Medicare is the only effective cost control medical system in the USA. Why? Because the government has contracted to pay medical costs at a rate that is exactly 6% above the average cost of any device or proceedure. As a result, what Medicare pays for my hospital bill is somewhere areound 10% of what a hospital would bill someonewho had no insurance. If someone has HMO insrance, the Hospital has probably contracted to bill about 15-20% above their actual costs. The only thing that this does not apply to is RX, which the pharmacutical companies have managed to get a law passed forbidding the government from negotiating RX costs. As a result, RX in this country costs 50% more than in any other developed nation. If this country had switched to a simgle payer universal health system, trillions would have been saved over a decade.
I am not just making this stuff up. My career was negotiating HMO provider contracts. The facts are also laid out in full in Time Magazine March 4 special edition, which was solely dedicated to this issue.
As I said. I'm no fan of the current system but I don't see where the ACA is going to be better.
The CBO says this thing is going to cost up the ass.
By law, a hospital must stabilize a patient with an emergency, regardless of whether he has insurance or not. This means that your taxes are already paying for the uninsured. The only thing that ACA is going to do is to shift the cost of this care from the taxes, to the private sector. There will be some increses in costs, because under the present law, a hospital is not required to give you a heart bypass or chemo treratment, since that is not "stabilization". however, in most cases, the uninsured manage to get this done under Medicaid, or other government programs. If all else fails, they simply write it off, and mark up the cost to your insurance comapny, instead, which simply passes it on to you. So, for the most part, all ACA is doing is "cost shifting", "not cost increasing".
I'm somewhat dubious of that happy theory.
As ACA forces the uninsured (mostly young kids) to buy insurance, it WILL be putting more money (in aggregate) into the overall HC coffers.
Now the question that I think TRULY matters is what will the HC establishment (HC insurance companies included) do with that NEW FOUND money?
Will they use it more effectively or will costs imply rise to absorb that new money?
Based on your employment you seem to have been more on board with ACA than I am.
So what cost containment measures do you feel will keep the system from inflating costs?
I don't see any, but like I say, I know that I am not up to snuff on the details of this law.
I'm hoping you can convince me that I am wrong, incidently, more than I can convince you that I am right.
I would be MUCH MUCH more convinced that ACA could do a better job if, for example, ACA did something to increase SUPPLY of HC.
But I do not see anything like that in ACA, do you?