I give thanks for the ACA every month when I get to pay a premium. Without the ACA, I’d be uninsurable.
I’m just saying… it’s not true that most healthcare costs are a result of regulation. Most healthcare costs are incurred by very sick people who are getting expensive treatments. Brain surgery and chemotherapy are not expensive because someone has to fill out some forms.
My daughter was born pre-ACA with an extremely rare medical condition, an “orphan disease”. She is fine at the moment, but 6 months after she was born I had some of the best doctors in the world tell me that her treatment would run into the millions if she got/gets really sick. She was born less than two months before I started my current job, and was diagnosed just a couple of weeks before my first day at work. She would be uninsurable.
Yeah, I’m okay with the premiums going up a bit.
My kids, H and I all have asthma. We all have other chronic medical conditions too. Pre-ACA we wouldn’t be accepted for insurance except group employer policies. I tried buying S a policy and he was rejected online after spending 30+ minutes filling out info on many, many screens. They didn’t like his diagnosis of asthma, no matter how well controlled and despite his never needing hospitalization and rarely ever needing any medication.
I am grateful I could buy insurance for myself and my loved ones, even with chronic health conditions. It sure being automatically disqualified from ANY policy!
Sorry some insurers have been hiking rates and hope proper adjustments are made to prevent any unwarranted hikes–state insurance commissioners are supposed to review and approve premium changes.
Post ACA our insurance has escalated (premiums and deductibles) to the point that I am afraid to seek medical care. It’s great that previously uninsurable folks now have coverage, but something is wrong here. This is not working.
Actually it is. For example just implementing EMR’s in doc office ran up to $75k per physician plus annual maintence costs. Icd10 cost upwards of 8 million per large practice. These are just some examples. So yes these costs are passed on to consumer. If you have ever been in a hospital ask a nurse how much time they spend inputting data? They spend most of their time inputting data than with patients hence what happens to the quality of care it diminishes.
I am in same situation as other posters as my child would be denied healthcare done that been there and did manage to get insurance so trust me i get the preexisting thing. However, ACA was not the answer and has run up costs. The exchanges cost how many billions? Layering bureaucrcy on is not the answer.
Another cost most people have never heard of is a system called epic that hospitals use that costs each hospital group from tens to hundreds of million to install and maintain.
The insurance companies are making massive profits. DH wants to buy stock but it rubs me the wrong way ethically, like buying cigarette stock.
Their profits are now controlled by the aca. The aca actually made the insurance companies more profitable. The individual market is collapsing with insurers pulling out which actually leave more people in the long run uninsured than before the aca.
I worked for years in the era of paper medical records and billing. The waste due to inability to share information is staggering. Not that I love Epic, but you have rose colored glasses about the health care environment of the past.
Nobody here has said things were perfect in the past. There were incremental changes that could have been made that did not involve more government control and interference. This is not working.
Nope, but quite a few things have been said as though they were universals when in fact they were limited to an extremely lucky segment of the population 
I can’t respond to the rest of your post without veering far into politics.
It’s working: more people are insured than ever. Insurance companies are held in check to a greater degree than ever before. That said, the costs are problematic. The bureaucracy is problematic. The system needs constant tweaking, oversight, expertise. But because America is the way it is, this imperfect, expensive system is about as good as access to healthcare will ever become.
'The individual market is collapsing with insurers pulling out which actually leave more people in the long run uninsured than before the aca." That is fact checkable, and the last word out was that since ACA was passed, the numbers of the uninsured have dropped by close to 10 million or so, and a good number of people who couldn’t get insurance because of the pre existing condition clauses now have health insurance.
What I find interesting is when people tell me how great medical coverage was working before ACA, that all we needed was tweaking. In the late 1970’s, when I was in high school, I debated health care and we had to do research all over the place, and back then they were talking about how unwieldy medical costs were becoming, that we had an exceedingly sophisticated system that could perform more and more miracles, but also was starting to become a cost burden…and that only got worse as time went on. Back then HMO’s were supposed to be the panacea, they were going to solve all the problems, because with doctors in medical groups, costs would be reigned in, care would be done in a way that was cost efficient…and it basically didn’t work, costs continued to soar, and the PPO/POS didn’t work.
