New blow to the US Affordable Care Act (Obamacare).

[kandrathe]

I think you're overlooking a significant if not larger segment, those for whom affordability is not the barrier, but pre-existing conditions.

Well, yes. But, wouldn't you agree that this group is probably in the "more costly" category (at least for insurance rates)? Their health care costs remain, however their contribution towards paying for it is removed.

Hm, these people are working more for the health insurance than the job, so we're replacing them with more motivated and productive workers? Gosh, that helps drain the pool of involuntarily unemployed, gets people off the government assistance programs, and boosts the economy all 'round. Sounds like a win to me!

Although, just because you are not collecting unemployment checks, does not exempt you from other social programs. It would be an ideal world if everyone were healthy, and loved getting up to head off to work everyday. Like the seven dwarfs I guess. No one is actually "drained" -- if you are under 65 you are counted as "discouraged". I'm not sure how being discouraged gets you off government assistance, or boosts the economy. A person who needs the job to pay for their insurance I would consider motivated. More like trapped, and so in that it frees people, I do think its a good thing. It's not that I disapprove of people getting the "good things" here, like accepting preexisting conditions, more coverage, etc. Our topic though is whether the ACA helps make things more affordable, or if perhaps "Affordable Care Act" is yet another law whose title is more of a misnomer, like "The Patriot Act".

For example on addressing affordability, we could just offer people who qualify (old, poor, whatever) a $5000, (or, even the OECD avg.) per year health insurance voucher. Take it to whomever you want to do business with, or augment it with some of your own money if you like. This in effect "fixes" the price that government would pay for services and forces the industry and consumers to figure out how to package health care consumption into that package. It constrains costs, but still leverages competition to create innovative health care delivery.

What is crazy about our "insurance" now with the ACA is that from an insurance risk POV, individual health is irrelevant to the cost of any individuals insurance. It's not that I advocate trying to control behaviors, just that what we have now is no longer something that looks like other types of insurance. Imagine if car insurance were grouped like this.

Or, how about we focus on accelerating and simplifying the process of getting new treatments to market. Part of what is killing us on drug prices is the ten year delivery cycle. The way it works is just crazy, and it needs an enema.

Or, why here in the US we don't "grow our own" health care workers and instead need to import from all over the world. Perhaps look at why we've throttled the number of doctors we train, and all the barriers we've put on foreign doctors coming to the US. If you want cheap health care, focus on the supply and demand issues.

Compared to every other industrialized nation, we have poorer outcomes, and higher costs by double. The point being in the US we've built both a private and public insurance system, and through HMO and group health insurance laws have made them complicated and expensive to administer. Having both, and separating them from consumer choices creates havoc with pricing.