Anything? My impression is that it mostly just cuts the number of people covered by insurance by 24 million, cuts health coverage offered by insurance (removing the 10 mandatory areas insurance must cover) and gives tax cuts to the wealthy.
It may reduce premiums for healthy people, but it’ll raise premiums for the sick. That is just cost shifting, it isn’t really reducing health costs. Some healthy people will probably see their premiums go down, but overall it doesn’t look like it’d have any positive effects on medical spending (which is at 18% of GDP, other wealthy nations only spend 8-12% of GDP on health care that covers everyone).
Some people will come out ahead financially (people who paid the penalty but didn’t buy insurance for example) but overall it doesn’t seem like it does anything to improve efficiency or quality of care. To the degree that it will cut costs, it’ll cut costs by reducing the quality of health insurance.
The argument I hear from the right is that ‘the ACA is too expensive’. Fair enough, but that is because our health system is too expensive. Does this bill do anything to fix the problem of our overpriced health system?
The ACA slowed the rate at which healthcare costs climbed, but it didn’t reduce them. In the minds of many people, slowing the rise is a failure. If something costs a dollar, and its cost rises by a dollar a year, and something is put into place that slows the rise to 50¢ per year, they seem to think it’s perfectly OK for them to be paying $6 for the thing after five years, instead of $3.50.
As I said in the other thread, in my opinion creating 24 million uninsured people will drive insurance premiums up because their treatments are paid for by people who do have insurance.
It essentially cuts all the of the taxes that were implemented by the Affordable Care Act to people who make over $200,000 that were necessary to pay for what the ACA did and cuts funds to Medicaid and other programs an approximately equal amount while deregulating the Insurance industry more than it already is.
IMHO, the US healthcare system is a complete trainwreck due to free market distortion and inefficiency. It really needs to be totally reconstructed in a way that divorces it from the free market.
Replacing the ACA with AHCA is kind of like replacing a tourniquet with a band-aid, the smallest one in the box. But neither one really fixes anything at the core and it’s going to be a problem until we muster the political will for a drastic revamp of the system.
It looks pretty much like what we had a hundred years ago. The sicker you are, the more you pay. The only difference is that now there are stockholders skimming enough off the top to make their sailboat payments. And the doctors don’t make house calls anymore.
I’m asking about the AHCA, the GOP bill that passed the house last thursday, not the ACA.
But on the subject of the ACA, did it really lower medical inflation? I thought the majority of the decline in medical inflation seen in the last decade was due to the great recession and medical costs being so high that people just avoided the doctor.
Reducing medical inflation is a laudable goal. Back in 1980, US health care costs were mostly in line with European nations like France and Germany. Then they started climbing rapidly while climbing much more slowly in Europe.
But since we are spending 18%, we do need to reduce medical spending. Other nations cover everyone for 8-12% of GDP.
Yes, it really did lower medical inflation, in a variety of ways.
First, if the public option had gotten through, it would have provided meaningful competition to the health insurance companies. No other entity other than the Federal Government was large enough to do this. It’s why the insurance companies fought the public option so hard and ultimately succeeded in eliminating it. Their success also eliminated the most important and effective cost savings measure intended with the ACA. Still…
The ACA limited health insurance companies’ administrative costs and profits to 20%. All else was required to be spent on actual medical care. This requirement led to some creative accounting, but it also slowed costs. The idea was that the more insurance companies could streamline their administrative costs, the more of the 20% they could keep as profit. I’m pretty sure this braking mechanism will be done away with by the AHCA.
The ACA required medical companies – hospitals, doctors’ offices, etc. – to all implement the same electronic platform for exchange of patient data. While initially painful to accomplish, the idea was that doing this would eliminate duplication of effort. Example: You go see your GP and he orders an MRI so he can have a better look at your ailment. Based on what he sees, he refers you to a specialist. Instead of the specialist ordering another MRI, the specialist has access to your GP’s MRI. Saves a lot of money and unnecessary procedures.
