> laundry list of

That’s a meaningless statement, look for an actual percentage here.

Healthcare costs have been spiraling for decades in the US, the ACA didn’t impact the long term trends to a noticeable degree. Actual healthcare reform could drive down costs massively, but that would mean a fuck load of people in medical billing getting laid off. Instead you’re paying for your doctor to talk with your insurance provider often for longer than they spend working with you, that’s the ultimate issue with US healthcare costs. Inflation adjusted “healthcare” spending is up from 2,100$/person in 1970 to 14,570 in 2023.

https://www.healthsystemtracker.org/chart-collection/u-s-spe...

What did the ACA require that shouldn't be part of healthcare in one the wealthiest countries in the world?

Annual check ups? Cancer screenings? Maternity care? Basic mental health? Forcing the insurance companies to accept patients with preexisting conditions?

These services should be available to everyone.

If a developed country cannot provide these things to its citizens it's a failing state in my book.

You don't need it until you need it, and needing it often comes in the form of a lightning strike from blue sky. The counterargument is that having everyone pay a higher amount makes it feasible to actually have this coverage available, when needed, without bankrupting the insurance companies, because the rare astronomically expensive care is covered by the premiums paid by the vast majority of people who are relatively healthy and are unlikely to need it.

Now whether the on-paper prices for medical care in this country actually have any relationship to objective reality is an entirely separate question of course. In general coming from an outside perspective, combining healthcare and for-profit motives in a single system seems particularly likely to lead to all kinds of perverse incentives, but, it's the system that exists, and it seems unlikely to change any time soon.

That’s how insurance works. You pay for a plan you likely don’t need so everyone older than you is reasonably covered.

If young people elected to get a barebones plan while in good health, who would subsidize them when they grow older?

The main point of health insurance is to cover things that most people don't need. Prior to the ACA, most health plans had lifetime coverage limits which could leave patients with serious conditions financially ruined or unable to access care. The ACA removed those limits so naturally coverage is now more expensive.

Have you been on an ACA bronze plan? I wouldn’t consider it a Cadillac plan nor did I find it covering lots of unnecessary things.

This is factually incorrect and in fact the opposite of what a Cadillac plan means.

Obamacare plans are actually the opposite: they are high deductible with limited networks.

Obamacare plans typically have deductibles between $5,000 to $9,000, with a narrow selection of networks, and high premiums if unsubsidized.

This is the opposite of what a a Cadillac plan is (or used to be).

Which are the specific things you think most people don't need coverage for? Prior to the ACA, it was pretty common to hear stories of people not on employer plans who were shocked to discover a coverage gap they have. Most people don't have much expertise in evaluating healthcare coverage and deciding which services they might need.

> The end result is we all have Cadillac plans that most people don't need.

That's right, those pesky things the ACA says should be covered like emergency services, ambulances and prescription drugs is definitely the issue here. You've definitely found the problem.

I can't believe people keep repeating this lie. Did no one live prior to the ACA where you could easily go bankrupt because your insurance decided it didn't cover things like hospital bills? Because I sure as fuck remember, considering that's what bankrupted my parents.