ryan said, "it wouldn't be tuesday if you weren't freaking out about health care."
it's not tuesday, but let's talk about it anyway.
certainly, patients may be insulted from seeing cost and subjected to excessive medical procedures, but this has not resulted from the luxury of a low deductible or co-payment. in this litigious age, doctors themselves have been insulted from the cost of medicine. they have no idea how much their recommendations, prescriptions, and orders cost. therefore, they have no way to know or incentive to prescribe more cost-effective evaluation and treatment.
here's another essay i dig: "a simpler, better solution."
usually i don't care much the room for debate forums. these two doctors (david himmelstein and steffie woolhandler) write an opinion that simple, succinct, and scary. they first simply argue that a single-payer health care system is more simple and efficient. done. then they note several disturbing problems with the affordable care act, which has a lot to do with how complicated the act is. first, this:
"If your income is below $31,321 for a family of four (133 percent of the poverty line), you will get Medicaid (unless you live in a red state that declined the federal assistance, like Texas or Alabama). And “Medicaid” nowadays means a privately run Medicaid H.M.O. But make one dollar more (or if Junior moves out, leaving a family of three) and Medicaid disappears; now you’re shopping for subsidized private insurance in the state-run exchange. That’s not a rare occurrence: 28 million adults cross the 133 percent line annually."
then they note that if you, "[m]ove from 400 percent of poverty to 401 percent, and individual premiums rise $2,303. Can’t quit smoking? Add $3,365."
the rules and exceptions are labyrinthine. flatly: the affordable care act is far from comprehensive and does little to make health care affordable to average americans.
mandating that all americans pick up health care is pointless if basic health care is still unaffordable. we can't argue for preventative medicine, medicine that deals with mole hills before they become mountains, then keep access to that out of reach while patting ourselves on the back for insuring the nation.
i had hoped the affordable care act could be obama's greatest legacy, and he has definitely been a fantastic president, but i think this may just be one of america's greatest disappointments.