I don’t know what ACA plans are like, but before ACA came around, it was next to impossible to buy individual coverage that was affordable that wasn’t fly by night insurance (those plans that advertise “69 bucks a month coverage” that covered very little. Something like 10 years ago, if you tried to buy a family plan with equivalent coverage to a group plan you would get at the office, in the NYC area it was running somewhere around 25k a year (when in a group plan it was about 16k a year; I know, when I was laid off, the COBRA cost was around 1300/month to keep the plan), these days it is much higher. And a lot of people simply went without insurance, it was estimated before ACA it was nearing 50 million people without insurance, and even if some of those were voluntary (ie young people who thought they didn’t need it), a lot of them simply couldn’t afford health insurance.
The problem with the health system are structural, and while ACA has problems with it, those problems were not solved, nor would any of the other supposed solutions I have heard , medicine is not like making tv sets, and even if you allowed people to buy health insurance across state lines, it wouldn’t help, because those plans need to pay out to doctors in the insured’s area, so likely would be just as expensive.
There are a lot of problems, to make money a lot of doctor’s groups and health organizations also own treatment labs, MRI’s, surgical centers and such, and they have an incentive to run tests, MRI’s and so forth, because they make money on the tests, too. Then, too, we have the pharmaceutical industry, that spend a lot of money on advertising, so that when a patient comes into a doctor, they are demanding an expensive name brand prescription, when there are other drugs with generic alternatives that would work just as well, but the commercial, that shows these people surfing with arthritis reputedly taking this fancy new drug, makes them demand the newer drug.
Then we have medicare, that prides itself on being this efficient medical care, that delivers care while reducing costs. The problem is that what they have done is borrow from peter to pay paul, Medicare has cut how much they pay for procedures to doctors and hospitals that accept it, so what the hospital does if medicare pays 30 bucks for something that costs them 60, they add that loss into what they charge patients with private insurance.
The politicians who say no one is denied medical care, that they can go to the hospital if they need care, don’t bother to realize that someone pays for that, that the hospital doesn’t get much from the state to pay for uninsured people, so they cost shift it, causing everyone else’s rates to go up. Worse, if people go to the hospital for care, it is likely they are really sick, that something that may have been fixed with early treatment relatively easy, is now a major problem, like the patient with diabetes or heart problems who didn’t seek out treatment suddenly needs surgery or more to keep them alive.
Then, too, one of the things that has changed that those yelling about ACA or health care don’t talk about is that the rising cost of health insurance has to do with the health insurance companies. Once upon a time, health insurers like many insurance companies, basically had as a working model that in terms of premiums, they collected enough to cover the cost of treatment (or estimate cost of treatment) for their insured clients. The way these companies made money was they invested the money they collected in premiums, and made money on the float, the money they had taken in that hadn’t been paid out yet.
Over the past 15-20 years, these companies after getting burned in several market turn downs, changed that, and today they make most of their money from basically the difference between premiums and the amount they pay out. They have made all these excuses, but what study after study has shown is that the insurance companies are raising premiums because they can, they have a captive audience, there aren’t that many companies, and given the financial reserves it takes to be an insurer, not likely to face competition.Insurance companies are in the same racket as other public companies, they want to please stock analysts so their stock price goes up and the executives and dominant shareholders value goes up, so they raise their rates well above inflation to show increases in revenue…which causes their stock price to go up. Put it this way, the health insurers claim they are squeezed, yet that doesn’t explain how the head of United Healthcare is making close to 100 million a year (one year he did, other years it is 60,70,80 million a year).
What is interesting is how these companies have had to backtrack on the cost of insurance. One of the standard fallacy was the cost of lawsuits and how that created CYA medicine. States based on this went ahead and put caps on lawsuits (even though studies have shown that the actual payout on malpractice claims is a tiny fraction of what often has been claimed, once the cases were appealed), they put pain and suffering caps and punitive caps, after being told medical insurance and malpractice insurance were soaring because of lawsuits…and after these caps went in, a surprising thing happened, the cost of health insurance in those states continued to soar…
The only way medical care is going to be reformed is not in tweaking the current system, which is too fragmented and too many hungry mouths feeding at it, to be fixed. If I had to hazard a guess, it likely would be a modified single payer system, something like France’s, which is a hybrid public/private medical partnership, but I won’t hold my breath on that one, there are too many forces who want to keep the status quo for anything to be done until the whole system collapses.
