The Insurance Companies have found a way to do something that Congress failed to do - Completely kill Obamacare. The only Insurer that offers statewide ACA policies in North Carolina (BCBS of NC) will not longer offer ACA polices to individuals in 2017 after taking severe losses on them over two years. There are no other insurers who offer policies in all 100 counties. There are two other insurers that offer policies in 13 counties (UHC is pulling out also, now leaving only 3 counties covered). This is the end of Obamacare in our state. The same is happening in at least 20 other states. The BCBS of NC CEO stated that not even premium increases of several hundred percent can make the individual ACA policy business viable. Say goodbye to Obamacare - taken down by the industry that thought they would make a killing off of it. Blue Cross CEO says insurer may leave ACA market in NC in 2017 http://www.newsobserver.com/news/business/article59636351.html
People can have a debate over if it is good public policy to provide health coverage for all of a country's citizens. The problems with Obamacare are not related to this fundamental debate. There are plenty of good examples of public healthcare coverage in other western countries (Germany, etc.). Many also include an option to select private insurance. The problem with Obamacare is that it was a giveaway to the drug companies, medical equipment companies, insurance companies (which backfired), and others. Obamacare was a combination of every dream that a lobbyist could shove into it in order to benefit their industry and not the people. If the people of the U.S. believe it is good public policy (which many do not) to have public healthcare then the proper way to go about this is to extend Medicare/Medicaid to all citizens while leaving the option of private insurance in place for those who work for companies. As with most countries the private plans will be enhanced over the public coverage. And those on public coverage will have to endure rationing and long waits for care such as knee surgeries. Of course, the question of how to pay for extending coverage to all is an open question.
let's not go through another contentious debate about healthcare. I'm sure Hillary can improve the ACA. Most likely all it needs is more money.
Two facts need to be kept in mind in deciding how best our U.S. Health care should be handled. One is that comparative studies of healthcare quality and cost of delivery have the U.S. rated not at the bottom, but below the bottom, of the list of industrialized countries we regularly compare ourselves to. Furthermore, the cost of Healthcare in the U.S. compared to that in other developed countries starts at near 100% higher and goes up from there. Republican politicians regularly ignore these dark facts in calling for more of the same dressed up in new clothes, just as the ill fated ACA did, once the 'public option' was eliminated. Regardless, there is still no credible way to put a positive spin on present day U.S. healthcare reality. In the now distant past, American Medicine was comparatively little regulated and there was less opportunity for regulatory capture by physicians, hospitals, and pharmaceutical companies. This is no longer true . Without exception, capitalism will always be disastrous for the client in the absence of competition, which is both the goal and the inevitable result of regulatory capture. This will remain immutable so long as there is no evolution in human nature. _________________________ References: New England Journal of Medicine, 2003. http://www.nejm.org/doi/full/10.1056/NEJMsa022615 "The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted." WHO ranking from a Canadian Perspective http://thepatientfactor.com/canadia...zations-ranking-of-the-worlds-health-systems/
Why do you refer to a system run by gov't regulators as capitalism? cap·i·tal·ism ˈkapədlˌizəm/ noun an economic and political system in which a country's trade and industry are controlled by private owners for profit, rather than by the state
There use to be something called the "Professional Class". These were typically Doctors, lawyers (believe it or not) and college professors. They were judged by their contribution and not their income. They made a typical good middle class income.
This is absolutely true. I grew up in that era. My father, my grandfather, three uncles, a number of cousins, were all physicians. I am rather an expert on the evolution of American Medicine in the 20th Century.
I agree with piezoe that the system was crazy, and it is even worse now. At least, 90% of people pre-obamacare had decent coverage. Now a lot of those people can't afford the jacked up rates or the gargantuan deductibles, all put in place to subsidize Obama voters. A full on socialist system would clearly be worse. Think going to DMV. A mixed system like medicare looks like the likely end point. I'm not advocating it, but it would be better than obamacare. Medicare works pretty well. The finances are getting ready to crash, but I am not sure how much of that is the system itself or the result of outrageous abuses in things like the disability part of it. Still, if you have government running something, rent seekers will game the system. They certainly did it with obamacare, with all kinds of useless mandated coverages that drive up costs. So ideally, you would have a private insurance system, but with some tweaks. I see at least three major issues in replacing obamacare. One is the linkage of health insurance to employment. It's an historical anamoly that is unfair to anyone paying for health insurance out of their own pocket. Plus it creates all kinds of disincentives, ranging from people not wanting to leave a job because of the insurance to employers holding down their head counts or hours to avoid mandated coverage. Two is the state by state regulation. Insurance costs vary wildly across the country because insurers sell it on a state by state basis, as required by law. If you had a national risk pool, it would open up the system for innovation and cost savings. Three is the problem of pre-existing conditions. If you force insurers to cover pre-existing conditions, almost by default you have to enforce a coverage mandate. Otherwise there is an incentive for the young and healthy to wait until they are seriously ill to get coverage. It is a knotty problem, but it is not so serious that the insurance market for the rest of us should get fouled up to address it. Probably the least worst solution is to have some sort of government, ie medicare-type, program for people who get caught without insurance. We already have Medicaid, but that is for the poor. You shouldn't have to go into bankruptcy because of an illness.
I don't see how this gets rid of obamacare. This doesn't repeal the federal law. It looks to me like each citizen will still be responsible to get health care coverage or pay the fine imposed by the law. No policies offered? Then they will have to pay the fine. To people that are stupid enough to vote for the tyrants that impose these things, I say 'tough' to them. To others, I sympathize with them.