Are we better off since ACA.?

HAS ACA DAMAGED OUR HEALTH CARE?

REFORM IS IMPERATIVE

Before introduction of the Affordable Care Act the majority of Americans had a very positive view of the quality of health care. The problem was the cost, which really did not have any realistic connection to the rest of the economy. Let's face it, without insurance, very few people could afford major surgery or extended hospital stays. We were told that the problem was the uninsured, and to bring down the costs we would mandate everyone buy health insurance and force all employers with over 50 employees to purchase insurance. At the same time the mandated coverage was expanded to include many services that could never be used by the policy holders. Insurance companies were also mandated to not use actuarial tables to set prices. Usually young groups of policy holders paid less than older folk. The idea was to force the young to subsidize the older. You could also purchase insurance on-line from exchanges.

When these exchanges went on line, out of curiosity, I put in my son's information to get a price for insurance. The premium at that time for a bronze plan cost around $110.00 a month, but had a $6000.00 deductible and paid 60% of the cost. If you were a low income person, you would be better off to put your $110.00 in the bank, because if you didn't have $6000 you really didn't have much insurance unless it was a catastrophic event and then you would still owe 40% of the cost. Before the Affordable Care Act, I paid for my son's insurance while he was in college. I paid $100 a month from Highmark with a $1200 deductible; it paid 80% of the cost with a maximum of $3000 out of pocket. Coverage for him was more affordable before the ACA. At that time there was about a dozen providers, but I understand the situation now is much worse.  Many older people who self pay their insurance have had to drop all coverage as they cannot pay the premium. My daughter's husband has a small company, they have gone through several insurance companies since the ACA because their insurance companies keep going out of the health care business. Every time they start over, it is another group, new doctors, no continuity of care. The ACA has not only become unaffordable for working families, but has also lowered the quality of health care. The government also took over $700 billion in Medicare money and moved it to ACA to subsidize low income care and to expand Medicaid. They compounded the initial problems of rising costs and uninsured individuals by creating problems across the board. Medicaid payments to doctors have been cut so much that many doctors claim they lose money on Medicaid and will no longer see Medicaid customers. Some will no longer take new Medicare people who have not been previous patients.  

Instead of looking at other ways to lower costs, the government tried to reduce costs by forcing providers to take less reimbursement and by hoping to force the young to subsidize the system. It really is not working except for low income or no income people who are subsidized, who may have insurance, but do they really have good health care?

The easiest way to cut health care cost would be to eliminate all insurance. This would be a pure free market solution and the cost of health care after some serious chaos would settle at a realistic price linked to the real economy. Two examples are breast implants, which are not covered by insurance are now advertised as low as $2500 and Lasik eye surgery, again not covered by insurance, advertised at $250.00 and up. Both these procedures can be purchased by most anyone who wants them.  It is interesting that there is tremendous competition in uninsured items, while no one ever asks about the costs of procedures that are insured. Now I know we are not going to eliminate health insurance, but we now have two choices, rely on government controlled and paid health care or introduce more market forces and market cost reductions. Government interference in the health care business has not made things better. Can more government control make it better? We will talk about those ideas next time.