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I would say that Obamacare is a problem, in several ways: 1. It's important to note that people buying insurance for themselves is a small minority of the mark
by harshreality 9y ago
I would say that Obamacare is a problem, in several ways:
1. It's important to note that people buying insurance for themselves is a small minority of the market (employer-provided and medicare/medicaid are the big parts of the pie), so it's absurd for the architects of Obamacare or any alternative health law to penalize (edit: or threaten to penalize, without conferring coverage in exchange for the penalty... no can do, that would be the evil public option!) the exact people they need to help the most: people whose employment doesn't provide insurance, and who don't qualify for medicare/medicaid.
If you're in a large health insurance pool with people negotiating for better coverage and pricing on your behalf, and the org behind the pool is already committed to paying the pool's insurance costs, things work pretty well. That's not a healthy private health insurance market; that's an opaque, balkanized system.
2. The (increased) number of insured is commonly cited by proponents of Obamacare as the metric demonstrating success. The numbers I've seen, however, show that while yes, more people have insurance, fewer people can actually pay their medical bills if they actually have to use their insurance. I have every reason to believe that's true, due to opaque pricing, massive deductibles for most plans, and the rapidly ballooning price of even the most basic plans. How is more coverage a success when most of those newly covered people can't pay their bills?
3. The obvious: healthcare insurance costs are skyrocketing. Obamacare can't be a success if just the cost of health insurance is going to start pushing massive numbers of lower-income people out of the marketplace.
1a. A tangent from point 1: The tie between employers and health insurance must die. There's too much incentive to do things that are just awful when most larger corporations will just eat the cost of reasonably good health insurance, and tweak their business elsewhere (increase prices; decrease other employee benefits) to make up those health insurance expenses if they go up.
- nradov 9y agoThe architects of Obamacare (ACA) didn't penalize people buying insurance for themselves on exchanges. In fact low income consumers receive subsidies. Being forced to buy insurance might seem like a penalty to some people who formerly went without, but in reality those people were freeloaders because if they showed up at an emergency room then the rest of us ended up paying for them indirectly. Although there are certainly flaws that need to be fixed, on balance the system is now fairer and more people have access to care.
- myegorov 9y ago>That's not a healthy private health insurance market; that's an opaque, balkanized system. "Healthy private health insurance market" sounds to me like an oxymoron. I certainly haven't heard of one. There should be no market for health insurance, or organ trade, or public transportation, or water supply/sanitation. These are costly (in a deregulated economy like in the US) and require heavy subsidies, not a for-profit race to the bottom.
- alasdair_ 9y agoThe UK has a national health service that is excellent and yet some people are happy to pay for additional health insurance to cover non-essential and service-related things. Want gourmet meals and a playstation in your room? That is a perfectly fine use of "extra" health insurance. Everyone had a right to free primary and secondary school education yet some people opt for private schools - this too is okay.
- myegorov 9y agoIt is understood that there will be those who buy bottled water where public utilities provide clean drinking water for all. Roughly 10% of the UK population are contributing to private health plans (https://www.theguardian.com/business/2017/jan/16/private-medical-insurance-sales-surge-health-nhs https://www.theguardian.com/business/2017/jan/16/private-med...). Apparently, the % of population fully covered by such plans is lower still (at under 1%). While this is a huge waste, this is not what I was alluding to. I have no argument to make if everyone in the US had access to health care comparable to that provided by the NHS.
- seanmcdirmid 9y agoSwitzerland solves this problem by disallowing group policies: everyone is thrown into the same pool individual market and companies cannot provide health insurance. Obamacare is just romneycare...a dumbed down version of the Swiss system. But they left out this very important detail and now it's coming back to haunt us. It is also politically difficult to eliminate employer provided plans.
- Tyrek 9y agoNot just that, but you have to consider the sticky wage effect - If group healthcare was outlawed, by how much do you think your employer would increase your salary? Would it be politically feasible for govt employees to receive the salary increase commensurate to the previous value of their healthcare benefits? There's a lot of questions there, and most of the intuitive answers aren't good for the average employee.
- seanmcdirmid 9y agoIt's funny, because why the USA has health insurance as an employer benefit in the first place is because of the wage freezes during WW2. Many of us know exactly how much our employers are spending on our health insurance premium. Some even talk about your total compensation package, if that number goes down, you'll definitely know in that case. More to the point, wages are used to attract employees, and employers still have to compete on that. Incidentally, since I wasn't eligible for housing fund match or 401k-style matching at my last employer because of my nationality, they gave us a 10% adjustment on our salary. So that just didn't disappear in smoke.