I am directly involved in health care and Mogul seems to understand many of the factors of why the ACA is not good for this country. No one is arguing that this system was not messed up in the first place, but the ACA will not fix what it was intended to fix. I would say the poor or worse yet the working poor will have just as hard of a time obtaining health care once this law goes into effect.  People that have insurance that are happy with it will see costs go up higher than they were already inflated to support the newly insured.

He is also right that the private sector health care costs are inflated due to government programs, but I will concede that it is not the only factor.  When Medicare doesn't even cover an office's overhead cost, then who do you think picks up the rest, private insurance. Don't get me started on Medicaid because in some states you are lucky if you get paid at all. Pre-ACA it didn't bother me so much to see a patient without insurance because you could make it up. In the ACA era, even though more people have insurance, they will be paying us at a rate that hardly covers overhead.  Since most of us went into medicine because we truly believe in caring for the patient, we will blindly go bankrupt.  We are confronted with comments like TSS makes when we try to make our case to the public.

Malpractice does increase the cost of Healthcare. Defensive medicine is a big part, but also passing cost to insurance companies and patients contribute. Some OB/GYN doctors pay 6 figures a year for malpractice. Try having that fixed cost on an annual basis and see what you have to do to prices.  That has to be passed on.  Medicare says screw you, this is all we are giving you, while the private insurers will increase some, but not much.  When all our payers are treating us like Medicare than we are done.

I think this country needs to decide what it wants.  Does it want healthcare that provides everything to everybody.  Is it our right to be on dialysis until we are 90 years old.  Should I expect a hip replacement when I am 91 despite having heart disease.  Should Medicare pay for bypass even though I still smoke. If so, be prepared to fork out more money as this is the path we are on now and don't think we could keep it up even if we wanted to.  Do we want national health care that has a limited budget so people over 55 year old won't get to go on dialysis while waiting for a kidney.  I think the sweet spot would be somewhere in between.  Instead of the ACA, we should have concentrated on fixing Medicare so it didn't go broke and work with private insurance companies to come up with creative ways to provide insurance to the working poor.  I emphasize working because there are safe guards for the disabled and poor, albeit they need some fixing too.

This is a huge issue and don't think we will solve this on Remote Central's installer forum, but looks like we are making an excellent attempt at trying.
Chad

FP Crazy, you make some excellent points as to why the cost of Health care is high and my summery above doesn't discuss some of them.  I am only arguing that the ACA wasn't and isn't going to solve most of the things that cause rising health care cost, and this thread is about whether the ACA is the answer to affordable healthcare.