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While the growth rates for healthcare have been lower over the past decade I would be hesitant to attribute it to the ACA. Most of the higher rates over the pre
by pg_bot 7y ago
While the growth rates for healthcare have been lower over the past decade I would be hesitant to attribute it to the ACA. Most of the higher rates over the previous 30 years were due to landmark legislation increasing demand for services. If you take a look at numbers you might be less convinced.
year | growth rate
2005 | 6.7% (Bankruptcy act passed making it harder to discharge medical debt)
2006 | 6.5%
2007 | 6.5%
2008 | 4.5% (Great Recession)
2009 | 4.0%
2010 | 4.1% (ACA Signed)
2011 | 3.5%
2012 | 4.0%
2013 | 2.9% (ACA Taxes)
2014 | 5.1% (Exchanges Open)
2015 | 5.8%
2016 | 4.3%
2017 | 3.9%
There are also a couple of timing advantages that people give credit to the ACA that would have happened otherwise.
There were a lot more prescription drugs created after the Orphan Drug Act and the Hatch-Waxman bills of the early 80's. So the timeline for that is 83-84 laws passed => research => 1990-1999 prescription drug explosion => 2010 - 2019 patents expire. This lead to a dramatic increase in costs over this period, but this is good since people now have access to drugs that wouldn't otherwise exist. The patents expire and the costs decrease, and they won't likely increase further due to the nature of those bills.
You could also make the point that from 2001-2006 you should see higher healthcare costs due to war.
A lot of the calculated savings are based on government projections of future spending. We can go off on a tangent on how good the CBO is at its job, but I think we could agree that predicting the future is hard and people are frequently wrong about their predictions.
Furthermore, lower costs aren't necessarily a positive thing. To put it simply if you are buying a BMW and I am buying a Kia, they are both cars but you aren't unhappy to pay the higher price.
Percentage increases also get harder to maintain as time goes on.
- tptacek 7y agoThe numbers here are quite helpful. The parentheticals are harder to understand and, for that matter, so is "higher healthcare costs due to war" (we have a nationalized health care system for war veterans).
- pg_bot 7y agoI wouldn't expect it to be clear unless you've studied the area for awhile but all of those are external shocks to the marketplace. Healthcare expenses increase during wartime since you have to treat newly injured veterans. That statement basically can be interpreted as "people get injured on battlefields and it costs money to treat them".
- tptacek 7y agoFirst, once again: we have a nationalized health care system for injured veterans. They not only have a separate payer system but also a separate provider system. Second: I have followed health policy for quite awhile, and it's not clear to me at all what impact you believe your parenthetical callouts had on health costs.
- pg_bot 7y agoFirst: I know you're not stupid so I have no idea what you aren't understanding when it comes to veteran care costs increase during wartime. Of course they have a separate payer and provider system. That system is included in the growth rate statistics. It should be fairly obvious that people being regularly shot at have higher healthcare costs. Bankruptcy Law: In 2005 there were 2,000,000 bankruptcy filings, in 2006 there were 600,000. This was a result of the passing of the BAPCPA in 2005. At that point in time 46% of bankruptcies were due to medical bills. This change increased the expected value of delinquent accounts which in turn should lead to lower costs for medical services. Great Recession: People put off non-essential medical expenses, or delay usage of medical services. Someone who might get braces doesn't, someone might take care of a parent themselves instead of hiring an in-home nurse, etc. ACA Signed: Marker for before and after growth rates. ACA Taxes + Exchanges Open: The two main policies of the ACA intended to curb healthcare costs go into effect. I would classify these two years as overestimation of savings and regression to the mean. Most insurance companies had to backtrack after their financial projections did not materialize.
- tptacek 7y agoNo, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).
- 7y ago