Metsfanmax wrote:I know because before the ACA, there was essentially no regulation preventing insurance companies from excluding individuals from coverage, and insurance companies did in fact exclude millions from coverage. The free market approach to this problem was the status quo before the ACA. Sure, there were plenty of other regulations on the industry, such as requiring them to retain enough money to actually pay out on claims, but this was the main one that the ACA was aiming to rectify.
There is no way that you can demonstrate to me that, prior to the Affordable Care Act, health care and health insurance were part of a free market system. You've identified a problem with health insurance: the exclusion of individuals from coverage. Two thoughts come to mind. First, and less important, health insurance providers are rarely engaged in fair competition. Second, and more important, why do people need health insurance in the first place? Healthcare is expensive, but why is healthcare so expensive? Why is it more expensive now than it was one hundred years ago? One of the least talked about, but most imporant, criticisms of the Affordable Care Act is that it does not solve the problem of healthcare costs and the reason for rising healthcare costs.
The easiest solution in the short term, politically and otherwise, to the problem of making sure people with preexisting conditions can get healthcare is to make sure they get affordable health insurance, which is ostensibly what the Affordable Care Act does (I'm not sure it makes healthcare affordable, so it may not do that). In my mind, the more effective solution, although much more difficult in the short term, is reduce the cost of healthcare itself.
Metsfanmax wrote:Health insurance is suboptimal for both sides, obviously. From a socialist point of view, insurance doesn't get at the root problem of why our health care system is inefficient and serves to exclude the poor. From a conservative point of view, we are now putting extreme regulation on the side of an industry that was previously unregulated. But that's the nature of political compromise. For me, the main point is that more people now have access to basic medical care. That has always been my stake in Obamacare. I'm really ok with accepting a suboptimal solution to this problem on economic terms if the alternative is no solution.
How many more people have access to basic medical care that did not have access to basic medical care prior to the passage of the Affordable Care Act? How much more, incrementally, will the Affordable Care Act cost? These are the two questions that must be asked that people who support and don't support the Affordable Care Act do not ask.
Here are the people that were uninsured prior to the passage of the Affordable Care Act:
- Illegal immigrants (8 million)
- Citizens not enrolled in Medicaid despite being eligible
- Citizens opting not to be insured (mostly young people)
- Citizens who live in states that opt out of Medicaid expansion
These are hardly wide swaths of people, with the exception of illegal immigrants and young people. So, in my opinion, you're accepting that a number of people, those indicated above, will now be insured and that is your reason for supporting the Affordable Care Act.
In supporting the Affordable Care Act, you are also now supporting government (read tax dollar) support of others' purchase of health insurance who could previously afford health insurance but will now choose, or be forced to choose by their employers, to purchase health insurance through exchanges where the price is not regulated. To me, this is worse than status quo, especially when a small fix to status quo, for example making Medicaid available to all of those listed above, would have cost less money. As a final word, the Affordable Care Act is very similar to health care fixes put forward by Republicans during the Clinton administration, which begs the question as whether this is an effective solution to an existing problem or an ineffective corporate boondoggle to insurance companies.