In the 1970’s my parents had their own private major medical insurance as my mom swid it didnt cost much. Whn my mom would take me to the doctor my mom write a check and no insurance was involved. The doctors office consisted of the doctor and his wife. Then they list that when laws were changed and you could not keep your private insurance and had to have employer insurance. So back then insurance companies had nothing to do with your primary doctor. I dont know how a system that involves countless back office personell and insurance companies in charge of payments could possibly make healthcare cheaper. You went from a one doctor office to countless individuals incolved in the treatment of the flu, strep throat or what not. Obviously healthcare costs were going to rise.
I have had every type of insurance including obamacare, cobra, high deductinle, hmo, ppo, temprary, uninsured and what have you. Problem with aca is the plans have way too high of deductibles hence going to the doctor or getting treatment is really unafforable after paying insurance premiums. Other problem is many of the plans lack any doctors to choose from. There were plans with the closest pediatrician 30 miles away from our house and we live in a densly populated urban area. Now for the HMO’s all good until you get a doctor who thinks your illness is in your head and wont refer you out. And no doctors arent all created equally.
ACA was supposed to cut costs but it hasnt. All those preauthorizations for drugs you never needed before well you just have to wait or pony up. So people aren’t taking their meds and land straight in the ER. I cant tell you how long it took to get a medical test ordered by the doctor that was denied and appealed. They eventually paid with two er visits in the mean time and eventually surgery. The gatekeeper mentality backfires. Sick Patients dont get better while they wait around they get more expensive. i was shocked this year when the birth control scropt required preauth. Pharmacists and doctors office spend how much time getting authorization?
I remember our healthplan with the ten thousand dollar deductible that cost over a grand a month that gave us a two dollar discount from the rack rate. It was usless. Self pay with same doctor was cheaper.
“a modified single payer system , something like France’s”
@musicprnt – I think we’re decades and decades from the American public being able to swallow a single payer system (socialist!) much less of the French variety 
@scubadive
“problem with aca is the plans have way too high of deductibles” – My ACA deductible is the same as the deductible I had through my Fortune 200 employer.
Post #34 is so full of inaccuracies and misinformation it is hard to know where to start… That “private major medical insurance” could be cancelled at any time if someone in your family got really sick, and insurance companies definitely did that. That “check” your mom wrote to the doctor was really paying a deductible – but what you get from a visit now is a LOT more expensive due to upgrades in medical care and equipment. So yeah… the checks are bigger. Back then the doctor didn’t even have any labs they could send out for that would be very helpful, for example, so you didn’t have a lab bill. You couldn’t be sent for an MRI, so there was no bill from that separate practice.
Company insurance was around long before the seventies, so I don’t know what “law” you are talking about that pushed your parents to corporate insurance.
“Obamacare” is not a type of insurance as you have listed it. It is merely a process to purchase insurance through all the same companies that have been providing insurance for the past 30-40 years, and possibly get a subsidy for that if you are low income. We personally have chosen to purchase through the exchange to get our state Blue Cross insurance because it has more providers, and covers our kid well at college. Of course you have to shop around – but you had to shop around 10 years ago before the ACA, too. I worked in health care billing in the 80s and again in the late 90s – and if you don’t think health insurance companies were restricting people’s care and referrals even back then, you have no idea what was going on. My guess is that you were young and not ever sick, so just didn’t notice.
Everyone who has employer insurance has been paying a ton for health care for years and there have been dramatic increases for years before the ACA – you just don’t realize it. You know those piddly-ass salary raises you have been getting for the last 10+ years? The companies have been paying more for health care, and just reducing how much they put into salary increases.
I sure as heck don’t have any answers to this complicated problem.
I side with the group that believes that today’s healthcare system is way too expensive. If you don’t have a plan that is nicely subsidized by an employer, you PAAAAAYYYY. And the cheapest plans come with such high deductibles that lower income people avoid seeking the healthcare they need. So they end up paying a lot of premium…for very little.
That said, I don’t think these escalating costs have anything to do with the ACA. In my opinion, the ACA’s outlawing the practice of charging more for, or more typically outright DENY, coverage for people with pre-existing conditions was 100% necessary.
If you are healthy today with no pre-existing condition, consider that to be a temporary state. We are ALL merely temporarily able-bodied and healthy. Every single one of us will develop some condition, some day, that an insurance company would deem a “pre-existing condition” and there goes your health care…poof. For some of us and/or our children, that day is now. For others, don’t be so smug…your time will come.
Both of my kids have to find new plans this year because the plans they have now are not being offered in 2016.
It’s a PITA, but at least they will find something…and can get insurance!