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And after the years of insurance premiums going through the roof, you still consider Obamacare a success story?


Not being able to exclude people because of preexisting conditions and ensuring children have access to coverage seems like a pretty big success story.

Is it perfect? No, probably not. But repealing it would likely increase the budget deficit according to the CBO and put a large number of folks into a much worse situation than they are in now.


Indeed, at the time it was widely understood that Obamacare was about access, not cost. This was a necessary compromise in order to placate the insurance industry.

The battle over cost was left for another day.


On the one hand, yeah of course guaranteeing coverage for children and preexisting conditions is an obvious win. And removing coverage caps.

But beyond that... has average life expectancy measurably increased because of this "extra" insurance coverage?

Has the number of medical-related bankruptcies measurably decreased as a result of the expanded coverage?

I can't find solid data but everything I've seen suggests that those haven't really changed at all.

Given that, in the grand scheme of things, has anything actually improved for us, collectively? Healthcare is much more expensive now, but maybe that would have happened regardless.


I saw this in the thread elsewhere, but it was a great point, so I'll repeat it: https://www.kff.org/wp-content/uploads/2023/10/Figure-1-12.p...

Where on the chart did Obamacare get passed / implemented?

It was always about access, not cost. That pissed me off back then that single payer was not even on the table in negotiations. It was watered down to get it through, but I am still thankful that something got passed... I would still have a messed up rotator cuff from when I was 15 otherwise.


Your link goes to a blank page. :-?



One of the big consequences of government programs is the unseen costs. How many businesses never got created because of the increased burden that Obamacare placed on everyone, how many ideas never came to fruition, how many new technologies never got created? How many young entrepreneurs never took the risk that could have lead to a great new technology, found a cure for cancer, etc.?


If anything, Obamacare enables people to take entrepreneurial risk rather than have to stay with a job for otherwise-unavailable health insurance.


Are you American? I know there are people who believe this Ayn Rand stuff but it always surprises me when I come across one


I do love Ayn Rand and her works, and Stefan Molyneux. Great philosophers that have brought a lot of value to the world.


One of the big consequences of being denied health insurance is dying.


Problems like the need for health insurance, and the high cost of health care in general, have only arisen in the first place because unnecessary government-imposed regulation and government-imposed overhead have wiped out nearly all real competition in the health care sector, and introduced numerous other inefficiencies along the way.

Artificially limiting the ability of new participants to enter the market on the supply side, for example, creates an artificially-oligopolistic environment without the natural competitive pressures that force pricing down.

Even worse, this in turn results in an environment that attracts people and organizations who want to exploit these government-created inefficiencies for personal profit, rather than attracting people and organizations who want to provide higher-quality and lower-cost service than their competitors.

The end result of this government intervention is artificially-high costs for abysmal service.

The situation only gets worse when government tries to intervene with even more "solutions" for the problems that government itself created in the first place.


Not my Circus, as I get European 'free' coverage: is this reflected in excess death data?


It is objectively a success lol. The elimination of preexisting conditions and annual/lifetime coverage caps alone was huge. Not to mention the tens of millions of people who received health insurance who wouldn't have had any at all.

It is insane to me you are going to sit there and try to act otherwise.


Are you currently playing the premium for a family of four with a decent deductible where it doesn’t feel like you empty your pockets because you want to make sure your pain isn’t going to kill you?


Is the implication here that if insurance is too expensive it is because of obamacare and nothing else?


[flagged]


> people forced to buy policies on the individual market

The individual mandate has been gone since 2019.


I'm quite naive, isn't the individual mandate being removed the reason why the premiums are going up? i.e. lots of healthy people stopped buying and thusly leaving only the expensive guys?


According to the latest data I could find, 2022 had the lowest rate of uninsured Americans on record: https://www.kff.org/uninsured/issue-brief/key-facts-about-th...

There were some pandemic era programs that increased the number of insured people, so it is possible things have changed since 2022. Either way, there is no evidence that the repeal of the individual mandate actually resulted in less people with health insurance.


Yes, that's a significant aspect of the problem now.

They were going up before, during, and post ACA mandate, though. They've been on an upwards march alongside the underlying per-capita healthcare costs for decades. https://www.healthsystemtracker.org/chart-collection/u-s-spe... ("Total national health expenditures, US $ per capita, 1970-2022" - $2k/year --> $13k/year per person)


By “forced” in this context I mean people who want to have health insurance but have no choice but to acquire it on the individual market.


> It is because of the ACA.

Linked elsewhere: https://www.kff.org/wp-content/uploads/2023/10/Figure-1-12.p...

That's a pretty straight line, with no noticeable change because of ACA.

> But it’s purely at the expense of the healthy subsidizing them with overly expensive policies.

This is how insurance works.

The US needs a proper public healthcare system. Good luck finding a way to make that happen though.


> This is how insurance works.

The point is not about insurance in general, it’s the isolation of the individual market from the pools of large employers.

Yes the healthy will always be subsidizing the rest, but it’s a specific subset of healthy bearing that burden. It’s not the system as a whole.

> The US needs a proper public healthcare system. Good luck finding a way to make that happen though.

