This is interesting to me in the sense that we cannot even agree on the most fundamental facts. Every credible estimate shows that the cost of doing nothing exceeds the cost of the ACA. Something is better than nothing by virtue of not being nothing is a terrible argument for something, and there are ample reasons to be skeptical of the ACA achiving its objectives, but cost of the legislation being greater than no action simply is not one of them.
I think of this as a similar conundrum as someone who is poor and working, but cannot afford to obtain reliable transportation. Say they have a 78' Cadillac that gets 10 MPG, drive an average of 1000 miles / month, and spending $2,000 / year in repairs. That puts their base cost of ownership at around $500 / month if fuel is $3.50 / gallon. Now let's also say they could get a new compact car that got 35 MPG, would cost $150 / month to finance, another $50 in additional registration fees and insurance, and would cost $1,000 / year to maintain. That puts the base cost of ownership at about $380 / month. On top of the owner cost, there is also cost to everyone with the Cadillac with higher air pollution and higher chance of vehicle failure that could cause an accident or otherwise stop traffic.
It's interesting that you bring up the conundrum of a getting a new car versus keeping your old one, being poor, and having very limited options as to what you can do because I'm pretty much in that boat right now myself. I understand the comparison you're making and it sounds good initially. I don't want to get bogged down on the analogy but this is I believe relevant to the discussion. I think there are some serious issues which you are not taking into account. For example, over the Mermorial Day weekend I went to four different dealerships with the express purpose to buy a car. The interest rates for these four different cars were 36.9%, 29.9%, 41.9%, and 26.9% respectively. Basically what's happening is that these car dealerships generally own the finance companies and they collude together so that the consumer is literally left with no choice to go through them if they are unable to secure a lower interest loan through their bank or credit union. Correlating this to the ACA, health care facilities will also collude together to keep their prices artificially high essentially trying to gouge the government financially at every turn. Essentially the healthcare providers are the car dealerships in this analogy. I guess what I'm trying to say is that you car analogy seems to assume all players and circumstances are static and won't change. In reality people and the market will shift in response to what the goverment is trying to do through this ACA legislation. And that's the larger point, we simply can not take these saving projections or cost controls at face value and assume they are accurate because nobody knows exactly how the ACA, if upheld, will change the health care system. Further, one thing we do know for certain is that when government tries to set prices for healthcare services, providers will then charge people who want to pay cash substantially more than they charge someone paying with Medicare to try and make up for lost revenue. We see this happen everyday in healthcare facilities across this country. Add in the fact that same services cost different amounts depending on where you live, which facility you go to, and even what the business agreement is.
http://www.nhhealthc...ceServices.aspx
Just a very basic example of the cost of doing nothing being higher when it may seem antithetical for someone in poor financial shape to buy a new car. There may be other options too of course, but that doesn't make it untrue that a new car may cost less. Some of us believe that health care is a matter of national priorities in a fiscal sense. Germany, Austria, Switzerland, Denmark, the Netherlands, Belgium, Norway, Sweden, Finland, Australia, New Zealand, Taiwan, Singapore...all countries that have managed to do universal healthcare with a mixed market approach while maintaining acceptable fiscal policies, some far better than America. Why can't we?
One reason, because doctors, upon graduation from college, have huge school loans to repay. To a lesser degree so do nurses and everyone else along the health care delivery line. Back to doctors though, combine loans with insane malpractice insurance costs and doctors typically will start their careers 150-200K in the hole. Did you know that in Germany students go to medical school for free? People in other countries, like the ones you listed, have pretty much grew up with socialism their whole lives and so to them it is no big deal to do with less money charged for services. But that's not the American way is it? Why should an American company charge 1.00 for something that costs them .10 to produce when they can charge 4.50? That's slight bit of sarcasm by the way.
What really bothers me immensely, and it's a reason why I don't trust this legislation or the people who produced it, is that they crafted this legislation in secret, behind closed doors, with absolutely no one outside the liberal left having any input. There wasn't any discussion or consensus about this. This legislation was essentially the elite liberal left forcing multiple and rather probable bad laws on us simply because they could.
I will agree with you that something needs to be done to make healthcare more affordable. I'm just not convinced this Obamacare is it.
