Obamacare: the good, the bad, the unpredictable & the dangerously unknown
This is from a more left wing perspective--the people who want single payer--but the arguments are the same. Basically Obamacare is going to be outrageously expensive, inflationary, and useless for most of the people it was supposed to help. Further, for those people who already had insurance through their employer, some of these run the risk of actually losing their employer-based insurance (as companies cut back and realize that the individual mandate lets them off the hook). This was an absolutely horrific piece of legislation.
...While the mandate may be “constitutional,” it is terrible health policy. Briefly, the main problems include:
The coverage under the ACA is so skimpy, with so much cost-sharing, it won’t prevent medical bankruptcy. It’s really “underinsurance.” The coverage is unaffordable. In Massachusetts, where a mandate plan has been in effect since 2006, the cheapest policy for a 55-year-old is $5,000 and carries a $2,000 deductible. It costs $7,000 before even a penny of coverage kicks in. The burden of the mandate falls on working and middle-income families, who make too much for Medicaid but too little to afford private coverage, even with the tax subsidies. It enriches the private insurance industry with $447 billion in taxpayer subsidies. It maintains the administrative complexity of the current system with over $400 billion squandered on administrative waste The vast majority of the uninsured are in working families. Hence, they are already paying taxes to support Medicare (which pays for medical training and other necessary health infrastructure), Medicaid, and other health programs. It doesn’t lead to anything even close to universal coverage. ACA leaves at least 26 million uninsured.
MarciaAngell, MD - Obamacare is simply incapable of doing what it is supposed to do -- provide nearly universal care at an affordable and sustainable cost. The problem is that three years ago, in his futile efforts to win over Republicans (remember the embarrassing courtship of Olympia Snowe?), Obama gutted the law before it was even passed. He made the private insurance companies the linchpin of the new system, and promised them millions of additional customers and billions of taxpayer dollars. He also did nothing to rein in the profit-oriented delivery system that rewards providers on a piecework basis for doing tests and procedures. So with all the new dollars flowing into the system and no restraints on the way medicine is practiced, the law is inherently inflationary.
Although there are some provisions to curb the worst abuses of the insurance companies, such as excluding people with preexisting conditions, there is nothing in the law that would stop insurers from raising premiums. A senior executive of the industry's trade association, America's Health Insurance Plans, told me privately that that's exactly what the companies will do if regulations cut into their profits. Thus, costs under Obamacare will almost certainly rise even faster than at present. No reform can work well or very long if its costs are unsustainable…
Many of the uninsured who are subject to the mandate to purchase private insurance will choose to pay the penalty/tax instead. That will lead the insurance companies to raise their premiums, demand that the penalties be greater, or both. Deductibles and co-payments will increase to the point that many people will have insurance they can't afford to use. (This is the case in Massachusetts.) ….