It does nothing at all to demand. People aren’t less healthy because the ACA exists. That’s the demand, not the number of insurance policies.
The ACA is primarily about insurance, not the health care costs directly. However, if you’ve ever looked at an insurance statement, you know that insurance companies frequently dictate prices, and succeed. Because the real health care cost isn’t the listed cost, and the insurance company has some leverage that individuals do not.
The health care situation in Europe is hardly homogenous, and not what you imagine it is. Those that do have single payer systems (i.e. England) have dramatically lower costs, rather than the higher costs you claim, and they aren’t horrible. They have less health care rationing than we already have here. Rather than listening to propaganda on the subject perhaps you could learn what the health care situation actually is in other Western nations.
The “barrier” you’re referring to doesn’t exist, companies do currently sell insurance in multiple states. However, it has to comply with state regulations.
You say single payer would force healthcare companies into competition… but how? And if you truly believe competition in the industry would lower costs, why not push to remove the barrier on selling insurance across state lines?
Your wish is granted. The ACA explicitly allows states to form compacts starting in 2016. We’ll see how many of them rush to do so.
Centralizing the control of health care costs won’t improve anything. Why do many doctors not accept medicare patients? Because medicare doesn’t pay well. Sure, they’d save on paperwork, but if the new single-payer system admins decided to start paying doctors less, there’s nothing docs could do. Docs in the UK (single-payer) make 30% less than here[1]. End result: fewer good quality doctors, research, etc.
ElGuapo, also consider your age. The ACA is designed to overcharge the young/healthy to pay for the costs of the older/sick. Pre-existing conditions cost a lot of money to cover! It’s healthcare now, not health insurance. Triggercut said it best:
$500/month for an individual policy covering two people at the mandated coverage levels a pretty low premium
Your plan might be more expensive because it has to include coverage you may not want/need.
They don’t have the same insane tuition fees. Even with the way the current government’s forced tuition fees at Universities up. Neither do they have anything like the massive, massive malpractice insurance costs American doctors need to deal with.
So…your contention is silly.
The system in the UK is taking a lot of damage, but that’s because of the Tories top-down disorganisation of the entire system! (To allow the profitable bits, and only those, to be hived off to profit-making companies…)
This talking point has never made any sense. As others have pointed out, nothing prevents an insurance company from selling products in more than one state, and many already do so. They simply have to obey state laws, just as doctors have to obtain medical licenses in every state where they practice.
I’m sure insurance companies would prefer to mostly ignore state laws, but I see no reason to extend them that privilege. Pretty much every other nationwide industry can compete across state lines and comply with local laws at the same time.
A quick google search says median doctor incomes (differing by specialty) range from $150k to 300k. According to the AAMC the average med student debt is $180k. You’re telling me that if we slash that tuition, doctors will be okay with 30% pay cut? Those numbers don’t add up. I’d rather have an extra $50k/year and the debt.
A 2011 survey of docs found the median annual cost of malpractice insurance to be $14k. So… my contention is not silly. And it’s only one piece of the puzzle. But it goes back to the original point: how can a single-payer system create competition to lower costs (and not decimate quality)?
Number of doctors who don’t treat Medicare patients: ~9,500
Number of doctors remaining in Medicare: ~735,000
That’s less than 2%. I suspect they are mainly composed of doctors who don’t take private insurance either (e.g. cosmetic surgeons, alternative medicine, etc).
$180k at 6.8% will cost $220k total with a 10 year repayment plan. Yes, I’ll take that + $50k/year for 30 years ($1.5 million).
Can you give a reference for competition == higher prices? It’s tough to discuss blanket statements like that. Then again, perhaps I’m veering off from the thread’s intent (sorry EG). I’m still stuck on “if you like your plan/doctor, you can keep it! And at $2500 less too!”
Magnet, I think that 9,500 number is the # who opted out in 2012. Only 3700 in 2009, so the number is increasing. 2% fewer accepted medicare in 2011 (33% of PCPs). 2% in one year is a big jump. But that jump makes sense when you consider the underlying reasons.
The total number of doctors who are currently opting out is roughly 9500. That’s a net change of ~6000 from the previous year. Yes, it’s a bigger net change than the previous year. But it’s still an insignificant drop in the bucket.
Keep in mind that the absolute number of doctors is also increasing. Because it turns out that I underestimated the number of doctors who are still participating in Medicare. According to HHS, it’s over 900,000. That number is climbing, too.
I am also relieved to find that my offhand speculation had some merit:
Maybe most doctors should be in it to help people, like they historically have always been instead of making money.
Kinda like people don’t become cops and firemen to get rich. Or join the military.
Nah, people who keep you alive should be all about the bottom line, that can only end in victory and a healthcare system that is the envy of the world. And by envy I mean mocked by every person from another nation I’ve ever talked to ever. But America is Exceptional and does everything better than everyone else. That’s why were at the top of any category you pick.
PS- the only category you’re allowed to pick is military strength
Is that really a constructive response? Yes, many doctors are in it to help people. Many are also in it for the money. Why they “should” or shouldn’t isn’t up to you. I’m concerned with results. I would argue that removing private options and giving control to the government will result in lower doctor pay. Lower pay means many will do something else, or retire.
Magnet, thanks for the clarification. Note that your initial # was correct - there are 1 million providers being paid, not docs.
In general you’re spot on. But in a person by person way, what you say doesn’t pan out. A cop, fireman or soldier doesn’t become what they are to get rich. But many, not all, but many doctors do indeed go into their profession for EXACTLY THAT REASON.
It’s hard to compare the salaries of doctors in the UK to what it would be like with single payer here, because the path is very different. Maybe in the very long term they would equal out given the same system, but there are lots of factors affecting those numbers right now, so it’s a bit ridiculous to assume that if we switched to single-payer doctor salaries would suddenly plummet 30%.
You’re making the bad assumption that junior doctors can afford to pay off in 10 years. And ignoring in 30 years that you’ll have paid $450k in insurance… (more for GP’s)
(Plus, let’s remember that American doctors are anomalously high pay by international is one element in costs…)
El Guapo…I am amazed at the deductible amount you quoted as I have been told that high deductible plans will disappear under ACA. We currently offer a $5k deductible and I have been told that will be gone when we are forced to convert to ACA rules at the end of 2014.
The ACA is flawed for a very basic reason. Costs. The ratio’s between the old and young will result in the young paying the largest burden, and we all know how well they are doing now. Insurance costs will have to rise as the old (counting me) pay relatively less by percentage.
There is nothing in the ACA which actually controls costs.
There’s nothing intrinsically unfair about such a transfer. It’s true that young, healthy people pay more today and old or sick people pay less today. But every young and healthy person today will be one day be old, sick, or both. And in general, if you know you will spend less in the future for health care, then you don’t need to save as much today.
Scuzz, in fact the opposite. I’ve never seen such high deductibles. Our old one was $2500.
In the end I ignored the marketplace, which was worthless, and called some places directly. They all still ask for pre existing conditions, which I thought was illegal now. What was the point of all this debate? Nothing has changed, it’s gotten even worse.
