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Great explanation, Dr. Goodman.
What is the time line for this to surface? 1 year? 10 years?
It depends on what milestones you are looking for and how fast people react. I think it’ll come faster than anybody ever thought, but that may not mean collapse, it could just mean explosion of the national debt at unprecedented rates.
Obama’s nose should have been growing by each statement he made in the beginning on the video..
Maybe he believed what he said. Which would be worse, if he actually believes what he says or is just lying to get ahead?
When are the ACA supporters going to admit this won’t work regardless of website or not?
Don’t hold your breath. ACA supporters don’t understand much beyond the words “affordable health care”.
They’ll admit that it is a bad system once they see the premium increases year after year. I’m just waiting for doctors to start offering discounts to though who pay cash at the time of service.
The problem is I don’t know if people are going to feel that pain directly as necessary. Cost can come out of quality just as well as price and the more muddled things get, the less likely that people correctly associate problem with cause. And don’t forget that the government will likely socialize these costs, taking the burden off of an individual.
These things are the tip of the iceberg.
Docs are going to be hard to find:
1. Many getting out or joining larger groups.
2. Payments will likely be lousy, so many practices may not participate, and many will become “concierge”.
3. Above will discourage med students from primary care.
Addtionally, plans will be limited as to providers, both hospitals and docs, because the insurance companies are looking for bargains.
The crux of the matter is that high health CARE costs have not been addressed, nor has access. As far as affordable insurance?????
Unfortunately, with the cap on how much people can pay or be charged based on their income their rate will never increase, but the subsidy to the insurer will. The insurer will, in turn, make sure they spend their 80% on claims so they can keep the 20% left over. It’s going to be a huge profit-center for them.
The amount of risk exposure doesn’t change by moving high cost patients from the risk pool of the state to the exchange. The only difference is who is exposed to the risk and who is receiving the reward for bearing the weight of the risky patients.
So why is it that young/healthy individuals pay the same premium that elderly/sick individuals pay? (Assuming same income level)
I agree that a death spiral will eventually form.
Sounds like you have a financial background, Rutledge. As do I.
We both know that diversification is the key to success in any market strategy. As Dr. Goodman explains, the “portfolio” of patients is going to show a exponentially increasing level of risk. The only way to combat this is large cash inflows by the govt to keep premiums at an “affordable” level.
There were certainly very few economist/financial experts on the committee who organized this system..
Eino’s (Economists in Name Only).
Unfortunately they are the “best and brightest” in the field. Economists love to talk about free markets, but when they get in power they almost always regulate and destroy. I guess power does corrupt.
Exactly. People dismiss “national debt alarmism”, but Dr. Goodman’s “Death Spiral” will get us headed toward monetary disaster faster than ever before.
This thing is going to spin out of control faster than anybody imagined.
Dewaine,I am also troubled by the death spirals, but I do not see a full monetary disaster.
Even if the exchanges had 20 million people, and they had an average subsidy of $7000 each, that would be $140 billion a year.
Not good, but that is what Iraq has cost and we are still plugging along.
I may have missed a point here, let me know.
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