With the ACA, Obama gave the drug companies a completely free ride as a political gesture so that they wouldn’t run those Harry and Louise ads. And he mostly gave HC providers a free pass too. The ACA was 95% about health insurance. Arguably the insurance was the least problem of the three.
A friend of mine shared her personal story, which dramatically illustrates just how big the problems are in the areas ACA never tried to address. She had kidney failure brought about by chemotherapy. She was on dialysis for years waiting for a transplant. Her insurance was billed about $60,000 per month or about $4000 per dialysis session.
There came a time when she had to travel overseas for business. She would be visiting three countries and staying long enough that she would require dialysis in each country. Her insurance did not extend beyond the USA, so she had to make arrangements to pay for the treatments out of pocket.
Those treatments cost her between $250 and $400 per session, which I would argue is the TRUE COST of the service when you don’t pile layer upon layer of overhead and profit-taking. Those treatments were not subsidized by the local governments as far as she knew. Her opinion was that the services were the same quality that she received in the USA.
The cost in the USA was about ten times what she paid out of pocket in other countries.
There was a time only a few decades ago where virtually all hospitals and health insurance plans in the USA were not-for-profit. My how things have changed. And that was a time when America was at its zenith with a strong, healthy, growing, and increasingly inclusive middle class. If we want to “make America great again”, maybe we should go back to the things that worked before.
But that is not what Trump, Ryan, and Price want to put over on us. Their plan is to effectively end Medicare, Medicaid, and the ACA by turning all of those into coupon programs. Rather than the Federal government being the insurer of last resort, so to speak, these fine gentlemen want to remove all responsibility and dump it back on the individual even though the individual has absolutely no control over the system costs.
We know how these coupon programs work. It will be, “Here’s a coupon for $1000. You go buy your own insurance — or not, we just don’t care either way. And if the insurance actually costs $10,000, well you should be happy we gave you that $1000 coupon because next year, it will be only $800.”
Block-granting Medicaid is exactly the same thing, except that the coupon goes to the states. The US says “Here’s $50,000,000 in a block grant coupon. Now you own Medicaid. If it costs you $100,000,000 to provide the care, well, that’s your problem. And next year it will be $40,000,000, so get used to it.”
