Re competition, almost no one has a choice of insurance companies based on quality or performance. Our jobs or the exchanges determine the players.
And at any rate, as noted above by @coolweather , the quality we care about is coming from providers and drug companies and hospitals. These, we also don’t have full choice among, nor transparent/consistent costs.
There is no free market in health care, whether one would support such a thing or not. Frankly, there never has been. In the olden days, you could go to your local quack or trust your own family wisdom.
(Genuinely asking, not trying at all to be snarky - )
@fractalmstr - what do you consider to be human rights; why is health care not on the list; and what does “it should be affordable for everyone” mean if you don’t consider it a right…? (How is that different from, for instance, food?)
Human rights to me:
-Freedom of religion
-Freedom from torture
-Freedom from slavery
-Freedom of thought
-Freedom of sexual identity/orientation
-… and anything else that involves individual liberties/freedom
The reason I think healthcare is not a human “right” IMO is that someone’s personal life choices can affect others in society. A person’s religion doesn’t affect me. A person’s sexual orientation doesn’t affect me. A person’s free speech doesn’t affect me. A person who eats poorly/smokes a lot/drinks a lot and has resultant health problems does affect me.
I don’t believe it is a black and white issue though… For example, people with genuine disabilities should be taken care of. I believe it is our collective responsibility to take care of those in need. I believe in affordable (but not guaranteed/ “free”) health insurance for all people.
I didn’t know that going in, but I knew that all the other countries that have our type of standard of living, do have some form of universal health care.
Regarding the OP’s question, to me this is what the ACA did for “me” or my family - it brought the USA in line with where I think a first-world nation should be, or at least on the right track. My immediate family has been fortunate to have employer-based health insurance and also to live in a state where we have, ironically, Romneycare which was of course the precursor to Obamacare. Under the ACA, our costs have risen as have everyone’s, due to the nature of healthcare. But it was partly offset by “free” immunizations and preventative care including contraception, without any deductible.
Significantly, I also care about how our country treats those who need it most. What frustrates me and possibly others, is seeing politicians fool people into voting against their own self-interest, sometimes extremely so in the case of funding for infrastructure, education, and healthcare.
Medicare Advantage, the private insurance version of Medicare, is competitive with plain vanilla single payer Medicare, though. I don’t say this to oppose single payer-- I’m for it-- merely to point out that in the Medicare case, private insurers seem to be able to offer care at the single payer price.
Can you point me to contemporary news stories to verify this? I don’t remember it.
I do remember talk of the public option-- but the public option was a plan to allow people to either buy private insurance or instead choose a government-run nonprofit insurer. On the exchange, there would be insurance plans from Insurer X, Insurer Y, etc., and then also the government-run system, and people would choose one of them. I don’t count that as single payer, because some people would choose the public option and others would not. It would be possible to add a public option to Obamacare right now, without much legislative fuss, although obviously that will not now happen.
There is no magic to age 26. The provision would have been a whole lot more profitable to insurance companies AND the ACA if the age was set at say, 24. That would have resulted in more young – and low cost – enrollees into the ACA, assuming that they were not employed. Thus, average costs for the ACA plans would have been lower, and so too, current price increases. (Why not age 30?)
btw:
The latter is irrelevant since the ACA essentially banned pre-existing conditions.
While probably true, I’d guess that the “most” would change their pov if we asked “everyone” if they would agree that the “affordability” goal could only be achieved by service rationing. (longer wait times, limited networks, extremely high cost designer drugs not covered, and the like.)
While probably true, I’d guess that the “most” would change their pov if we asked “everyone” if they would agree that the “affordability” goal could only be achieved by service rationing. (longer wait times, limited networks, extremely high cost designer drugs not covered, and the like.)
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@bluebayou - people say things like this, but I don’t understand, because:
This isn't actually a problem when looking at the data from other countries
and
Even in this thread, some have explained that we already have long wait times, limited networks, and random refusal/rationing (definitely happens more in private companies because they have a vested interest in denials)
and
Do the speakers/listeners imagine that in our current system, they'd be the ones instead who do have access to the better care? Because statistically speaking, most will not be those "winners". Or rather, those who currently are the "winners" (or were pre-ACA), tend to sway more liberal on the issue.
It’s like a kid hearing a fairy tale about a king/queen and all the serfs, and identifying with the king/queen when in reality, most end up as the serfs. How many lower/middle-class people will end up with “designer drugs” in an open-market healthcare system?
I thought this was interesting, from the AARP on this exact subject (though a few years old):
What is considered a problem is in the eye of the beholder, yes? For example, is the US willing to accept a shorter line for those who are willing to pay? Granted, the extra wait time of 12 weeks may not be a medical “problem,” I have no doubt that a many in the US – and even on cc – would not publicly countenance a different queue for those with money and those without. As an example,
While their system does seems to work well overall, it does have its fair share of (in some cases) significant problems (see “ACHIEVEMENTS, PROBLEMS, AND REFORM”). I didn’t realize doctor pay was so low over there… $55k/year average in 2003. Do you think doctors here would accept a significant pay cut?
Both my wife and I have pre-existing conditions which made us uninsurable pre-ACA. (I can’t get life insurance beyond company sponsored life insurance, for example). Prior to the ACA, it was common for policies, even those offered by large employers, to have annual and lifetime maximums. Both she and I manage our conditions so that our current use of medical care is modest, but the possibility of significant illness and surgery is always present.
I retired 6 months ago, at 62, with the expectation that, when my COBRA coverage ran out, I would be able to purchase a high deductible plan with no pre-existing illness restrictions and no lifetime maximums, for the 2 years before I qualified for Medicare. When I retired, I freed up a good job for a younger employee.
I didn’t anticipate that the ACA might be eliminated. Had I known, I probably would have worked for an additional year and a half, so that COBRA continuation would have taken me through to qualifying for Medicare (assuming that’s not privatized).
I don’t know how this is going to play out, but there is a significant risk that, not only will people who bought individual plans on the exchange lose coverage, but people who otherwise have plans that now comply with the ADA will see coverage eliminated or significantly reduced.
I’m in the same situation, bagoshells. My husband retired early, believing that even though he has severe asthma he would be able to get insurance. And it turns out my Sjogrens is also a disqualifier as a pre-condition, at least for some insurers. So now what? We’re not old enough for Medicare for a few years.
High risk plan schmy risk plan-- those don’t work, won’t work, and are just a way to pretend to solve the problem that health care costs a lot for people who use it, while not actually solving the problem that health care costs a lot for people who use it.
@bagoshells - your story is my fear. I am 58 and was hoping to retire in a few years. I, too, have a preexisting condition that makes me uninsurable. Prior to this election, I was planning to buy insurance on the exchange to tide me over until I became Medicare-eligible. Now it looks like I may be working longer than I’d planned - not because I want to, but because I may have no other option for healthcare.
Add all of our family to the group with preexisting conditions. I fought my employer’s insurance company, many years ago, when my surgery was pre-approved and then disallowed. I lost and we were nearly bankrupted by the medical bills. That experience is always in dh’s mind when we discuss his retirement plans, especially since he wants to provide for one of our adult children with a serious chronic disease. Dh hasn’t said he won’t retire before 65 but I’m no longer counting on his early retirement.
Apparently no one knew the answer to my question in #284. I don’t know either, but I’m guessing that if something was put into the law by regulation (something not passed by Congress) then that regulation can be taken out by the new HHS also. That could affect what is covered specifically, and whether other exemptions will be put in by regulations. Any ideas?