Supreme Court upholds ACA

[HejiraNYC]

Originally Posted by KarmaContestant

There is no legal requiremnt to lower the cost of premiums, because we are a free-enterprise capitalist economy, and price controls are considered a no-no; so yes, the insurance companies will continue to determine the rate of premiums.

This is where this program falls apart. If insurance companies are making a windfall of new revenue due to all of the new younger/healthier people who are now paying insurance premiums, they should be required to somehow reduce insurance costs for consumers across the board. Current insurance premiums are based on the calculated risk of disease based on demographics. When the demographics are changed so drastically, insurance companies must adjust the premiums accordingly, and more than likely the adjustment should be downward.

As far as this: "I am not hearing about the concessions that insurance and healthcare companies are making to truly expand access to coverage":.

No denial for pre-existing conditions
No dropped coverage when you get sick
No price gouging based on health, age, smoker, etc...
Children can stay on parental insurance plans until age 26.

Granted, these aren't concessions, but legal requirements of the Affordable Health Care Act. One cannot expect a for-profit industry that makes billions in profits by price gouging and denying coverage to make concessions, but the idea is that the pool of funds will be greater when more peope are covered, and the cost of services could drop. How? If premiums are to decrease, Americans will really need to get serious about preventative care. Going to the doctor every six months for regular checkups and physicals. Getting off their fat asses and engaging in physical activites. Putting down the starchy carbs and eating fruit and vegetables. It's time to move away from treating (and extending) illnesses with expensive therapies and begin preventing illnesses with affordable lifestyle changes.

I am not understanding your logic. For one thing, why do you assume that the cost of services will drop? If anything, expanded coverage = expanded healthcare utilization. But what does that mean regarding major medical endpoints? The system could be flooded with people looking to get the latest and greatest diagnostic/screening tests and who are enabled by all-too-willing physicians and laboratories who receive generous fees for these services. Recent evidence already suggests that some mammograms are unnecessary. Early PSA screening has also been found to be unnecessary, if not downright detrimental to health outcomes. It seems not improbable that people will demand these tests... just because they can.

I also don't understand your premise that people will suddenly become more willing to engage in lifestyle modification to prevent major medical illness due to Obamacare. Yes, people need to stress the importance of prevention; however, it would seem that people would be less willing to take care of their health when the safety of healthcare coverage to save them in their time of need. I have known quite a number of people whose philosophy about life is basically "there's a pill for that." Why eat salads and oatmeal when there are pills (almost free under insurance) that will reduce blood pressure, reduce LDL cholesterol and prevent fat absorption? Pass the steak! Although the current insurance system is not perfect, at least there were financial consequences for smoking, being overweight, etc. Without any element of personal responsibility under Obamacare, it seems that there will be less incentive for people to eat well, exercise and stay away from tobacco.

This can be argued, but I believe the prices of premiums will be determined by the free-market (as in, you and I). Be healthy and reduce the costs of care so that the costs of premiums can decrease as well. Or - continue to engage in unhealthy lifestyle choices and watch the fat-cats laugh their way to the bank as premiums continue to increase at the same rate as greed and laziness.

Just like the current American energy cartel, and it truly is a cartel in every sense of the word, insurance is similarly a cartel. Insurance companies will band together to prevent any significant reduction in premiums- that's the American way. Of course any Republican will tell you that the free market will establish the most rational market... but we all see how well those "free market" principles fared after the great recession. No, it should not be socialized or subject to price controls per se... but they definitely need to be regulated closely. As we have seen already, big business and big money can never be trusted to regulate themselves.

Personally, I support the Affordable Health Care Act, but prefer a socialized health care system where 100% of services (or close to 100%) are covered for 100% of the population, and all paid for with taxes. Denmark, Sweden, France - all are great models for what we should have here.

I am a bit conflicted regarding a single-payer system, such as you are describing. Yes, these are systems that seem to be working fairly well in many other western countries. But the problem with a single payer, making medical and formulary decisions for everyone, is that it has the potential to stifle innovation. Where are most drugs developed/researched? Where are the greatest advancements in medicine discovered? Who is essentially subsidizing (indirectly) the healthcare of people around the world? Yes- the United States. And it's only possible thanks to the absence of price controls, tax breaks and a free market. No, drug companies are not saints... but it is a vital segment of the economy that actually improves quality (and quantity) of life for the public at large. Sadly the U.S. consumer ultimately ends up subsidizing the patient in France who enjoys 10 Euro top tier prescription drugs.