What's your health insurance status? Will the ACA help you?

[BlueStreak]

34. It does nothing about Pharma

And that is a huge factor in making US HC costs twice what they should be. It does a little about the other 3 factors:

b) the cost shifting to cover uninsured people showing up at the ER

This is the main goal of ACA. Unfortunately we took the slowest, most convoluted, least effective path to dealing with that. But it is better than nothing. In the very best case, it will take 5 years to substantially close the uninsured hole. For one thing we have to win another big election to deal with the damned SCOTUS and do something about the Medicaid hole. And even after practically everybody has coverage, it will take another 4 years of arm wrestling with industry to get them to stop overcharging everybody who has insurance. They have been in the habit of jacking up our costs for so long, this will not end quickly. So best case, we're talking 2018 before seeing significant results here.

c) Profits and abuses of the insurance industry

Thought the abuses had ended with the passage of this law? Wrong. Just look at what these bastards are doing canceling millions of Americans this quarter and sending out all sorts of letters intentionally trying to trick consumers not selecting expensive products that are not in consumers' best interests. The ACA law says they have to put 80% of the premiums toward HC, but they have armies of accountants and lawyers hard at work looking for ways to skin an extra 10% out of that. And even if they really did do 80%, that is crap. It should be 97%. These people aren't doctors, nurses, orderlies, researchers, or chemists. We don't need them. They don't add one damn thing to society. There is absolutely no reason why we should be spending a penny more than 3% for administration.

d) inefficiencies in the delivery system

There are a few things in the law that can actually make a difference here. I have already seen the benefit of improved electronic records up close. This may be the least appreciated part of the ACA law. And certainly the law's emphasis on dealing with health at the primary care and clinic level before it becomes an expensive ER proposition is a very good thing.