Timelordwho wrote:
Obamacare makes fundamental marketplace changes that introduce clarity, which is generally pro-consumer.
How on earth do you think Obamacare introduces clarity to the market? It adds more layers of complexity and regulation without actually changing the underlying delivery mechanism (insurance). It makes things much less clear precisely because you have no freaking clue what you're actually paying for, and frankly, no control over what you're paying for either. That's very much anti-consumer. Pro-consumer would be allowing me to pay for just what I want. That's the opposite of what Obamacare does.
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The fact that less consumers will be tricked into badly designed plans with high premiums and low benefits is a net loss to many insurance companies, and despite the fact that people with bad policies did partially subsidize people with good policies (lowering costs for some) it is a net consumer benefit.
Except that the net effect has been to trick (actually force via purchasing mandates) more consumers into badly designed plans in which their premiums and deductibles have gone up, not just a little bit, but massively. And it then attempts to hide that fact behind subsidies which some favored businesses or consumers may or may not qualify for. How's that for clarity? And hey, it empowers the secretary of HHS to basically cherry pick who falls into the "favored" category after the fact, more or less on whim, and subject to whatever random social and political pressures happen to be in effect at the time.
Which is a terrible model by itself, but also suffers from being incredibly non-transparent and certainly not more "clear".
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It also removes the inefficient hospital administered subsidy of the poor by insurance policy holders, which disincentived insurance purchases, and enshrines a direct government subsidy to replace it. This expands the subscriber base of the insurance providers, so well managed insurance providers stand to benefit, while ones relying on on cash cow bad policies stand to lose greatly.
No. It just gets around the disincentives by legislatively forcing people to purchase the insurance. It didn't solve any problems at all. It just eliminated the choice to avoid them. Also, as I pointed out earlier; there's no such thing as a free lunch. Those subsidies are now paid via taxes. It's the same thing. So instead of subsidizing health insurance for the poor (uninsured) via higher premiums passed on from hospitals otherwise burdened with health care costs incurred by those who can't pay their bills, we just tax folks more to pay for it. Same ultimate result, except that instead of the hospital simply offsetting an increased cost to themselves by charging the paying customers a bit more, we have actual subsidies. So the hospitals have every incentive to charge full price for those services (cause they're no long having to pay it themselves).
Imagine that a store suffers with theft (as all stores do). They pass the cost of that theft on to their paying customers as just part of the cost of doing business. This is analogous to a hospital passing the cost of uninsured folks on to the insured. However, the paying customers aren't going to pay too much more, so the store will do what it can to reduce the cost of theft, and charge as little as possible to their customers. If someone like the government comes along and just hands gift certificates to the store to people who would otherwise steal stuff (No, I'm not comparing uninsured folks to thieves, it's just an analogy), what do you think will happen? The store will happily collect those certificates, right? But here's the thing. They'll also raise their prices since now they're being paid the cost of the goods via the government subsidy. Before, they were losing money on those goods walking out the door and had to balance that with the paying customers. They had to always deal with the fact that if they raise prices too much, more people will just steal stuff rather than paying for it (ok, the analogy isn't perfect at this point, but hopefully you get how this works in terms of costs of insurance). Now, the government will pay the cost for any who can't afford it. So whether that percentage is high or low no longer affects them from a business perspective.
By doing this kind of subsidy, you massively increased the amount of wasteful expenses that will be charged. Because... why not?
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It's fairly unsurprising that an insurance provider that already has high market penetration would suffer, as they benefit less from the additional exposure provided by more customers and probably have a reasonable percentage of accounts with badly structured policies which are endangered by the reduced competitive barriers.
It's not about whether or how the insurance provider (or health care provider) will suffer, but which solution incurs a greater cost to the paying customers. I'd argue (have been arguing) that Obamacare causes costs to increase. I'd even further argue that this is the actual point of the system. The higher the costs go, the more people wont be able to afford to pay it, and the more people will shift from the "paying for their own health insurance" and into the "relying on government subsidies for their health insurance" category. Which, if you are a big government advocate looking to move the country from privately funded health care to publicly funded, is precisely what you want to have happen.
It's not more expensive by accident, but
by design. What's shocking is how many people either can't, or wont, see this. Is it that they really think Obamacare will lower prices, or that they know it'll raise prices, but agree with the end goal so strongly that they're basically willing to lie to defend it? That's the part that bugs me the most really. It's clear that many people want single payer as their goal, but pretend that Obamacare isn't designed to break the existing model so badly that it'll make it easier to get there. Which seems inherently dishonest to me. I still come back to the idea that if you have to lie to people to get them to do what you want, maybe what you want isn't such a great idea in the first place?
Edited, Dec 8th 2015 2:29pm by gbaji 
