayoz 10y ago
    As they did every year, pre- and post-ACA.
    - kobeya 10y ago
      Excuse me, "go up by a larger factor year-over-year than had previously been the norm."
      - kmicklas 10y ago
        That's not even true.
      - ceejayoz 10y ago
        Because they started lower, apparently. https://www.washingtonpost.com/news/wonk/wp/2016/09/19/skyrocketing-obamacare-premiums-still-lower-than-employer-sponsored-insurance/ https://www.washingtonpost.com/news/wonk/wp/2016/09/19/skyro... > A new analysis from the Urban Institute found that the average unsubsidized premiums in the Affordable Care Act exchanges, commonly known as Obamacare, are actually 10 percent lower than the full premiums in the average employer plan nationally in 2016.
- MrZongle2 10y ago
  "How could you possibly just assert there are far more people in your position?" Because I fall well within the middle class, have 2 kids, and am in reasonable health yet am paying far more for poorer health care than I did a decade ago, and beyond the anecdotal evidence that is the same for every family I've spoken to for the last few years it is clear that the ADA is deeply disliked by a vast swath of America for precisely that reason. The ACA is a shell game that siphoned money from people who had it, dropped it into a big corporate hole, and spat out a bit of it at people who didn't have as much. As a political issue, we are seeing "success stories" trotted out so as to convince the rest of us that gosh, isn't this worth it? No, it isn't. There has been no net gain with the ACA. It was passed so we could see what was in it, and turns out most of what was in it was a lobbyist Christmas wrapped in a ton of politician incompetence. It was wealth-destroying political nonsense in the same sense as "cash for clunkers". Feel good, think less.
fencepost 10y ago
I absolutely believe that healthcare costs have gone up. They've been going up for some time, and at rates quite a bit higher than inflation which is why even employer-provided insurance pre-ACA was getting more expensive, lower-quality and in some cases being dropped entirely by companies. What I don't believe is that healthcare costs have gotten more expensive FASTER THAN THEY ALREADY WERE because of the ACA, any more than I think that my cat died in 2012 because of the ACA ("Gee, Thanks Obama!") which I'm sure some people would also argue. So in your comment, I absolutely believe > Healthcare costs have become expensive as shit But I think you're trying to assign blame where it's not due with > because of the ACA.
- antisthenes 10y ago
  You're right, it's not because of the ACA. The ACA introduced no cost controls and just shifted the costs around from 1 demographic to another (mostly to the lower-middle and middle class healthy people, who don't actually use much health care). So obviously for every sob story of a saved life, there's at least 2-3 stories of relatively young (26-30) healthy people whose deductibles and premiums have gone through the roof. That's why people on the internet can't ever agree whether the ACA was a good thing, because there's plenty of anecdata from both sides. I think we, as a population have to accept that Americans, in general, are very unhealthy people. It's quite obvious with ~35% obesity and the #1 killer being heart disease. Naturally, mitigation health care is an order of magnitude more expensive than preventive care. Hence the rising costs of health care (for everyone, even though some people don't feel the pain of costs, whether by being subsidized or being rich)
  - fencepost 10y ago
    > The ACA introduced no cost controls and just shifted the costs around from 1 demographic to another (mostly to the lower-middle and middle class healthy people, who don't actually use much health care). In a lot of ways that's exactly what insurance is. It's pooling resources to cover expenses for the people who need it. In any given time period most people won't need it, or won't need it to an extent higher than their contributions, but it's there just in case. There's variation in premium amounts to account for the difference in likelihood of need (so those younger generally-healthier people pay lower premiums), but a very important part of making it work is having a large enough pool that only a limited percentage needs to use it each year. There are also measures that were taken to try to reduce costs, but how effective they were may be up in the air. The only one I can name offhand was the requirement that insurance companies spend at least 80-85% of revenue on medical expenses. At least one person noted that might also lead to higher costs (via overpaying to let that overhead grow), though I think that that's the kind of problem that market factors would actually address - if you're overpaying, that money has to come from somewhere so you're also charging higher premiums and will shed customers as they seek cheaper insurance. Other cost-cutting measures have been killed off through effective lobbying (e.g. Medicare being barred by law from negotiating drug prices, introduced back with Medicare Part D and the Donut Hole). And yes, the general fitness level of Americans is pretty poor. Unfortunately, addressing that is more of a public health matter, and since the onset of modern medicine public health has been more and more relegated to a secondary role. Interestingly, some insurance companies seem to be trying to revive non-medical measures to improve the health of their customers through things like discounts for fitness assessments, fitness programs, etc. The assessments and advice resulting from them may make a difference, but even just the embarrassment factor of being unfit and going for one may help change behaviors. I'll just note that in general, obesity is different from anorexia - fat people realize they're fat, are often concerned or embarrassed about it, and a large percentage of them would like to be be if not thin at least a lot less fat.
attaboyjon 10y ago
I'm a Type 1 Diabetic. I am self-employed. Without ACA I could NOT have bought insurance for myself and my family.
- intellegacy 10y ago
  Other people are subsidizing you. Basically, sick people get a better deal. Healthier people pay more to cover sick people. I'm sure you are happy but let's not pretend other ppl aren't covering your ass.
  - paulcole 10y ago
    >Other people are subsidizing you. You say this is like a bad thing. Shouldn't the healthier members of society be happy to contribute to the health of those less fortunate? Gross to think otherwise.
    - intellegacy 10y ago
      First of all leave your judgment elsewhere. Else there's no point in discussion because to you it's "Gross" to even have a different opinion. It really depends on the people you have in your society and what the sick people are contributing. Getting sick needs to have some kind of downside to it. Else people have no incentive to stay healthy. They can take as many risks as they want to their personal health because it's going to be paid for by other healthy people. America in particular has a large obese population which is addicted to popping pills and overmedicating in general. If you give people free license to eat whatever they want or take as many drugs as they want without consequence our healthcare costs are going to be unaffordable very soon (they nearly already are) Once you are in a system where everyone is forced to contribute, one person's actions affect others. If you don't take care of yourself and get sick, others are forced to pay for you. If you have too many people who don't take care of themselves, the healthy people are the ones who get screwed because it's effectively a wealth transfer: They're paying for sick people to have the license to do whatever they want. The reality is that sick people are a drain on society's resources. Obviously we need a humane solution to treat them but the answer shouldn't just be a blank check. There are sick people who require hundreds of thousands of care YEARLY. They are not temporarily sick, they are permanently sick. I dont' think it's fair that they pay the same rate as healthy people. If you are permanently sick, that sucks but you should pay more of the burden.

