Quote:You still didn't address my main point: that the US does not have the best health care system in the world. 

 

When you speak of "best" there are parts of the system that are clearly the best in the world while others need improvement. Total cost is definitely an issue, as much of the discussion in this thread shows. I don't disagree at all, American healthcare financing is too complex and has too many players. When it comes to actual care though, we break it down into two distinct categories: Acute and Preventative. Studies from every political perspective agree that, if you suffer an acute episode, the best place in the world for access, diagnostics, and treatment of your condition is the USA. Preventative care is an entirely different animal though, and the US lags significantly behind other countries. Several reasons for that  include the size and mix of our population, the land mass of our country, the baseline health of our population, cost for services and relative lack education of the population about prevention in health.


 

The last one is something that physicians can impact the most and the most quickly. Last year the ACA mandated that preventive services be free of out of pocket costs for patients and included in all new insurance plans. Do you know how much our compliance rate for simple annual physicals improved? 6%. Basically 37 out of every 100 patients thought a physical was important enough to make time for EVEN when it was "free." In the land of the Hoveround where Type 2 Diabetes in king we can't get folks to take an hour out of the day once a year to check on their health. We're currently building a program to encourage our patients to use those benefits, but it's going to be a long process to change the mindset of the population, and we certainly have huge incentive to do so. That compliance rate for preventive services is measured and evaluated by the federal government to determine whether or not our reimbursement should be reduced in aggregate. That's right, physician's pay is reduced based on whether or not the patient panel will come in for their preventive services. The incentives are there, now we have to change their behavior. Hopefully we'll see that change in the near future and the US will close that quality gap in the preventives, because cost isn't an issue there anymore.


 

 

I think your "sabotage" theory is way off base, and is dead wrong.  The ACA is an attempt to regulate an industry with runaway costs that every single American relies on for their lives.

 

Perhaps there is more sensible legislation, but at least the ACA is an attempt to address a very real problem:  the elimination of the American middle class due to catastrophic health care costs.  As for "free market", what could be more "free market" than listing all possible choices and letting the public decide - like the ACA is doing with their exchanges.

 

The government hasn't taken over the industry any more than the NHTSA has taken over the auto industry.  They've set reasonable standards and regulations - like eliminating the $5000 deductible garbage plans you so eloquently decried a few pages back. 

 

Actually, the cheapest plans offered under the ACA (bronze plans) average about $300 per month and have a $5,000 deductible. I guess they didn't eliminate those plans after all! And don't forget that those premiums will average 20% more for 2015, what a great deal! Source: http://www.healthpocket.com/individual-h...Fd7KjTF-So


 

As for whether or not the government is taking over healthcare, here's what the ACA looks like from a functional perspective. Way too many government segments, way too much complexity to pay for a service, and it can (and will!) only get worse from here.


 



 

If rising health care costs didn't threaten to ruin our country, this legislation would be unnecessary.  But they are, and it finally reached a point where our politicians couldn't just sweep them under the rug anymore.  One party is still trying, which is a shame, because the ACA is their idea - Massachussett's system writ large.  So tweak it, because the public knows that if it's repealed, it will not be replaced with a better idea.

 

After the first year full year these are some of the results:


1. People who liked their insurance plans lost them because the law said the insurance company  could no longer offer it.


2. People who liked their doctor had to switch to someone else because of their new insurance plan, or it will cost them more OOP to keep him.


3. Many, many, many people will pay in excess of 15% more for their premiums in 2015


4. Many of these patients were pushed to Medicaid instead of a commercial plan. Medicaid care is of significantly lower quality which puts these patients at risk.s 


5. The young and healthy, who are needed to keep the actuary table balanced, are choosing to pay the tax fine rather than pay for insurance. And according to the site at the link,  the CBO recently came out and said that 90% of the 30 million Americans who didn't buy it won't have to pay the penalty in 2016, so that, coupled with the removal of pre-existing condition rules, means that this particular cohort can wait to see if they get sick to buy a policy. All those premium dollars needed to keep the ACA afloat aren't going to come in. Lots of info here: http://obamacarefacts.com/obamacare-individual-mandate/


6. The implementation of healthcare.gov was a fiasco that cost us over 2 billion dollars. A web portal cost 2 BILLION dollars and it didn't work. That's certainly not bending the cost curve in any meaningful way.


 

The ACA is legislation that took us the wrong way. It gives the government more say, more power, more control; all things that make the industry worse off, not better.