FIFY - ACA might have functioned in that manner but it was breaking down as insurers dropped out of marketplaces and consumers were getting fewer and fewer choices with increasing costs.∞∞∞ wrote:As a society, we need to determine what we actually want from health insurance.The ACA is primarily designed to be a safety net from catastrophic events, items that were bankrupting (and killing) people when that didn't have to be the case. The cost structures aren't really designed for typical doctor visits, and I think that's why people are annoyed - they're paying more for the most common health care items.
On the flip side, individual insurance plans before the ACA lowered co-pays for doctor visits, but screwed a lot of people when a catastrophic event occurred and they exceeded their cap limit. Lives were being lost and entire families could potentially face financial ruin.
So that brings me back to the original statement: what do we actually want from insurance? In its purest form, insurance is supposed to protect you from a worst-case scenario. In that way, the ACA originally functioned as intended. But obviously Americans expect insurance to help them with day-to-day costs as well. So how do we do that? Is it an overhauled ACA? Is it private insurance with more oversight? Is it single-payer? Or is it a hybrid of public and private insurance?
I wonder why a hybrid model won't work. Make a basic single payer system available to all. Cover basic preventative care (physicals, screenings, etc.) and catastrophic care. Consumers would need to be smarter in how they used healthcare to help manage their out-of-pocket costs. Better care would be available for purchase or through employer plans. You would still end up with haves and have-nots (highly competitive industries with higher pay would be the ones most likely to offer additional health insurance while industries with lower pay such as retail and food service wouldn't offer insurance to their hourly employees) but the have-nots would have something to help discover catastrophic illnesses earlier and to help take care of them when they occurred. Everyone can't have a Cadillac health plan.










