A key part of the ACA is the idea that healthcare exchanges would allow for competition, and the competition would result in lower insurance rates, thus saving the consumers of healthcare money. Has this been the case? In the state in which I reside, there are many healthcare insurance providers. State law requires that they publish their plans, with the costs clearly explained (they do). Such plans seem to follow the same format (from all providers)-“Gold” "Silver’, “Bronze”-with a gamut of deductibles, co-pays, coverage exclusions, etc. What I do not see is any significant price differences-they all are within a few dollars of each other.
Does this mean that there is no price competition here? Or is it the case that all providers simply follow the price leader, and no real competition will take place.
Now, there is a second issue here-all of the large hospital management firms are merging (or attempting to merge). Some of the health plan providers are in fact owned by the same parent firm-why would these subsidiaries compete with each other.
So, has this premise of the ACA panned out or not? Presumably, the larger the insured base, the more money is taken in.
No, health care costs have not gone down. Any other answer is spin.
Regards,
Shodan
what I hear is that health costs are increasing at a slower rate than we’ve seen in the last several decades.
What I’d like to hear are the solid ideas that can improve the ACA, perhaps some, this time, from Democrats?
For starters, add a public option like expanding Medicare, to leverage lower overhead and no profit motive… Give it the power to negotiate drug prices.
Health care inflation has been low since about 2008. Obamacare played a probable role in it, but so did a bunch of other things (lack of new medical technology, higher deductible plans meant fewer utilization of services, the recession cut demand, etc).
It is true, health care costs continue to climb. But it is also worth pointing out that the estimates of how much Obamacare will cost overall has fallen by 11%, because the growth in insurance costs is slowing.
The problem is that a strong public option that could negotiate drug prices would lower costs, that is why it wasn’t enacted. Getting the ACA passed required getting groups like AHIP and pharma to support it. A public option and drug negotiations would cut into their business model.
This is what I do not understand-cutting demand also means that services go unused-so the overhead is the same. With fewer users, costs rise to the remaioning users. take residential drug addiction treatment-if people are denied coverage, the unit has fewer patients to spread costs over. So “saving” money leads to higher costs… Suppose hospitals mandated only one night stays-then you would have tons of empty wards, with the same overhead costs.
Assuming providers don’t react to the shift in demand, you’re correct. Whether that’s true or not is left as an exercise to the reader.
You wouldn’t have the same overhead costs. You’d have lower supply costs and considerably lower staffing costs.
Part of the problem to that question is the use of the word “lowered”. It means one thing to a lying politician and another thing to normal folk.
To most normal people if you spend 1000 this year and spend 900 next year that is lowered cost. If you spend 1000 this year and 1100 next year that is increased cost.
To a politician if you spend 1000 this year, but the cost was projected to increase by 200 next year but it only went up 100 next year to that 1100 then they “lowered” your cost.
That, my friend, is how they lie to you constantly.
Bullshit. The quote for my policy went Up when it was passed. I was given 2 quotes which were based on the outcome. It went up close to $100 month. That wasn’t “inflation” that was the additional cost consumers had to pay because of the mandated changes in the policies. On top of that I lost hours because the company I worked for wasn’t going to take on MY debt just because a bunch of politicians thought it was a good idea… So they reduced my hours.
It was a poorly designed, poorly managed, poorly financed policy that harmed more people than it helped. To date it’s added 1/3 of the people it was suppose to insure. We’re 9 trillion dollars further in debt and this is part of the reason.
Since this has already been infected by a lot of political commentary, let’s move it over to Great Debates.
Colibri
General Questions Moderator
You do know that your experience doesn’t necessarily translate to millions of other people, right? Whether it is good or bad, fantastic or awful, one person doesn’t define reality.
You do know this, right?
Exactly. You can make assumptions about everything. I would like to see actual numbers about whether these exchanges have done anything to actually lower costs. I do not see it. Healthcare has become a “right”-so providing it to people who have an unlimited demand for it (as in the case of in patient addiction treatment) will surely increase costs.