colemickens 10y ago

How could you possibly just assert there are far more people in your position? There are tens of millions of people who had no access to health care that now have it. And can you explain exactly how the ACA has made healthcare unaffordable for tens of millions, since you assert more are disaffected by it than helped?

kobeya 10y ago
And there are hundreds of millions of people who have seen their premiums and health care costs go up.
- ceejayoz 10y ago
  As they did every year, pre- and post-ACA.
  - kobeya 10y ago
    Excuse me, "go up by a larger factor year-over-year than had previously been the norm."
    - kmicklas 10y ago
      That's not even true.
    - ceejayoz 10y ago
      Because they started lower, apparently. https://www.washingtonpost.com/news/wonk/wp/2016/09/19/skyrocketing-obamacare-premiums-still-lower-than-employer-sponsored-insurance/ https://www.washingtonpost.com/news/wonk/wp/2016/09/19/skyro... > A new analysis from the Urban Institute found that the average unsubsidized premiums in the Affordable Care Act exchanges, commonly known as Obamacare, are actually 10 percent lower than the full premiums in the average employer plan nationally in 2016.
MrZongle2 10y ago
"How could you possibly just assert there are far more people in your position?" Because I fall well within the middle class, have 2 kids, and am in reasonable health yet am paying far more for poorer health care than I did a decade ago, and beyond the anecdotal evidence that is the same for every family I've spoken to for the last few years it is clear that the ADA is deeply disliked by a vast swath of America for precisely that reason. The ACA is a shell game that siphoned money from people who had it, dropped it into a big corporate hole, and spat out a bit of it at people who didn't have as much. As a political issue, we are seeing "success stories" trotted out so as to convince the rest of us that gosh, isn't this worth it? No, it isn't. There has been no net gain with the ACA. It was passed so we could see what was in it, and turns out most of what was in it was a lobbyist Christmas wrapped in a ton of politician incompetence. It was wealth-destroying political nonsense in the same sense as "cash for clunkers". Feel good, think less.

fencepost 10y ago

I absolutely believe that healthcare costs have gone up. They've been going up for some time, and at rates quite a bit higher than inflation which is why even employer-provided insurance pre-ACA was getting more expensive, lower-quality and in some cases being dropped entirely by companies. What I don't believe is that healthcare costs have gotten more expensive FASTER THAN THEY ALREADY WERE because of the ACA, any more than I think that my cat died in 2012 because of the ACA ("Gee, Thanks Obama!") which I'm sure some people would also argue. So in your comment, I absolutely believe > Healthcare costs have become expensive as shit But I think you're trying to assign blame where it's not due with > because of the ACA.

