The ACA was a huge attempt to control health care costs as well as increase access to care under the auspices that mass enrollment of healthy people would in turn lower the risk pool and thereby costs. It didn't happen, but that was one of the goals. Also, it helps to remember that the ACA was supposed to be straight up single-payer healthcare at the outset. This resultant thing is just a weird compromise that pays off the insurance companies. So if it was up to me, children would be covered until 18 at least with a CHIPS-type program. It's a moral obligation to take care of those who can't take care of themselves for me. That would still leave the market to develop solutions and provide other options (which I don't think will look similarly to what we do now; it's unsustainable). The reason I want to look at the pre-existing conditions question is that the number seems really really high when they say that 15 million people will be losing healthcare. And so when I started digging I found out that the number largely includes a huge expansion of Medicare which right off the bat included an 'increase' of 11 million people as insured. They're not really insured in the common understanding of the word, so it's misleading to say that they'll lose insurance coverage. They're just restructuring the medicare program and they'll lose access to that. All in all, measuring insurance coverage is a ridiculous starting point. I don't want people to be insured. I want them to get the healthcare they need. In a perfect world for me that comes from the free market, but health care is a strange economy because as kleinbl00 pointed out, there is a disinterested, always paid third party in the room that just keeps raising prices without regard to what it does to the customers on either side. I think that has a lot to do with how hard it is to become a health insurer due to regulation (i.e. I can't start a health insurance company to compete due to huge and multiple barriers to entry even on a small town-level scale). You see a simliar, thought not exactly the same by any means, argument in the internet side of things. People bitch about internet costs, and Comcast says you can go fuck yourself because they know you can't buy it from anywhere else due to regulation. Then you say fine, I'll start my own ISP with blackjack and hookers. And you can't, because Comcast has regulated monopolistic access to the wiring needed. And you can't, because Comcast lobbies to keep it that way. So you end up in a high-cost no competition situation where it would make sense for your city to start up an ISP and run it as a state-owned entity, giving the same people who fucked you over by cozying up to Comcast control over your internet access. I don't think the government is my friend. I think they are in the pockets of a lot of people. I think that if I can remove them from my life as much as possible it increases my liability and risk personally, but that is a cost I am willing to pay. So I don't want them in healthcare.
If the ACA was not sustainable, then Trumpcare as drafted so far will also be unsustainable. They're basically the same system. The only difference is in the amount of tax credit and how much the insurance companies can charge. In this video , rep. Tim Ryan says that in Ohio, the head of the Ohio hospital association says that 1 million people may lose their coverage under the new Trumpcare as drafted at this point and 25% of hospitals will close. If it's unsustainable to have insurers pull out of the market, it will be less sustainable not to have hospitals to give care at all. Looking at a study the GAO did that was released in 2013, the factors of the growth of health care costs are the aging population, more people seeking health care under the new insurance programs and technological advancements in health care. Neither the ACA nor the proposed Trumpcare plan touches on these issues. Hoping the market would develop solutions on its own when the healthcare industry is a monopoly is unrealistic. There's no incentive for the market forces to work. The similarity of health care to Comcast is that they're both monopolies. The difference is that people can walk away from their internet service. People cannot walk away from health care. Their lives literally depend on it. I'm curious how far you go with this philosophy. In this video , Obama talks with Bill Maher (could Bill Maher be any more in love with Obama?) about all the ways that government has socialized a number of institutions. Schools, prisons, retirement (social security) and elder health care (medicare) are some examples. Are you willing to allow the privatization of schools and prison? As Obama notes, if prisons are privatized, there will be a bigger incentive to incarcerate people. If schools are privatized, the rich will become the only people who can afford going to school, creating an elite class and an uneducated one. Are you in favor of privatizing schools and prisons? You mentioned single payer health care which is basically government sponsored health care. Are you in favor of single payer health care? If so, wouldn't this be more government intervention, not less?So if it was up to me, children would be covered until 18 at least with a CHIPS-type program. It's a moral obligation to take care of those who can't take care of themselves for me. That would still leave the market to develop solutions and provide other options (which I don't think will look similarly to what we do now; it's unsustainable).
Federal health care spending is expected to continue growing faster than the economy. In the near term, this is driven by increasing enrollment in federal health care programs due to the aging of the population and expanded eligibility. Over the longer term, excess cost growth (the extent to which growth of health care spending per capita exceeds growth of income per capita) is a key driver. Slowing the rate of health care cost growth would help put the budget on a more sustainable path. There is general agreement that technological advancement has been the key factor in health care cost growth in the past, along with the effects of expanding health insurance coverage and increasing income, but there is considerable uncertainty about the magnitude of the impact that the different factors will have on future health care cost growth.
I don't think the government is my friend. I think they are in the pockets of a lot of people. I think that if I can remove them from my life as much as possible it increases my liability and risk personally, but that is a cost I am willing to pay. So I don't want them in healthcare.