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Comment by koolba | Hacker News Reader

For the small minority that get fully subsidized plans of course it’s great. Free stuff is always great for the receiver.

But that’s only 5M people. For everybody else it just made healthcare more expensive.

Nothing, absolutely nothing, in the ACA brought down costs. And hiding it behind ever increasing subsidies eventually comes to a breaking point.

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Bringing down costs while expanding the number of people getting healthcare was never in the cards unless someone had a magic machine to mint thousands of new doctors and not have to pay for patented medicine. Not to mention enormous tort reform.

However, the increase in costs did slow after ACA:

https://cepr.net/publications/health-care-cost-growth-slowed...

> … unless someone had a magic machine to mint thousands of new doctors.

That exists. Just buy them from overseas.

Grant special visas to doctors who commit to working at clinics for X years. Pay them some guaranteed wage that’s higher than they make in their homeland and they’ll take the deal.

That would increase the supply of providers, which shifts costs down due to basic economics.

Sure it’s not “fair” to the rest of the world, but that’s not our problem to solve. Too bad the AMA hates this idea.

>Grant special visas to doctors who commit to working at clinics for X years. Pay them some guaranteed wage that’s higher than they make in their homeland and they’ll take the deal.

Do those folks get bodyguards to keep the ICE thugs from disappearing them? If not, I'd expect they wouldn't come here for any price. Just sayin'.

That’s a ridiculous interpretation of the regime change in the graph (which is much better interpreted as raising costs to adapt to profit caps).

Which was another stupid part of the ACA. Capping profits at 12% of the gross just means the only way to increase profits is to increase your costs. It directly incentivizes raising prices!

> Nothing, absolutely nothing, in the ACA brought down costs.

How it possible to calculate this theory when you don't have a control group? Said differently, if everyone is subject to ACA you can't compare it to a group of people that aren't subject to ACA. Also, insurance premiums are a direct result of how many people are in the pool.

If the control group was "just use the previous year before ACA" then there was absolutely scenarios where people got cheaper healthcare after ACA even without the subsidies. Like real estate markets, insurance markets aren't national, they're local.

FWIW - I'm neither advocating nor opposing the implementation of ACA, just stating it's not easy to conclude "healthcare costs more/less now".

What about those who had pre-existing conditions who were able to get insurance? Doesn't that bring cost down for them?

High risk pools existed before the ACA.

High risk pools existed in 35 states, and almost universally refused to cover preexisting conditions for about the first year.

So?

This isn't an argument, you're just stating a fact and didn't offer up an opinion

> Nothing, absolutely nothing, in the ACA brought down costs

Source for that claim?

It’s basic economics, supply and demand. To lower prices you need to either increase supply or decrease demand. The reverse shifts the curves the other way and costs go up.

The ACA did nothing to increase supply. There were no new doctors or clinics.

And the subsidies and mandates to purchase insurance increase demand for medical care.

So it causes prices to rise.

So, no source!

Given that the ACA forced insurance companies to sell insurance to people they previously found unprofitable to sell insurance to, basic economics suggests that the ACA probably raised the cost of insurance. That's not to say it makes it a bad thing. I would actually argue the opposite.

Also the ACA requires insurance companies to make a max gross margin of 20%. This looks like a cost saving measure at first glance, but it's actually the opposite. Now insurance profits are actually increased by an increase in medical costs, and therefore the insurance companies are disincentivized to control costs.

So, no source?

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