Ban corporate self insured policies so that the risk pools are unified to contain everyone.

Eliminate the deduction for offering insurance. Right now the same policy is cheaper if paid by the company as its pretax dollars (vs after tax dollars for an individual policy).


"Ban corporate self insured policies so that the risk pools are unified to contain everyone."

There should be only state or nation wide risk pools.


Show me where on the chart PPACA came into effect.

https://www.kff.org/wp-content/uploads/2023/10/Figure-1-12.p...

It should be obvious, right?

I don't deny that it sucks that health insurance is so expensive. Of course it sucks. And I have tons of empathy for anyone who is suffering under the expenses. But blaming our current costs on PPACA is just not supported by the evidence I'm seeing. If you have other evidence I should look at, I welcome it.


Insurance is going up across the board, it’s not a healthcare thing. Obamacare can be successful while premiums go up as well, it is not mutually exclusive.


How do you know that Obamacare isn't the thing that's causing insurance to go up across the board?

If everyone is ensured, no matter the pre-existinf conditions, people take more risks, live more dangerously, drive a little faster, eat a bit worse, etc. Nobody ever talks about the hidden consequences of these oh so wonderful government programs.


Socialized healthcare systems tend to create stigma around peoples unhealthy choices. It no longer is harming just your health and wallet. It is costing society money.

This creates an incentive to pass laws prohibiting products and lifestyles deemed unhealthy.


Privatized healthcare has the opposite incentive, whereby unhealthy choices may be ignored or even encouraged because they're a money-making opportunity.


It turns into this endless cycle of "we need to ban this and ban this and ban this" and never looking at the actual cause of the problem. Just the government creating more work for itself and creating more laws to control people's actions.

I think the stigma point is definitely true, but it's not doing anything to improve things. Obeise people are looked down at by society, but in the US 70% of the population is obese and the number just keeps growing. The natural incentive system is broken by government programs. Why should I bother eating healthy and limit my diet when I can just get health insurance when I get diabetes?


For 1, because my private health insurance premiums had doubled (ignoring switching plans for new teaser rates) the years before the ACA was passed.

Anecdotally, when the ACA marketplace went live, and I purchased individually, my health insurance costs decreased for a year (no subsidy)


Obamacare was talked about for YEARS before it was passed, I don't think it would be far fetched to imagine that the insurance companies started raising prices as soon as the topic started getting traction. It's a multi trillion dollar industry after all and they spend big $$$ on analysts to plan for the future.

Of course the price went down after Obamacare got passed. Can you imagine how much outrage there would have been if it had passed and everyone found out that it was going to cost them double or triple what they used to pay? The government took out some loans (using your future and your children's future taxes as collateral) and made sure they were lower. And then a year or two later when everyone stopped focusing on it and it had gotten normalized they stopped propping it up.


https://www.healthsystemtracker.org/chart-collection/u-s-spe... - see the chart labeled "Total national health expenditures, US $ per capita, 1970-2022".

We've been seeing healthcare costs (and premiums, which largely have to match those) go up in pretty much a straight line since at least 1970.


Thanks for the share. I imagine the costs has a high correlation with the American obeisity epidemic, which has continued to get worse and worse. Obamacare creates a disincentive for people to live and eat a healthy lifestyle. Why bother eating a good diet when you can just get health insurance anyways no matter your pre-existing conditions (be they natural, or much more likely, due to your lifestyle choices).

Eg: 90-95% of diabetes cases in the US are Type 2 (Lifestyle related)


I think it’s a bit of a stretch to say people are unhealthy because insurance is cheaper. The average person does not live in a way they want to harm themselves.

I would say it’s because most Americans don’t walk or bike much, food desserts are plenty, transit infrastructure sucks, overworking, and lack of time for vacation/self-care all contribute.

You are forced to have a job if you expect typical medical coverage, and making people do something they don’t want to do won’t incentivize them to take care of their health.


> Nobody ever talks about the hidden consequences of these oh so wonderful government programs.

Are you ok? Did you just wake up from a coma and suffering from some selective amnesia? Have you been living under a rock? Maybe you missed any and all libertarian content? Or the articles about how safety precautions give a sense of safety which result in more risky behaviors? (From bicycle helmets to OSHA stuff.) But maybe you have ran into articles about how car safety standards act as a birth-rate suppressor? No?

Spare us this "why nobody thinks of the consequences".

Premiums are going up because healthcare costs are going up, because there's a growing number of elderly, also because all services related costs are going up. (Because the Baumol effect, and so on.) Not to mention that as economic surplus grows (ie. GDP grows) people are willing and able to spend more on healthcare.

...

Check veterinary service costs and pet insurance premiums. Obama did that too?


Can you prove to me the counterfactual point: that without Obamacare, insurance premiums would have not risen?


They were going up before the ACA. Not sure what that has to do with anything.


The premiums are going up because someone has to pay for the profits of the for profit insurance companies, of the for profit hospitals etc

They all have to report yoy increase of earnings right?

So there enjoy your capitalistic health insurance. Which by the way dumps you once you are old, then I have to pay for you too despite the fact it is you who wanted a completely deregulated health insurance market.


Yes. Welcome to how insurance works.




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