# So, Have The Obamacare "Exchanges" Lowered healthcare Costs? **URL:** \ **Category:** Great Debates\ **Created:** [June 28, 2015, 1:31pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695 "2015-06-28T13:31:07Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [June 28, 2015, 11:05pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/21 "2015-06-28T23:05:49Z")
> [@ralph124c](#): > > 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. Which is why you go to the body shop your insurance company tells you to go to (or one of a selection) and not one you choose. Also, there is a ceiling above which repairs are not worth it for cars. Not so for people. > [@](#): > > 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. There is competition, but to get the business of large corporations. Before the exchanges there was basically no competition for individual coverage, and while you could get quotes it was difficult. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [June 28, 2015, 11:09pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/22 "2015-06-28T23:09:28Z")
> [@ralph124c](#): > > 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. That assumes that health care is maximally efficient. If it inefficient - doing tests that are not required, doing expensive treatments that don’t help, then you can reduce costs and provide more coverage. And we know it is inefficient. The ACA includes a board which is supposed to analyze treatments to see which are not cost effective. That would help reduce costs, but not right away. I believe the Republicans are trying to kill this. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [June 28, 2015, 11:13pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/23 "2015-06-28T23:13:49Z")
> [@Voyager](#): > > Also, there is a ceiling above which repairs are not worth it for cars. Not so for people. So you’d think. But how many times have conservatives trotted out the old “oh, then you’d spend one billion dollars to keep a 102 year old alive a month longer?!?”, as if they don’t do the same the instant a fetus is involved? ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [June 28, 2015, 11:14pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/24 "2015-06-28T23:14:20Z")
> [@davida03801](#): > > 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. First of all, there is a difference between costs for an insurance policy and healthcare costs for the entire country. States with enhanced Medicaid coverage will have higher costs (paid for by the Feds) without increasing the cost of private insurance, and maybe even decreasing it if the hospitals become more efficient. As for the national cost of coverage, please show me a reputable cite saying anyone expected it to go down. Predictions of increased costs did not come out of someone’s hat. If you ran a business dependent on oil, and reputable consultants said that it would increase by 20% over the next year, and it only increased by 10%, you’d be pretty happy. Ditto for healthcare costs. In fact, the date that Medicare runs into trouble has gotten pushed out thanks to the lower expect rise in costs. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [June 28, 2015, 11:15pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/25 "2015-06-28T23:15:23Z")
> [@Leaper](#): > > So you’d think. But how many times have conservatives trotted out the old “oh, then you’d spend one billion dollars to keep a 102 year old alive a month longer?!?”, as if they don’t do the same the instant a fetus is involved? Especially since the 102 year old is already covered by socialized medicine, and none of these horrible things have happened. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 28, 2015, 11:56pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/26 "2015-06-28T23:56:25Z")
> [@Leaper](#): > > So you’d think. But how many times have conservatives trotted out the old “oh, then you’d spend one billion dollars to keep a 102 year old alive a month longer?!?”, as if they don’t do the same the instant a fetus is involved? I think the Republican point is more complex than that. First, wasting taxpayer money on the last days of life proves that government is inefficient and shouldn’t be in charge of health care. Second, if the government were to allow someone to die early just because a bureaucrat decided not to approve some spending, then the death panels are real and the government can’t be trusted with health care. So, no matter what happens, the government is wrong. ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [June 29, 2015, 12:38am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/27 "2015-06-29T00:38:22Z")
