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Michael Parker wrote:

Fantastic, people can shop the market and buy the plan that best fits their needs.

No, it’s not “fantastic.” Insurance is not like lettuce, where everyone is buying lettuce, and your lettuce is like my lettuce, each head costing approximately the same to produce, no matter who produces them, and no matter who buys them.

Insurance costs to the individual consumer are directly related to the number of people in the pool. The more people of varying prospects there are in the pool, the lower the premiums will be (particularly when insurance company profits are capped, as they are by the ACA.)

When large numbers of people can elect not to be in the pool based on better prospects, then the costs for those with poorer prospects have to be covered by the remainder of the pool membership. So what happens is the prices don’t stay the same — instead, they rise proportional to the number of people leaving the pool. This difference can be enormous.

So for instance: When young, healthy and non-preexisting condition individuals all run off to a less expensive pool they “shopped for”, then those remaining in the pool that covers the less healthy is a much smaller number of people. Their costs will skyrocket because the main costs of the group remain, but a significant amount of income to the pool is gone.

This is what “shop the market” is revealed to mean when you actually think about the process: the individuals in a society not pulling together for everyone, and the unfortunate becoming even more unfortunate.

The idea that underlies “shop the market” is basically this: “I don’t want to help pay for care for others.” The consequence is that they save money, and others suffer for it.

The root of the problem is the incorporation of health insurance in the first place. Because we have inserted these middlemen into the process and allowed them to triage the gateway to healthcare via a combination of health prospects and income, we have relegated many of our fellow citizens to ill health and in many cases an earlier death. This, to save a few dollars.

Almost the entire world has recognized that it is imperative for a country to see to it that everyone receives the health care they need without becoming financially broken — or not receiving it at all. Something in many American’s psyche cannot grasp this profoundly positive moral and ethical position, and is satisfied with replacing it with selfishness.

It is nothing less than a tragedy.

The ACA is far better than what we had before, and it is far better than any solution that allows health insurance to cross state lines. But it is also a sop to the insurance companies. If we want lower costs and healthy citizens, then everyone needs to be taxed, and government, without a profit motive, needs to pay the medical costs. This will reduce costs, eliminate the damage done by pooling those with similar risks, and simplify life for everyone.

Unfortunately, right now, a great deal of control is in the hands of people who simply don’t give the south end of a northbound rat for the health and welfare of others. There’s going to be a great increase in suffering if these people get their way, as seems likely today.