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  • w.heinlein w.heinlein Nov 14, 2013 12:57 PM Flag

    The real problem with the ACA

    The focus on the website and its problems and the political embarrassment that it causes the President is all very amusing, but it distracts attention from the real health care problems that the ACA won't fix even when it is up and running smoothly as eventually it will be. I know I sound like a broken record, but a health care reform that doesn't address the insane medical care pricing system cannot ultimately succeed. The fundamental question that neither the proponents nor the critics of the ACA has asked is this: Why do doctors, hospitals and drugs cost so much more in the USA than elsewhere? Or, as I would prefer to put it, why is there no meaningful competition in the supply of medical services? The answer is as obvious as it is troubling: there's no meaningful competition because the providers (doctors, hospital corporations, insurance companies) all benefit from high prices and state and federal legislators help them keep those prices high. Examples are infinite. If you have a simple procedure done in a doctor's office insurance may not pay for it. Have the same procedure done in a surgery center or hospital and insurance will pay for it, even if it costs 10 times as much. A great deal of what the law mandates must be done by a doctor could just as easily be done by a well-trained para-professional at a fraction of the cost. To date, the only time that happens is when the doctors would rather not do something, such as take blood or administer routine injections. Successful doctors become millionaires; successful hospital corp. execs become billionaires. If the result was better health care, that would be OK. But when the providers get rich and patients get lousy care, it's not OK. And the ACA does nothing to solve that problem.

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    • I imagine that malpractice lawsuits have a lot to do with it. When a procedure is done in a hosptial there are going to be a half-dozen people involved, so it's difficult to get credible testimony against the group at a malpractice trial. If only one doctor is involved, it's going to be easier.

      Eventually Obamacare/ACA needs to clamp down on malpractice suits. Some better venue than civil courts need to be found because juries don't understand enough about medical issues to render fair verdicts. If doctors don't have to worry about lawsuits the prices will come down quite a bit.

      The other reason things cost more in the USA is because doctors and hospitals are private enterprises who charge all the market will bear. In other countries they are employees of government who work for civil servant's pay.

    • We figured all that out day one. We've known this was going to be a monumental failure.

    • The problem with ACA is that its website doesn't work. And it does not save the vast majority of us any money if we use it. It will destroy an alreasdy fragile economy by putting less back into the system and taking more our of our pockets.

      • 2 Replies to stellah121212
      • Think we're going to find that most sign-ups are subsidized and Obamacare will need more funding....that will take a vote and won't pass.....Tea Party was right all along!!!!!! Remember, Obamacare is a TAX!!!!

      • The website will work eventually. In the meantime, the states that created their own exchanges are doing a fine job of signing people up Some people save a great deal; others not so much; some pay more. It's an imperfect system. If it were up and running perfectly, would it be better than what it replaced? Yes, imho. Would it be a good system? No. Sooner or later we have to face the reality that the health care system in the United States operates for the benefit of the providers rather than the patients. As long as that is true, "reform" amounts to re-arranging the deck chairs on the Titanic.

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