I think it's amazing how everyone agrees America is broken, but disagree on every other possible detail.
What If I said it was perfect as is? Would I get lynched?
If, hypothetically, the only people who ever needed healthcare were the ones who already have insurance, and healthcare costs suddenly stopped rising in the near future, then taking into account the generally high quality of American healthcare and the lack of other downsides (eg. waiting times), then yes, it might be perfect. However, the thing is that the people with insurance who don't have to directly bear the costs indirectly increase the costs for those who do, making the system increasingly unstable. The US healthcare system is sufficiently socialized in important aspects that it's not a great example of "free market healthcare" in action, and it's sufficiently not-socialized that it's not a great example of "socialized healthcare" in action. It's a bit like the Frankenstein's monster of healthcare systems. In the 1940s and 1950s, when it began to become fashionable to nationalize things like healthcare, Americans were swinging decidedly against direct interventionism as a result of WW2 rationing, etc and thus Truman failed to get it passed. Also, the AMA was decidedly against universal healthcare, ironically despite the fact that nearly all of their influence came from laws passed in the early 20th century. So instead regulations, controls, programs, and incentives were latched onto the system's back until it became such a damn mess that no one could recognize it anymore.
Now, because pretty much no one likes the US system as it stands, it gets attacked for a variety of different reasons and the solutions tend to be completely different, though it also gets defended for entirely different reasons too. For example, one argument in favour of the present US system is that it basically pays for the rest of the world's cheap pharmaceuticals; the companies basically sell drugs to other countries at a loss because the US pays extortionate prices for mildly improved drugs, so if the US dropped the system the rest of the world would have to shoulder vastly increased prices. In general, though, defenders of the US system tend towards "it's better in a lot of ways and it's closer to the ideal system than others", whereas attackers have systems that they actually think ARE the ideal.
It's a wonder how Americans can look at their system, in which insurance has been basically transformed from traditional "insurance" into a messy ol' third party payment system that puts a wall between the consumer and the costs of their healthcare, and say "You know what we need to do? Take our garbage third party payment systems and make them mandatory for everyone! Yeah, that will definitely solve our problems!".
With one option comes reliability. There's no "Man, I hope my insurance covers this."
There are other problems that I'm sure you're aware and very critical of, but this isn't one of them.
But it doesn't change the
incentives, which are one of the biggest problems. If there's a drug that increases my survival rate for a problem by, say, 0.5%, I'm far more likely to buy it for $5000 if someone else is paying for it instead of me. In turn, this passes off the costs of a few people with expensive drugs onto every other person, regardless of how big the "pool" is. In the present system, that means that people getting lots of payouts from insurance companies (that aren't "insuring" anything), are driving up either rejections or costs in the form of payouts. This problem is the same under the ACA, except the costs are more spread out but more people are roped into the system (eg. people without insurance who aren't using it at all). In a universalized system, this is either changed by restricting access to certain drugs altogether, by adding waiting lists, etc etc but the problem is still there regardless.
The obvious (immediate) solution here would be to try to remove the incentives for third party payment in the first place, but apparently that's not possible for some reason.
Y'have to wonder what'll happen when health care costs just become so exorbitantly high that Obamacare has to be replaced...
"Our damn free market system isn't working! We need to add more half-assed controls that will cut costs and rescue the system!"
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Topic: American Politics Omnibus Megathread of DOOM (Read 71708 times)