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'A full-blown crisis': Americans brace for a surge in healthcare costs

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Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#241

Post by Jensson »

Jordan-117 wrote: post #201
dogemaster2028 wrote: post #43

Earlier quoted context omitted.

Obamacare failed at reducing costs. It mostly focused on insurance expansion and in consumer protections, not on dealing with hospital, drug, and provider pricing structures that actually drive the spending in the US healthcare system.

The ACA had its most effective cost-control mechanisms stripped by its political opponents. Sen. Lieberman (a turncoat Dem who had campaigned for John McCain) forced the removal of the public option, which would have helped hold prices down through competition. The Supreme Court struck the requirement for states to participate in Medicaid expansion, which limited the benefits for millions in a swath of conservative s…

> The ACA had its most effective cost-control mechanisms stripped by its political opponents.

Because of lobbyism, healthcare sector is extremely strong politically and don't want to reduce their income, Democrats aren't immune to that they have mostly been just as pro corporate as the republicans are they just are pro different corporates.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#242

Post by johnnienaked »

stephen_g wrote: post #236
johnnienaked wrote: post #233

Earlier quoted context omitted.

That's obviously a false dichotomy. Almsot no one is paying $4k/mo for insurance premiums.

And nobody is paying $2K a month for healthcare taxes either!

When I lived in Canada I paid about $4k a month in taxes, the majority of which went to health care

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#243

Post by johnnienaked »

ryandrake wrote: post #237
stephen_g wrote: post #236

Earlier quoted context omitted.

And nobody is paying $2K a month for healthcare taxes either!

One again, HN rat-holes on a detail rather than the overall message. Replace what I wrote with "Some people would rather pay $2X/mo to an insurance company than $X/mo in taxes." Jeez!

It just doesn't have the same rhetorical effect when you make it even, does it?

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#244

Post by mulderc »

pxmpxm wrote: post #29
mulderc wrote: post #19

Earlier quoted context omitted.

Have you been on an ACA bronze plan? I wouldn’t consider it a Cadillac plan nor did I find it covering lots of unnecessary things.

Bronze plan is shitty catastrophic insurance at like 5x the actuarial cost to try to fund risk pool and all the mandated benefits thst the o/p alluded to

I have been on both a Bronze plan and Catastrophic insurance. They are not the same at all.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#245

Post by dogemaster2028 »

JumpCrisscross wrote: post #167
dogemaster2028 wrote: post #161

Earlier quoted context omitted.

It’s good that they choose to do that themselves. In fact, the US allows you to SEND THE GOVERNMENT A GIFT at https://www.pay.gov/public/search/global?formSearchCategory=... (You can even Venmo) If you want to do it, do it for real, instead of just being performative. But don’t try to force everyone to follow your performative pseudo gift.

> the US allows you to SEND THE GOVERNMENT A GIFT How is this relevant? Cutting the deficit doesn’t solve the problem. And the folks who created this mess just blew out the deficit by trillions.

It’s relevant because while the comment says that “they’re okay giving up buying first-class tickets” what they really imply is that they want everyone to give up buying first class tickets.

If they want to constrain their own choices to help a nameless “someone,” they can literally do that themselves without involving the taxpayer at large. Just send the check to HHS or to a specific charity or individual.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#246

Post by dogemaster2028 »

Jordan-117 wrote: post #201
dogemaster2028 wrote: post #43

Earlier quoted context omitted.

Obamacare failed at reducing costs. It mostly focused on insurance expansion and in consumer protections, not on dealing with hospital, drug, and provider pricing structures that actually drive the spending in the US healthcare system.

The ACA had its most effective cost-control mechanisms stripped by its political opponents. Sen. Lieberman (a turncoat Dem who had campaigned for John McCain) forced the removal of the public option, which would have helped hold prices down through competition. The Supreme Court struck the requirement for states to participate in Medicaid expansion, which limited the benefits for millions in a swath of conservative s…

The Supreme Court is not “a political opponent.” It’s literally the way the country works. It found the requirements for states to participate to be unconstitutional. In fact, it was also SCOTUS who eventually determined in 2012 that the individual mandate penalty was functioning as a tax for constitutional purposes. This was the basis for upholding the law. The mandate itself was not upheld under the Commerce Clause but survived because the financial penalty was deemed a tax.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#247

Post by loeg »

BrenBarn wrote: post #90
nradov wrote: post #34

Earlier quoted context omitted.

