I'm sure anyone who reads this blog or follows my FB posts knows that I think this is a good thing, to start with, to fix our outrageously broken system of payment and care delivery. The best that can be said is 'at least we got started'.
Most of the asshats protesting have probably never bought individual health insurance. They're using the employer-based system that is a fundamental part of the broken shibboleth of healthcare. Let me tell you *exactly* what it's like to buy an individual/small family plan, and this was a good and sanctified HSA plan to boot. I got this plan after I left one job to be self-employed. I needed insurance for myself, my wife, and young son. I was making enough scratch that I actually maxed out the FICA contribution. That's right I stopped paying FICA after a certain point and got a nifty ~13% tax cut post that cut-off. That's something that's never brought up in tax discussions isn't it(Let's cut taxes on people who already have a tax cut from FICA)
First, we get weighed, measured, and blood tested. If not, you're out of the preferred rate plans immediately. Secondly try to remember anything that's ever happened to you and write it down on a large form. Even if it was something fairly routine, like having a gall bladder removed, if you don't have a physician's note or something similar, you'll be boosted out of the preferred rate plan. Third, don't ever ever ever be a woman who's of child-bearing age. Even though we qualified for super-spiffy low rates, being that my wife was of child-bearing age, we had to get a maternity rider. That doubled our premium. By the way, you can't get a rider after you get pregnant, so a pregnancy test is in order too to make sure you don't have a pesky pre-existing condition.
Ok, so we're tested, measured, and found not pregnant - great! Our broker tells us that we can qualify for any of the traditional plans starting around $1200-$1400/month. I know what you're thinking - pocket change! Even though I'm self-employed at the time with a decent wage, that is just too much to handle on a monthly basis with a house, car, etc. So we opt for the HSA with its much more reasonable premium of $420/month and a lifetime cap, for the family, of $7 million. I don't know what all the fuss was about with insurance so cheap!
Oh wait, the HSA requires you to take a high deductible. The deductible we had to take to make the monthly premium work out was $10k/year, but you get to take it out pre-tax - wheeeee!!!!!! I set about putting back $275/bi-weekly(you do the math) hoping(gambling) that nothing major will happen during the first year or else it would have been Visa helping to finance that as well.
So for all this cash outlay on my part, the insurance generously contributed 10% of every office visit bill. Now using this awesome tool of capitalism, I was able to negotiate prices with my doctor's office! Go go cash.
Every fucking office visit cost me between $120 and $140 dollars after insurance kicked in. How often do you think we took a visit to the doctor? That's right, we sure as hell didn't over consume because we were going to wait until the very last possible minute to go - that always works well for illnesses doesn't it? Thankfully nothing bad happened to us.
Did I mention that the $10K limit is a yearly limit. So let's say something big happened at the end of one year (November, December) - well I've got that handy in my HSA account I'll just drain that now to pay these bills. Now January rolls around and guess what, the major illness hasn't gone away. Oh and at any time, the insurer could have kicked the sick person off of the policy, or all of use really and refused all of the bills.
So let's sum up: I pay a huge premium, take on a lot of risk, all for the privilege of having no pricing power, and no guarantee of coverage should anything go horribly wrong. One can see how buying insurance on the open market is very reasonable, and gives one a sense of peace and well-being.
The above described transactions and 'market' are what the ACA bill has reformed, not employer-based insurance, and not care delivery.
So if this 'system' was so great and didn't need reform, I'd like to see how many doom-sayers jump right out of their employment-based insurance and into that market. Oh wait, that market has gone away hasn't it. It will be missed, like bubonic plague, cholera, and typhoid.