rayjay
Meanwhile, the insurance companies cannot compete among state boundaries so the government has created an oligopoly
.States were free to allow insurers from other states to sell to their citizens before Obamacare, and they are still free to do so today. What Obamacare did was establish an "essential benefits package" -- basic minimum standards that all individual policies must meet, no matter where they're sold.
Indeed, many states have explored the idea of allowing insurance companies from other states to sell within their borders; 18 looked into allowing out-of-state insurance sales before Obamacare became law, and 13 have considered it since. But very few have actually decided to do so. And the ones that have report unanimously that it has accomplished nothing.
Why? Because a license to sell insurance in a given state isn't the only thing insurance companies need in order to be able to actually sell insurance. They need to learn the state, analyze the health care needs of its population, recruit participants, build a network of providers, negotiate rates, and more.
If you're a huge insurance company like Blue Cross, you might have the resources to replicate this effort in states across the country, which is why you can get Blue Cross insurance in multiple states. But smaller insurance companies based in a single state have found again and again that, even when offered the opportunity to sell across state lines, it simply isn't worth the hassle.
And that's why allowing cross-border insurance sales has failed miserably in every state where it's been tried
. Wyoming, Rhode Island, Washington, Georgia, Kentucky, Maine.
http://www.huffingtonpost.com/al-franke ... 32508.htmlrayjay
the government favors litigants in the courtroom (as do the juries since they hate the insurance companies) resulting in large payouts to attorneys and their clients for malpractice
Torte reform in texas did nothing to alleviate either health care cost inflation or physicians leaving the State.
http://healthcare.dmagazine.com/2012/08 ... ing-costs/Rayjay
It's clearly not only the ACA's fault, but the ACA did exacerbate the problem by mandating insurance
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Without the mandate, what do you get?
Start with the fact that people without health insurance, get their health care primarily from emergency rooms, where by law, they can't be turned away. Huge bills were left unpaid by these people, and were paid for by increasing charges to patients who do have insurance.
You also end up with people waiting longer to seek treatment, usually meaning their treatment is more expensive and often less effective. Preventative care for those without insurance doesn't happen.
The mandate made sure that healthy people, who previously gambled that they wouldn't get sick, now don't get to gamble. Some of them, by gambling, managed to avoid big health care costs. Some lost the gamble and incurred crippling bills.
... But today their insurance premiums help keep everyone's premiums lower, and they can seek earlier treatment and are secure in knowing they won't be bankrupt by a car accident. Its no different than any other insurance pool. Only other insurance pools are for people who are required to have such to drive a car for instance.
The difference with health insurance is that everyone participates in the cost of service delivery whether they are insured or not. And the law means that the uninsured do eventually have their costs covered as the providers pass the losses from providing care to the uninsured to the insured....
The mandate also allowed people previously uncovered to seek care earlier and in less expensively delivered methods, like doctors offices and clinics. It will save lives as a result.
Please explain how this isn't an improvement over years before the ACA?
The ACA is a deeply flawed system. And you are right that it hasn't been as effective against health care inflation as many hoped. But certainly better than your personal experience.
(see below) Mostly because it still disallows many of the levers that national health insurance plans allow that do keep health care costs lower.
But the notion that previously there was anything resembling competition on pricing in health care is erroneous. Nor that any of the proposed fixes (insurance across state lines, malpractice torte reform) will have any significant effect.
Sanders offers the only solution that can effectively lower health care costs. Clinton accepts the monstrosity that is the lobbying and legislation morass that gave birth to the ACA. And Republicans have nothing but repeal of the ACA. and "I won't let people die in the street".
Repeal would remove coverage from millions, allow insurance companies to bring back basically worthless insurance, (essentially legalizing fraud), allow people to be uninsured which means their care costs would be backstopped by others anyway, and does absolutely nothing to attack the costs from providers... The evidence for this is a review of the conditions that pre-existed.
Rayjay
Although I've had double digit increases before, I've never seen anything like a 34% increase in insurance rates
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http://kff.org/health-reform/issue-brie ... ketplaces/The average increase last year , according to Kaiser, was 2% for Silver and 4% for Bronze plans.