The ACA required that all preventive care be free under ACA plans. While this required an additional outlay of expense on the part of insurance companies – which was intended to be compensated by the risk corridors established by the ACA, and which Marco Rubio undid with hidden stipulations in a legislative spending bill in late 2015 – the intent of covering preventive care was that expensive health care procedures would soon be avoided by catching disease early. It’s a lot cheaper to remove a mole than treat Stage 4 melanoma, for example.
President Obama understood that making medical care available to so many people all at once was going to put a strain on insurance companies to cover their accumulated ills and made provisions for it within the ACA. Too bad Rubio successfully undid the risk corridor provisions. His success also ensured that health insurance companies would raise their rates and bitch like hell just before the November 2016 election. And they did, of course.
So yes, the ACA had cost-savings measures built in. The biggest one, the public option, was successfully removed by the health insurance companies. And now the others will be undone as well, if the AHCA is passed by the Senate.
By the way, Hillary’s plan was the very one Bernie is out there touting now – to lower the age for entry into Medicare to age 50 or 55. The idea was to gradually lower the age over time until everyone was covered under Medicare. Voila. Single payer.
In answer to the OP’s original question, no. The only cost-savings measures I see so far are based solely on reducing availability of care or the quality of the insurance policies being sold. If it passes, we’re basically going back to how things were before the ACA and transferring the “savings” into the pockets of the wealthiest 2%.
I had to get insurance this year through the ACA marketplace. Our premiums doubled for a policy with a high deductible for literally the worst available policy. I understand that those who are sick may have to start paying more, but that makes sense to me, as long as the rates for those that are healthy go down.
There are undoubtedly many of us who could have (and maybe did) go uninsured for our indestructible years, then found out why decent coverage is not a luxury.
A lot of answering the OP depends on the assumptions we make at the outset. It will reduce some costs for some, mainly through cost shifting to other people or entities.
The federal government will spend less (depending on exactly how the uncompensated hospital payments end up working). Young, healthy people will spend less and get less. Insurance companies may spend less, but will likely have fewer customers. Employers may spend less.
State governments will spend more. Old people, sick people, and people with disabilities will spend more.
I can’t come up with a single way quality will benefit.
The goal of the AHCA is to do that.
I believe the typical economic pattern will occur-the costs will not go down as much at the costs will go up. So more money will leak away from healthcare into “administration”. Such a thing isn’t limited to government healthcare, prices rarely go down as fast or as far as they went up in any market.
While you will benefit in the short term, you will pay more when you get sick and need the insurance. And if you never need the insurance, why are you paying for it now? Even under ACA the penalties were trivial compared to the cost of insurance.
I get that the cost of insurance is high, higher than people should have to pay, but I don’t get why making it higher is a solution.
Are you in a group plan, or do you have an individual plan? Just curious.
Marco Rubio is a pandering assclown. I’m enjoying trolling his Facebook page. So is half of Florida, apparently. You should see the posts responding to his “Day of Prayer” post with Christian imagery.
The Republican Party is being very shortsighted. They deny climate change. If only we could keep the planet from warming, we’d have more ice floes and we could solve the problem with old people, those with pre-existing condition, those with disabilities, and others who require expensive care, by using that natural resource.
Only on SDMB would “free market distortion and inefficiency” have heads nodding and go unchallenged. One of the problems with the health care system is that it is far removed from the free market, and also very inefficient because of that. There is a huge disconnect between who pays and who benefits, and also between how prices are set and negotiated/agreed to by patients and insurance companies.
It seems to me the system needs to go one of two directions: a) much further toward free market dynamics where consumers can compare and negotiate providers and prices, or b) much farther toward single-payer nationalized medicine where costs can be constrained by fiat. What we have now is the worst of both worlds.
And to answer the OP, I don’t see how the ACHA does much of anything to improve quality or lower costs, overall. There would be winners and losers, much as what happened with ACA. But I don’t buy for a minute that the ACA lowered costs overall.
They do? I thought most people agree that the climate is changing, and always has over the eons. I thought the disagreement is regarding whether and how much is due to humans.
Oh, but that’s as irrelevant to this thread as the rest of your post.
