ACA Fail Fractal
Americans Feel Crushed by ACA High Deductible Plans
show comments
  • Boritz

    “Without price transparency, for example, high deductible plans are more
    likely to keep Americans away from medical care altogether, rather than
    encourage them to shop smartly for it.”

    Price transparency only helps so much. You can’t afford what you can’t afford with or without a transparent price. Many now feel that “I can’t afford to get sick under my ACA coverage.” and with good reason. Cost/affordability is rightly identified.

    • B-Sabre

      I agree that not everybody is going to be able to afford proton therapy for cancer treatment, but I think there are enough examples (including several discussed on this site) where hospitals take advantage of the lack of transparency in costs to increase their margins by overcharging for routine and mundane care. Several years ago I had a bicycle accident and ended up fracturing my left forearm. After a trip to the emergency room, I had some painkillers and a sling. And the sling was approximately 6′ of fabric tape, about 2 sq ft of cotton fabric, and a cheap metal buckle. All for about $20 according to my bills. I took a look at the sling, and decided I could probably manufacture one for about $1 in an industrial setting.

      • FriendlyGoat

        Hospitals could dispense the same aspirin sold at Dollar Tree, where you get 140 full-strength pills for a dollar, and charge patients accordingly too. But they don’t.

  • Andrew Allison

    ACA was, and is, misrepresented: it’s catastrophic insurance (in both senses). The deductibles and subsidies are what make the insurance premiums “affordable.” Simply put, there’s a choice between high deductibles and unaffordable premiums. About the best that we can hope for (short of major surgery on the act itself) is that the deductibles will encourage people to shop for routine care and, if the demand for routine care declines, so will its cost. It’s ridiculous to think that people can shop for urgent care, so some other method of introducing competition (transparency) is called for. Insurance companies, which in some case are already doing so, are the logical source.

    • qet

      I’m not sure if you want urgent care to be provided by the low-bidder. As for routine matters, I agree, and the bit in the WaPo article about how some people had not sought care when sick or injured is some evidence that professional care for them was not really required in those circumstances, so the disincentive worked as intended.

    • FriendlyGoat

      It’s better for hospitals and hospital doctors if you’re under-insured on the low end than if you’re under-insured on the high end. That’s because the ACA leaves providers with less uncompensated care and likely fewer patients discharging large medical debts in bankruptcy. Why are we surprised that this is a side-effect of a law in the age of lobbying.

      Medicare works the same way. All the patients eventually pass away, regardless of the medical interventions. Can we imagine a modern society where the wives, children and grandchildren of the deceased are all hounded endlessly for the bills from over-priced end-of-life care? Can we imagine the hospitals just writing off most of it?

      You are, of course, right for mentioning transparency. It is the greatly under-used tool to drive affordability of anything.

      • Andrew Allison

        You’re right, of course, that ACA was written by and for the insurance and hospital industries (the latter of which gravely miscalculated by investing heavily in demand which has not materialized). I trust, however, that you recall the vote on this absolutely dreadful piece of legislation.

  • Sibir_RUS

    Largest Public Pensions Face $2 Trillion Hole, Moody’s Says The 25 largest U.S. public pensions face about $2 trillion in unfunded liabilities, showing that investment returns can’t keep up with ballooning obligations, according to Moody’s Investors Service.
    And this is only the statistics of the 25 largest. Bloomberg gave a breakdown on the problems of individual States in 2012.
    For example, in Illinois the pension funds have only half of the needed money.
    For 2014 detailed statistics are not available, but most likely the picture is even more deplorable.
    It is the negative consequences of Quantitative Easing.
    When the FED prints dollars (QE1, QE2,QE3…) and actively buys the bond market, bond prices go up. For the government (Treasury) this is good since they can get money at low interest rates, but for other buyers of bonds, which in contrast to the FED do not have printer for dollars, it’s bad.
    In 2008, the portfolios pension funds and insurance companies were filled by bonds with a normal income, however, five years of “Quantitative Easing” a large part of their portfolios turned into a “dummy”, which brings about 2.5% per annum while these organizations need to get at least 5-7% (in some cases, 9%)just to continue to pay pensions.
    «you should also realize baby boomers are retiring in record number»

    This applies not only to pensions but also to pay for medical operations, production of medicines and subsidies on food.
    If the printer will continue to spit out new dollars (QE4, QE5,QE6…), cutting thereby yield bonds, the U.S. economy will experience a social disaster:
    – pensions will no longer be paid
    – the health system is collapsing completely,
    – a significant part of social programs and subsidies will remain without funding.

© The American Interest LLC 2005-2017 About Us Masthead Submissions Advertise Customer Service
We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for us to earn fees by linking to and affiliated sites.