@FlyingHighNow:
Sorry for a delay in response. I am pretty busy lately. Let me start at the end of your post and work backwards. You wrote:
Millions of Americans are upset because millions of us want everyone covered with affordable health insurance and healthcare?
Are we a nation of cold hearted barbarians? What neighbors, friends and family members are expendible, so we can pay a few dollars less in taxes?
This makes it sound as if everyone must be favor of the ACA and more socialized medicine, otherwise they are "cold hearted barbarians". It is, in fact, just the opposite. Nobody wants people to go without healthcare. Or food, or clothing, or anything for that matter. Do you really think that those who oppose government programs have, as their motivation, a denial of a high standard of living to individuals? There are reasons why the ACA and other government programs are opposed.
The medical market is just like any other market - food, clothing, housing, or paperclips. If you separate the consumer from the cost (by offering to pay for the product), the price of the care will necessarily rise. This is because neither the consumer nor the provider is getting correct feedback from the market through prices. From the perspective of the consumer, the price = 0, and it looks like an infinite supply. From the perspective of the provider, demand is way up, so these are signals to expand and raise the price. The ACA is "affordable" only in the sense that some people aren't paying for the medical care. The price is still being paid on the provider side, and the price will still rise. This causes those that do not have insurance to pay more because they are actually still attached to the price. Their stories come out as bankruptcies, and large bills as hospitals cost shift onto them (as in your cited book). It also causes those that do not qualify for subsidies to pay more. Somebody has to pay the higher prices, and the prices ARE going to go up. The nature of markets isn't going to change, anymore than the nature of gravity.
Also, for those that get their care subsidized, where does the money come from? The rich, perhaps through high taxation? No. The rich have free will, and will simply raise their prices, or stop hiring, or actually lay off some employees, and more likely a combination of all these. So who really pays for it? Perhaps the money is borrowed? I'm sure the creditors will want to be paid back in the future. How is that sustainable since the cost of care will continue to rise? So who is really paying for it? Perhaps the money is just printed? Well, then inflation will take the value out from the poorest - since they have the least amount of assets that can act as a hedge. Inflation is hidden taxation, mostly on the poor. So who really pays?
The problem is actually greater than just the cost at the provider level. The producers are also consumers in a sense - they buy the materials needed to provide their care. The price structure for these goods and services will also inflate. Eventually, it has to stop. The cost will be too high. At some point, there will be price controls and rationing put in place. The boom can't go on forever. The bubble can't inflate forever.
Who pays when uninsured people use the emergency room for medical care and the bill is hundreds of dollars? What if they are admitted and need surgery and the bills run into the many thousands of dollars? Isn't it less expensive to use preventive care and to screen regularly, catch things early? Our republican governor fought hard to get expanded medicaid passed in our state, because as a former business man, even he could see how much more cost effective it is to insure people and give them timely medical care.
"Republican" doesn't mean anything anymore. They are for exanded government too.
Again, this is to ask: "How do we pay for this care?". I ask, "Why can't people afford the care on their own?" - or in other words, "Why is the price so high that people can't afford it on their own?" There was a time when people just went to the doctor without insurance, and paid for it. It wasn't a crippling expense. (see previous paragraph)
Markets need less regulation (so that you don't have such high entry barriers to new providers - there needs to be competition), consumers need to be attached to the cost so that they shop around, and there needs to be a stable money supply. For decades we have had none of this. We don't have a market in health care, and that is the problem.
MMM
