>>>So what do you think would have happened without the ACA? I know that our health insurance cost was going up year after year after year, and going up a lot.
>>
>>ACA doubled down on everything that is wrong with American Health Care.
>>
>>"Health Insurance" is a misnomer for our system.
>>True insurance is used to protect against catastrophic losses, not ordinary expenses.
>>
>>Without getting wonky about it, the best comparison is homeowner and fire insurance.
>>It is true insurance:
>>* It protects you against large and unpredictable losses like a fire.
>>* It does NOT cover mowing the lawn, periodic painting, replacing broken windows, and other ordinary expenses.
>>
>>So, what was wrong with our system pre-ACA?
>>* Too much bureaucratic overhead, especially for small dollar amounts.
>>* "Somebody else pays" = No regard for cost by patients or physicians = Out of control spending.
>>
>>The simplest example of "Somebody else pays"
>>* Poor people taking their sick kid to the ER instead of a GP - because they will never pay the bill.
>>* The ER visit is like $3000 but somebody else pays, so they don't care.
>>* Visiting a GP would cost $50 or $100 out of their own pocket, so they opt for the "Free" ER visit.
>>
>>ACA has robbed me of the only tool I had left to combat out of control medical costs:
>>Buying a low cost "Catastrophic" policy and paying out of pocket for ordinary expenses.
>>
>>Paying out of pocket - as I did when I was uninsured, I had a surprising amount of control over cost.
>>I had the same medical problem while insured and again while uninsured.
>>* Insured cost for treating a kidney stone = over $10,000 with like $700 out of my pocket
>>* Uninsured cost for treating a kidney stone = about $300
>>
>>Why was the insured version so expensive?
>>Initial GP visit = $70
>>Painkillers = $15
>>MRI = $700
>>A useless ER visit = $3,000
>>Two outpatient procedures to clear the stone = $7,000
>>
>>Why was the uninsured version so much cheaper?
>>Initial GP visit = $70
>>Painkillers = $15
>>MRI (non-insurance cash price) = $225
>>ER Visit - declined = $0
>>Outpatient procedure - declined = $0
>>3 gallons of water and a day of agony to flush the stone = $6.00 (Walmart bottled water tastes better than tap water)
>>
>>Can I shop and cost-control every medical expense?
>>No. Duh.
>>A heart attack or car crash injuries would be impractical and stupid to price shop medical treatment.
>>
>>Before ACA, i could have purchased high deductible catastrophic medical insurance for like $6,000.
>>After my experience price-shopping medical care while uninsured, I was leaning that way anyhow.
>>
>>So, comparing to my present ACA-compliant plan, I would have had another $11,000 every year in my pocket to cover out of pocket medical bills.
>>And yes, a very high deductible plan would have exposed me to a loss of $20k in a very bad year.
>>But having $11k more in my pocket EVERY year would soften that a lot.
>>
>>Some people don't believe that medical costs can be controlled with Econ 101 supply and demand in the free market.
>>In fact, medical procedures are like anything else - normal Econ 101 supply/demand and competition in the market DO drive down prices over time.
>>
>>Lasik vision correction is not covered by insurance.
>>People pay out of their own pocket, and doctors compete on price, service and quality.
>>* "Today, LASIK is done with a computer-guided laser. ... it cost $3,800"
>>* "less than half the 1997 cost with a much shorter recovery time and lower risk of human error."
>>* Forbes Magazine Mar 23, 2012
>>
>>In short:
>>Expensive layers of bureaucracy and regulation drive costs up over time and give us the quality service like we expect at the DMV or Post Office.
>>Competition in a free market drives costs down and improves quality over time.
>
>I agree with most of what you said.
>First dollar medical insurance is insane.
>However, I think you're overlooking the complicity of the providers here.
>When I switched from a cadillac plan to medicare, previously "indispensible" procedures not covered by Medicare were no mysteriously longer required.
>At least a dozen times, when I've asked why a procedure was necessary the answer was "What's the problem? Your insurance covers it."
>It's whacky now.
>All the privacy nonsense, patient advocates, quality control experts, blah blah blah.
>Hospital administers are typically pols getting paid for a favor.
>Michelle Obama was a "community outreach" VP at a hospital in Chicago and her salary mysteriously tripled to $300K when her husband was elected to the US Senate.
>The repubs are worse here in NJ.
>The average cost per day for an hospital here in NJ is about $7K if you're getting meds like anti-biotics.
>That's obscene.

Agree with every word.