thegreekdog wrote: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.
I wasn't arguing that they were. I don't know why you're hung up on this point. I said that this particular facet of the health insurance industry was not regulated. I then went on to explicitly state that the health insurance industry is not, in general, a free market system. So, drop it.
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 issue of health care costs is indeed important but it doesn't actually address the issue of the uninsured, except perhaps tangentially. We do
live in a society where a substantial portion of the population cannot afford or is refused access to insurance. Ensuring that they get insurance does not have to be mutually exclusive with decreasing healthcare costs overall. Calling this a criticism
of the ACA is a red herring that distracts from the main issue rather than coming up with ways to solve it.
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.
I agree, and basically everyone looking at the problem agrees. For the short term, government subsidies are what are needed to make sure that most people are insured. The ACA is surely a bandage and not a full scale surgical operation, but that doesn't make it a bad idea. Furthermore, it's not clear whether it's government action that will ultimately be able to lower healthcare costs, is it?
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.
I do not know why you suggest this. Perhaps the most important justification for the law during its formative stages was the raw number of uninsured Americans, and it has been made clear (e.g., analysis by the CBO) that the ACA is expected to insure about 30 million people over the next several years, which (besides being a rather large number) is the majority of the uninsured. 50 million uninsured is very clearly a "wide swath" of the population. It's possible that there are some supporters that do not know of this analysis, but that does say anything about the value of the legislation.
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.
There are strict regulations on the plan pricing on the health insurance exchanges. Furthermore, the establishment of the tier system for health care plans is argued (by some) to possibly decreases prices. Even if they can't do that, at least the prices are very well managed by the government. Furthermore, the health insurance exchanges generally result in better competition, and I would expect a fiscal conservative to approve of this.
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.
Yes, and here again Republicans in Congress precluded the much more radical possibilities that could have truly overhauled the healthcare system. They're obviously not completely to blame, but they did a pretty good job of throwing a wrench in the works.