Taking away the ability for people to vote with their premium dollars to punish bad service and reward good service has been an utter failure. All the posturing and yelling about people who have lost their coverage because they lost their jobs fails to point out it was Congress that artificially brought it about. And this attempt to force everyone into the pool by making it mandatory only reinforces what a bad thing it was.
You want to believe that Geico writing policies in San Francisco and Corn Husk BFE isn't the same, fine. But it doesn't change the inconvenient fact that we had a long history of decent care with routine care that was affordable for most people and didn't force them to use the ER for simple care. It did work and the spiraling out of control of expense didn't exist until they decided to muck with it.
Did people who couldn't afford expensive care suffer relatively speaking, from the affluent in certain cases? Yes, but nothing like we see now. My Dad was a Controller at a medium size hospital that had been around for 80 years. He took the job in the early 70's and watched it close despite always running at near capacity in the late eighties.
Health insurance is the same as other insurance. From my Dads point of view they cratered simply because the old model of limited capacity based on likely need got blown up by the artificial limits and increased administration of the managed care model.
It was like forcing the corner Jiffy Lube to suddenly have tire mounting and rebuilding transmissions because unlike individual policies that would pay a certain amount if you went to any licensed provider, out of network meant they wanted to penalize the patient because none of the healthy premiums went into their coffers.
The managed care theory that was supposed take the expenses of new tech and treatment fails because it made every group duplicate capacity and liability exposure resulted in needing to have little used equipment on hand or pay the much higher premiums. There are parts of the country with no obstetricians, not because of too few babies to catch for the MD to make a living but because there is no way under the current structure of liability and the artificial carving out of groups makes it a loser.
We shouldn't be discussing people dying because they don't have coverage. We shouldn't be looking at a shortage of MDs, let alone GPs, right before the biggest lump of geezers is poised to slide down feeble-hood. This is the worst way to fix the problem.
All of a sudden Pops hospital needed to have an assload of equipment and hire additional administrative help because it was no longer about x number of people they needed to serve. Even though there was enough need for the hospital my Dad was head bean counter for and the similar scope facility 40 miles the other way under the fee for service individual perspective, simply because the area's largest employer's parent company had an agreement with the corporation that owned the other hospital. While it wasn't the only reason, it did contribute to to his facility closing and a bunch of people had to go a long distance and wait longer for treatment.
There is little in these proposals that make the cost of medical schools less, it maintains the need for huge duplications and inefficiencies and shoves more vital services into the area of "Third rail". Social Security reform has been shoved off into a corner despite the acknowledged need by everyone. Even worse, during the same period, FICA was dumped into the general fund and spent.
Exactly how does that run through any lumpy, wrinkled, micro, macro or telescopic model of economics fit and, with expanding coverage by 30 million with no more caregivers and no plan to do anything about it?
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