Of course, we knew this before the ACA was passed.
So, if the Republicans had succeeded and doing nothing would had meant that the prices would had gone by $200 dollars more it would mean that the Democrats would be responsible then. :rolleyes:
As I pointed a long time ago, the ACA was not going to do much about the grossly insane costs that we have now in health care, but as I said quoting Lincoln: “One war at a time, gentlemen”. Now that one war is won, it is time for all to do one of the more meaningful fights, and part of making the ACA better should involve dealing with gouging in medicine prices and other issues. The point here is that it is indeed the big fault of the Republicans if the fight is not geared to that now.
I (personally)think that price competition could work in health care services-if the market were opened up to true competition. Like encouraging small urgent care clinics, and paying subscribers rebates (if they have on-line monitoring systems). I think there will be a technology revolution soon (in diagnosis) which will save a lot of time and money. But I don’t see any real competition at the moment.
This is specious reasoning. If increasing competition does little to lower costs, as you assert, then why would more competition be a total game-changer?
The problem with health care is that people shop for insurance plans, but they don’t shop for health care treatments. How many labs have you comparison shopped to see if you could get the lowest price for a CBC? If you’ve broken a bone recently, how many x-ray techs did you compare before choosing where to go? People just don’t do that stuff. Do you even know how much your last doctor visit cost in total?
It is really like what happens if you get into a car accident and need some body work: you know you’re going to pay your $500 deductible, and beyond that, consumers don’t care whether the fender costs $501 to replace or $2,000. That’s the insurance company’s problem.
Just because you can carefully shop for the best insurance for your car doesn’t mean that your shopping does a whole lot to tackle the underlying issue: sure, your car insurance company can negotiate better rates with a few body shops and funnel customers there, but for an awful lot of medical issues, consumers just don’t have the patience for being steered to a small number of doctors, labs, or therapists. So we either pay to have generous options on which doctors to see, or we bitch about how our cheaper plans don’t do everything we want, like that new pill that is 10% more effective, and ten times the cost, of the pill you started five years ago.
And you think a website with more insurance plans for comparison shopping purposes is going to address the underlying reasons why health care costs are growing?
Post-Obamacare insurance pricing really shows how well insurance companies were able to use demographic information to their advantage. They used complicated heuristic models and data mining techniques to predict the party affiliation of their insured and then adjusted rates accordingly.
Of course it isn’t a perfect system, but by and large most Republican insured found their rates skyrocketing. Prior to Obamacare implementation, their rates had either been falling or increasing at a negligible amount.
Most Democrats actually suffered worse in the years preceding Obamacare. To prepare them for the political shift and maximize profits, the companies conspired to make sure that Democrats’ insurance rates climbed steadily in the years prior to implementation. To keep the Democrats mollified and malleable, they made slight changes to the shape of the price-increase curve (i.e. so it wasn’t as steep as it had been). They also threw in a lot of extras and expanded care, but that was mainly to prevent a single payer or similar option.
Truly amazing how Big Data was used to screw over most Republicans and save the Democrats just enough money to keep larger changes at bay.
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The problem with health care is that people shop for insurance plans, but they don’t shop for health care treatments. How many labs have you comparison shopped to see if you could get the lowest price for a CBC? If you’ve broken a bone recently, how many x-ray techs did you compare before choosing where to go? People just don’t do that stuff. Do you even know how much your last doctor visit cost in total?
It is really like what happens if you get into a car accident and need some body work: you know you’re going to pay your $500 deductible, and beyond that, consumers don’t care whether the fender costs $501 to replace or $2,000. That’s the insurance company’s problem.
Good point-try getting a straight answer about the cost of services. Once, I paid a dermatologist out of pocket for a screening (for skin cancer). One time it was $80.00, another time $150.00; each time it was about 20 minutes. Granted, we are dealing with a professional’s expertise in recognizing things, but having a price list or hourly rates would help.
There is no competition because the big insurers have set rates, which all follow. In a competitive situation, some would push rates down, in hopes of increasing their market share. this seems not to happen.