antisthenes 10y ago
You're right, it's not because of the ACA. The ACA introduced no cost controls and just shifted the costs around from 1 demographic to another (mostly to the lower-middle and middle class healthy people, who don't actually use much health care). So obviously for every sob story of a saved life, there's at least 2-3 stories of relatively young (26-30) healthy people whose deductibles and premiums have gone through the roof. That's why people on the internet can't ever agree whether the ACA was a good thing, because there's plenty of anecdata from both sides. I think we, as a population have to accept that Americans, in general, are very unhealthy people. It's quite obvious with ~35% obesity and the #1 killer being heart disease. Naturally, mitigation health care is an order of magnitude more expensive than preventive care. Hence the rising costs of health care (for everyone, even though some people don't feel the pain of costs, whether by being subsidized or being rich)
- fencepost 10y ago
  > The ACA introduced no cost controls and just shifted the costs around from 1 demographic to another (mostly to the lower-middle and middle class healthy people, who don't actually use much health care). In a lot of ways that's exactly what insurance is. It's pooling resources to cover expenses for the people who need it. In any given time period most people won't need it, or won't need it to an extent higher than their contributions, but it's there just in case. There's variation in premium amounts to account for the difference in likelihood of need (so those younger generally-healthier people pay lower premiums), but a very important part of making it work is having a large enough pool that only a limited percentage needs to use it each year. There are also measures that were taken to try to reduce costs, but how effective they were may be up in the air. The only one I can name offhand was the requirement that insurance companies spend at least 80-85% of revenue on medical expenses. At least one person noted that might also lead to higher costs (via overpaying to let that overhead grow), though I think that that's the kind of problem that market factors would actually address - if you're overpaying, that money has to come from somewhere so you're also charging higher premiums and will shed customers as they seek cheaper insurance. Other cost-cutting measures have been killed off through effective lobbying (e.g. Medicare being barred by law from negotiating drug prices, introduced back with Medicare Part D and the Donut Hole). And yes, the general fitness level of Americans is pretty poor. Unfortunately, addressing that is more of a public health matter, and since the onset of modern medicine public health has been more and more relegated to a secondary role. Interestingly, some insurance companies seem to be trying to revive non-medical measures to improve the health of their customers through things like discounts for fitness assessments, fitness programs, etc. The assessments and advice resulting from them may make a difference, but even just the embarrassment factor of being unfit and going for one may help change behaviors. I'll just note that in general, obesity is different from anorexia - fat people realize they're fat, are often concerned or embarrassed about it, and a large percentage of them would like to be be if not thin at least a lot less fat.

attaboyjon 10y ago

I'm a Type 1 Diabetic. I am self-employed. Without ACA I could NOT have bought insurance for myself and my family.

intellegacy 10y ago
Other people are subsidizing you. Basically, sick people get a better deal. Healthier people pay more to cover sick people. I'm sure you are happy but let's not pretend other ppl aren't covering your ass.
- paulcole 10y ago
  >Other people are subsidizing you. You say this is like a bad thing. Shouldn't the healthier members of society be happy to contribute to the health of those less fortunate? Gross to think otherwise.
  - intellegacy 10y ago
    First of all leave your judgment elsewhere. Else there's no point in discussion because to you it's "Gross" to even have a different opinion. It really depends on the people you have in your society and what the sick people are contributing. Getting sick needs to have some kind of downside to it. Else people have no incentive to stay healthy. They can take as many risks as they want to their personal health because it's going to be paid for by other healthy people. America in particular has a large obese population which is addicted to popping pills and overmedicating in general. If you give people free license to eat whatever they want or take as many drugs as they want without consequence our healthcare costs are going to be unaffordable very soon (they nearly already are) Once you are in a system where everyone is forced to contribute, one person's actions affect others. If you don't take care of yourself and get sick, others are forced to pay for you. If you have too many people who don't take care of themselves, the healthy people are the ones who get screwed because it's effectively a wealth transfer: They're paying for sick people to have the license to do whatever they want. The reality is that sick people are a drain on society's resources. Obviously we need a humane solution to treat them but the answer shouldn't just be a blank check. There are sick people who require hundreds of thousands of care YEARLY. They are not temporarily sick, they are permanently sick. I dont' think it's fair that they pay the same rate as healthy people. If you are permanently sick, that sucks but you should pay more of the burden.