I support subsidies to help low-income citizens who legitimately can't afford health insurance, but some of the temporary ACA subsidies passed in 2021 were ridiculous. They were handing out cash to early retirees as young as age 55 with incomes over 400% of the poverty line. https://www.cnbc.com/2025/10/17/aca-enhanced-subsidy-lapse-g... I don't want my tax dollars wasted on subsidizing them. Give the money to someon…

If we start to think about who "actually needs" things, we need to question whether any of the very wealthy "actually need" their wealth. I would be fine with seizing all of anyone's income (including unrealized capital gains) in excess of, say, $20 million just to give everyone else some cute stickers and lollipops. The giant flow of wealth to those at the top is a far greater misallocation than any amount towards t…

It's fine to hold fringe viewpoints, but it's on the <20% side of an 80-20 (or less favorable) issue electorally. It isn't happening.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#248

Post by loeg »

_DeadFred_ wrote: post #238
nradov wrote: post #221

Earlier quoted context omitted.

That ignores competitive pressures. Commercial health plans aggressively negotiate rates with their network providers in order to get market share with cost sensitive customers. If your claim was accurate then insurers would just take whatever rates that providers set but the reality is that doesn't happen. Health plans routinely drop more expensive providers from their networks.

Rental companies have incentives to get market share with cost sensitive customers too. They would totally never have a system (or use colluding software) where everyones rates just go up. Fun fact, people in fact can't just 'do without' for housing/medical care, so can't act in a manner that keeps the market in check. Therefor neither of those two segments can be treated as actual markets, or expect the typical bene…

> Rental companies have incentives to get market share with cost sensitive customers too. They would totally never have a system (or use colluding software) where everyones rates just go up.

If you're talking about RealPage, the actual effect it had was putting more units on the market and lowering rents, not raising them.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#249

Post by dogemaster2028 »

ethbr1 wrote: post #228
Jordan-117 wrote: post #201

Earlier quoted context omitted.

The ACA had its most effective cost-control mechanisms stripped by its political opponents. Sen. Lieberman (a turncoat Dem who had campaigned for John McCain) forced the removal of the public option, which would have helped hold prices down through competition. The Supreme Court struck the requirement for states to participate in Medicaid expansion, which limited the benefits for millions in a swath of conservative s…

It's also important to keep in mind that reforming the US healthcare + insurance system was always going to be an evolutionary, multi-stage process, because of its complexity. You shouldn't change all the parts in an engine to different specifications at the same time. The ACA therefore blended structural improvements (insurer admin cost caps, standardized benefits, no prior condition exclusions, guaranteed access, e…

In a constitutional republic like the US, it’s simply too risky to execute major improvements in a big bang fashion. It’s not that different from engaging in a multi-decade software migration project. Sometimes, small changes is really the only path forward.

Part of the reason why Obama, initially a unifying force, eventually became known as a Divider In Chief (in addition to some racial commentary around police work) was that the bold changes of Obamacare left too many victims behind who ended up worse off.

You have to start with the principles of the country and work with them in mind, if you expect to be successful. You also have to assume future change will be dependent on the political winds of the future.

There is likely a lesson somewhere here about introducing “lean healthcare” style of changes instead of “big bang,” but I haven’t taken the time to articulate them.

Maybe starting with principles and making yearly changes that can easily be undone or redone by future administrations is the only path forward.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#250

Post by protocolture »

nradov wrote: post #118
protocolture wrote: post #108

I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing look…

There is no US healthcare "system" in the sense of having a cohesive entity pursuing a unified goal. It's a bunch of separate entities each pursuing their own goals, often in conflict with each other. If we were designing a healthcare system from scratch it obviously wouldn't look anything like what we have today. But we arrived here through a process that economists call "path dependence", and this makes it stubborn…

Thus the quotes, but thanks for the link about path dependance, thats a concept I have been aware of but unable to name for a long time. Lucky 10000.
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