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Well, the subsidy just buys us some time to stabilize the risk pool. Meanwhile, the ACO+Factory model is emerging, which flips the incentives; changes the way t
by kmundy 10mo ago
Well, the subsidy just buys us some time to stabilize the risk pool. Meanwhile, the ACO+Factory model is emerging, which flips the incentives; changes the way the product is consumed, so we stop overpaying in the first place.
- GlibMonkeyDeath 10mo agoI agree we need to remove the perverse incentives across the entire system. I also agree the current ACA subsidies are a band-aid. It's incredibly frustrating because this is a solved problem - even just fixing the most egregious flaws in the ACA would be a huge improvement. I am very skeptical, though, that in my lifetime American voters will ever be unified enough again to take on the de facto doctors union, the health insurer oligopoly, and the pharmaceutical companies, all of whom currently benefit from the broken system, and basically control the government top to bottom.
- kmundy 10mo agoYou’re right—Congress is the bottleneck for the important stuff (Residency Cap, MLR). And the lobby is massive. I'm a tad more hopeful than you though. I'm hoping that if we all have a shared understanding of how these well intentioned rules (MLR, GME caps) are unwittingly benefitting insurers, it helps bring some clarity into what precisely needs to change & will, perhaps, build some pressure on legislators.