Good to see this side of Hugh! I think he important part of his essay is that there is vast confusion in our healthcare system. Obamacare (of course NOT the name of the ACA) is an epithet used by the Repugnants to demean the Affordable Care Act as if it were only a political artifice. The reality is that the ACA ia only a step, introducing a government commitment into a problem that, if not solved, would bankrupt our economy. Perhaps businessmen like Hugh could put more thought into how to move ahead?
ObamaCare Is it working?
Our president and the Democratic Congress are singing the praises of Obama care. It definitely has given more people access to health care. It protects people with pre-existing conditions from losing their benefits when they switched jobs. It allows those starting out on the professional lives to participate in the parents health care program for several years. But, is the claim that Obama care has lowered health costs really true?
The answer is that it is not. While premiums have only risen marginally aren’t some cases even declined, the out-of-pocket cost of healthcare for the average worker has increased. Instead of raising the rates what the insurance companies have done is increase the deductibles – in many cases – even in network. This is caused a dramatic rise in the cost of healthcare to millions of American working families.
Why is this happening? What can we do about it? Unfortunately, the answer is very little unless the Democrats and Republicans in Congress start understanding the importance of gray rather than black and white. The truth of the matter is that Obama care was a bad compromise. The plan was actually developed by Republican((Mitt Romney and a parentheses adopted by a Democrat president Obama and then emasculated by a divided Congress without the fortitude to look at the root of the problem or to compromise.
There are really two different ways of solving the problem. First, is a single-payer system where the administrative work of dealing with co-pays and networks would no longer exist. This is a system favored in most parts of the world including most of Europe and Canada. There still is a private system available to patients who are willing to pay a premium but basic coverage as to the single-payer system.
If you are true antisocialist and believe in the free market system you can endorse the Republican view that allowing insurance companies to compete across state lines would keep cost down and improve coverage. That is to in theory but if and only if one major thing is changed. As of now, insurance companies are exempt from the antitrust laws of the United States. Therefore, even if you allowed insurance companies to compete across state lines the likelihood of installing a true free market system would not exist unless you would through the antitrust exemption.
Would either of these approaches fully solve a problem about the cost of healthcare? Absolutely not. We need to streamline our system which currently is multilayered with hospitals and group practices insurance companies and single practitioners. I forgot HMOs. Too many people have their fingers in the pie all wanting to make significant profit. People should be able to make a good living in medicine but not so much that they render medical care unaffordable to the average person.
The other issue is one of diagnostic tests. Our medical profession so concerned with malpractice and so enamored with their electronic toys including CAT scans and MRIs run outpatient costs with the necessary testing. Of course there are times when these tests are indicated. But, when Johnny just comes in with a sprained ankle setting them from MRI is probably unnecessary.
Do not be full by the rhetoric on both sides of the aisle in Congress or from the White House. Neither side is totally wrong but neither side is totally right either. We need to go back to the day when people work together and created a constructive dialogue to fashion legislation to help the people of the United States.
“While premiums have only risen marginally aren’t some cases even declined, the out-of-pocket cost of healthcare for the average worker has increased. Instead of raising the rates what the insurance companies have done is increase the deductibles – in many cases – even in network. This is caused a dramatic rise in the cost of healthcare to millions of American working families.”
My premium doubled, yes, doubled at the start of 2014, 500 something a month to 990 a month, with a crazy high deductible; then I had to change companies because my medical plan didn’t work with the anorexic Blue Shield network that was left in CA once the insurance companies had their way with us. The ACA was compromise written by the insurance companies, for the benefit of the insurance companies. While I no longer have to worry that being an old, fat, asthmatic with a newly diagnosed thyroid condition will cause me to lose my insurance, or not be able to buy any in the first place, I have to worry about being bankrupt by broken bone or diagnostic test
Hi
The ACA was designed as transitional legislation. The compromise is not with the insurance companies but with two things 1. The Republicans. Their asinine irredentist opposition meant that even good ideas (eg a national insurance exchange) got lost in fights within the Democratic party. 2. The Reality. American healthcare is an awful mess. Many of the solutions from the left , eg single payer, can not work until we have some rationalization in the system. For example it is a myth the Medicare costs less because its admin overhead (as a single payer) is lower. I am told that this is not true. The admin costs of medicare are likely as high a any other program but get hidden in cost transfers.
I have seen one impressive set of data in Seattle where we have five very different health care systems. The actual costs per age adjusted patient are about the same .. ranging from my own health care system (socialized medicine under the State) to co-ops (Group Health), Church run systems (Sisters of Providence) to bare-fisted profit making health care.
All the studies of the ACA do show it has either cut cost or cut inflation for “the people” as a whole. This, however, may mean individuals are paying more .. usually because the ACA has more strict standards about what must be covered or because of the rationalization of cost transfers.
So, you may be paying more because those old folks on Tucson, land of the indolent retiree, are actually now paying their way.