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ACA Agonistes
The Next Big Health Care Debate
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  • lord acton

    A) Heath care providers: doctors, hospitals, pharmaceutical companies and medical equipment suppliers have been gorging for years.
    B) The middle men, a.k.a. insurers need to make their vig, right?
    C) Tons of folks get their care for little of nothing (I’m not saying some folks shouldn’t get taken care of nor am I saying that the care they receive is adequate).
    So the only way this can work is for the payers: patients (who aren’t in category C above), employers and the taxpayer (those in the fortunate half who pay taxes) to be squeezed like lemons until every drop has been rung out of them. I’d say we are getting there.

    • CapitalHawk

      “Tons of folks get their care for little or nothing ”
      And that is the problem. When people pay $10 at the all you can eat buffet, they will fill their plates until they are bursting with food. When they have to pay separately for each bite, people are much more careful about over-ordering and over-paying. The main problem with spending in the health care arena is the virtually complete disconnect between the amount of services consumed by the consumer and the amount paid by the consumer. Make every single service be separately ordered and priced and then force the consumer to pay some percentage (10-20%) of each and every service, and watch the amount of health care consumed plunge. Note, that this also would solve the “defensive” medicine that people decry when arguing that we need to reform medical malpractice law.

      • lord acton

        So true. But our elected representatives (God have mercy on their souls) work for groups A and B and farm the votes of group C. So your eminently common sensical proposal has approximately zero chance of ever happening.

        • CapitalHawk

          I know. If only there were some politicians who were willing to “speak truth to power”. I’m sure that at least one of them thought that was a good idea at some point in their life, right? I mean, where’s the audacity, the hope, the change?

  • Jim__L

    Did the spending bill yesterday actually de-fund any portion of ACA?

    If not, the argument that ACA is somehow “orphaned” is meaningless. Only the tax was disavowed. That in no way represents progress.

  • Anthony

    Yuval Levin is a serious public policy thinker and contributor and his referenced National Review article is important reading for Americans concerned about healthcare costs as well as healthcare economic effects on insurance. That said, healthcare in America remains a robust and growing incoherent mechanism of immense size, scope, and scale. Much work (as has been enumerated many time here at TAI) remains to be both initiated and organized – caveat: healthcare is very well fed, embedded interests.

  • Andrew Allison

    ACA is not the biggest loser in the spend bill, the taxpayer (as always) is. TheCadillac Tax was intended to raise significant revenue to pay for other key components of the ACA, including subsidies to help low- and middle-income families afford coverage through the health insurance marketplaces. Guess who’s going to make up the shortfall.

    • Jim__L

      No one? Future generations, through rampant inflation, actually having to pay back the national debt, or the bankruptcy of the government?

      No way that today’s taxpayers are touching that. That’s what the story was about.

      • Andrew Allison

        We’re in agreement again. This has got to stop [grin]

      • Andrew Allison

        Thought you might appreciate: HMRC [UK IRS} have returned a tax return to a man in Evesham after he ‘apparently’ answered one of the questions incorrectly. In response to the question “do you have anyone dependent on you?” The man answered: “2.1 million illegal immigrants, 1.1 million crack heads, 2.2 million unemployable Jeremy Kyle scroungers, 900,000 criminals in over 85 prisons, plus 650 idiots in Parliament, and the whole of the European commission.”
        HMRC deemed this response as unacceptable. To this, the man replied saying “who did I miss out?”

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