But the health insurers will be laughing all the way to the bank.. just like they did when the exemptocrats passed obamacare. Medicare is “administered” by an insurer.. so are most medicaid programs i have seen.
Our health care systems are actually very much like the regional trusts of the traditional National Health Service.
Our health care system is very much NHS transition ready.
Our systems such as Partners and Inova might receive annual global budgets.
Drugs could be bought nationally on an “all the doctors” prescribe basis, with patient co-pays to cover the manufacturing costs of chemical drugs.
I’m not so sure I would make that bet.
What you say is true; as far as administering the programs. The insurers have no risk. Yeah, I saw my Mom’s Medicare statements; Procedure: $1272. Reimbursement: $78.82.
But two factors:
1: when ACA was being built, the health insurers were figured in as “partners” and they could probably see (if not directly lobby, if not actually write the damn bill themselves) that they could preserve their revs; because the sponsors of the bill were naive goofball idiots who suddenly thought themselves capable of authoring a massive, massive program overflowing with government slop. The Democrats who “produced” the bill were not, as usual, interested in the actual results; they were interested in painting a picture of themselves providing this glorious handout that would cover everyone and save every insured $2500 a year. Wow! And so the Dems luxuriated in this synthetic image of being seen as the saviors of mankind and you and I would joyously re-elect them. (the ONLY thing they are interested in) Compare this with the known pattern of Democratism: Offer the giant freebie without regard to how it might be paid for, with the idea that you’ll re-elect them before anyone can figure out the infeasibility, to say nothing of the truly negative effects of their legislation. The government will of course bail them out should the costs exceed the estimates (they always do) but the net effect is that the taxpayer funds the Dem re-election campaigns; a generation becomes dependent upon the bloat, and after some time the law becomes irrevocable. Rinse & repeat.
As it turned out, the insurers actually figured out ways they could make even more (or at least as much——the so-called “risk corridors”) and their stocks have been on a tear since the inception of ACA and started upwards IMMEDIATELY after ACA,
1: The form of investment you or I may have in the insuring companies (HCA, UNH, CAH, etc; is in the form of STOCKS and if the perception is that these companies are going to get gored profit wise, then their stocks will fall and potentially give up a lot of the gains they achieved over the course of the rollout of ACA.
Is it different this time? You say “no”. I say “watch out”.