Unfortunately, despite Obama promising to lower premiums by $2500/family, they have gone up in most states. From 2009-2013, premiums went up for families by an average of $2,976. And Obamacare unfortunately is helping hide how bad the numbers are by cutting $700b from Medicare from 2013 to 2022. ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [June 29, 2015, 12:41am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/28 "2015-06-29T00:41:43Z")
> [@ralph124c](#): > > 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. In the few places where competition has been allowed to happen in the healthcare field, specifically boob jobs (all cosmetic surgery actually… I just like the word ‘boobs’) and lasik eye operations, the costs have come down and quality has gone way up. Not unreasonable to say that that would happen in other fields as well. If people have to pay for and can shop for services, it’s amazing how well the market will work. ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [June 29, 2015, 12:42am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/29 "2015-06-29T00:42:42Z")
> [@ralph124c](#): > > premise of the ACA panned out or not? Presumably, the larger the insured base, the more money is taken in. Busy trying to slow down the Titanic, get back to me in five years. ---
**Author:** ![Donald\_Rump](https://avatars.discourse-cdn.com/v4/letter/d/9fc29f/32.png) [@Donald\_Rump](https://boards.straightdope.com/u/Donald_Rump)\ **Post date:** [June 29, 2015, 12:56am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/30 "2015-06-29T00:56:49Z")
> [@Mr\_Smashy](#): > > Unfortunately, despite Obama promising to lower premiums by $2500/family, they have gone up in most states. From 2009-2013, premiums went up for families by an average of $2,976. Prithee do you have a cite for that? ---
**Author:** ![elfkin477](https://avatars.discourse-cdn.com/v4/letter/e/a9a28c/32.png) [@elfkin477](https://boards.straightdope.com/u/elfkin477)\ **Post date:** [June 29, 2015, 1:18am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/31 "2015-06-29T01:18:37Z")
> [@Leaper](#): > > So you’d think. But how many times have conservatives trotted out the old “oh, then you’d spend one billion dollars to keep a 102 year old alive a month longer?!?”, as if they don’t do the same the instant a fetus is involved? The costs to tax payers aren’t the same, though, even if they are spending the same amount today. The fetus is likely to grow up to be a tax payer and share the burden of paying into social security and medicare for several decades. The 102-year-old is just going to be a drain on social security and medicare for the month or so longer they live. ---
**Author:** ![rsa](https://avatars.discourse-cdn.com/v4/letter/r/839c29/32.png) [@rsa](https://boards.straightdope.com/u/rsa)\ **Post date:** [June 29, 2015, 2:43am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/32 "2015-06-29T02:43:49Z")
> [@davida03801](#): > > 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. The lie my friend is you and your’s fallacious arguments. I second the request for a cite that it was ever promised that total healthcare cost would go down in absolute terms. ---
**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\ **Post date:** [June 29, 2015, 2:51am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/33 "2015-06-29T02:51:31Z")
> [@Mr\_Smashy](#): > > Unfortunately, despite Obama promising to lower premiums by $2500/family, they have gone up in most states. From 2009-2013, premiums went up for families by an average of $2,976. It’s like “how much more misleading could this be.” And the answer is “None. None more misleading.” **None of the major Obamacare changes to insurance markets took place until 2014** – not guaranteed issue, not community rating, not the exchanges, not the coverage regulations, not the subsidies, not the mandate. The only major one that took effect earlier was allowing children to be on their parents’ insurance until 26. So I don’t know what your point about premium increases between 2009 and 2013 is supposed to prove. ---
**Author:** ![Kolak\_of\_Twilo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kolak_of_twilo/32/73_2.png) [@Kolak\_of\_Twilo](https://boards.straightdope.com/u/Kolak_of_Twilo)\ **Post date:** [June 29, 2015, 4:08am UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/34 "2015-06-29T04:08:00Z")
> [@MilTan](#): > > It’s like “how much more misleading could this be.” And the answer is “None. None more misleading.” **None of the major Obamacare changes to insurance markets took place until 2014** – not guaranteed issue, not community rating, not the exchanges, not the coverage regulations, not the subsidies, not the mandate. The only major one that took effect earlier was allowing children to be on their parents’ insurance until 26. So I don’t know what your point about premium increases between 2009 and 2013 is supposed to prove. Well, no fair being accurate. Boo. 😃 ---
**Author:** ![davida03801](https://avatars.discourse-cdn.com/v4/letter/d/b5e925/32.png) [@davida03801](https://boards.straightdope.com/u/davida03801)\ **Post date:** [June 29, 2015, 6:50pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/35 "2015-06-29T18:50:00Z")
> [@rsa](#): > > The lie my friend is you and your’s fallacious arguments. I second the request for a cite that it was ever promised that total healthcare cost would go down in absolute terms. I was not answering the question if ObamaCare lowered costs or not. Argue that with others. I was pointing out the use of the word “lowered”. It means one thing to politicians and another thing to everyone else. My point is correct, and it is a common way politicians lie to us all. ---
**Author:** ![Rhythmdvl](https://avatars.discourse-cdn.com/v4/letter/r/85f322/32.png) [@Rhythmdvl](https://boards.straightdope.com/u/Rhythmdvl)\ **Post date:** [June 29, 2015, 7:07pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/36 "2015-06-29T19:07:07Z")
You keep on using that word… Also, given that the private market has utterly failed to create an equitable health care regime (‘equitable’ from a more humanitarian standpoint, not a mercenary libertarian view), highlighting that the government’s running of healthcare would be inefficient misses a crucial point: under certain conditions, it’s _okay_ for the government to be inefficient. For example, I’m sure that complete privatisation of the police or military could result in more economic efficiency. However, I accept the government-related inefficiencies. Same in healthcare. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [June 29, 2015, 7:20pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/37 "2015-06-29T19:20:12Z")
If the private insurance industry could operate more efficiently, then why doesn’t it? ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [June 29, 2015, 7:22pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/38 "2015-06-29T19:22:29Z")
> [@Mr\_Smashy](#): > > In the few places where competition has been allowed to happen in the healthcare field, specifically boob jobs (all cosmetic surgery actually… I just like the word ‘boobs’) and lasik eye operations, the costs have come down and quality has gone way up. Not unreasonable to say that that would happen in other fields as well. > > If people have to pay for and can shop for services, it’s amazing how well the market will work. When you have a heart attack, go out and shop for the cheapest cardiologist, and tell me how that works. If you try to look in advance, good luck guessing how you are going to get sick. On thing the Obama Administration has done is to start publishing the comparative rates for various hospital procedures across hospitals. That’s a start, not because people will shop, but because insurance companies and the hospitals’ board are going to put pressure on more expensive hospitals to cut costs, especially if their outcomes are no better than cheaper hospitals. It already appears to be happening. ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [June 29, 2015, 7:24pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/39 "2015-06-29T19:24:43Z")
> [@davida03801](#): > > I was not answering the question if ObamaCare lowered costs or not. Argue that with others. > > I was pointing out the use of the word “lowered”. It means one thing to politicians and another thing to everyone else. My point is correct, and it is a common way politicians lie to us all. I don’t agree. When I hear the statement that X lowered Y I take it to mean that Y wil be lower with X than it would be without it. I think is reasonable to say that planting a tree that will shade your house will lower the temperature of the house on sunny days, even if the temperature of the house is still going to be higher on a sunny day than it will be on a cloudy one. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [June 29, 2015, 8:50pm UTC](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695/40 "2015-06-29T20:50:10Z")
> [@davida03801](#): > > I was not answering the question if ObamaCare lowered costs or not. Argue that with others. > > I was pointing out the use of the word “lowered”. It means one thing to politicians and another thing to everyone else. My point is correct, and it is a common way politicians lie to us all. Sometimes it is true. If health care spending went up 10%, but the number of people in the system, the absolute cost went up while the per capita cost went down. I’m not saying that this is true today, but something going up in absolute terms doesn’t mean a lot. [Previous page](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695.md?page=1) [Next page](https://boards.straightdope.com/t/so-have-the-obamacare-exchanges-lowered-healthcare-costs/723695.md?page=3)