10 Ways Blowing Up The ACA Will Hurt YOU, YES YOU
Geoff Nesnow

Interesting, my read is almost exactly the opposite. Mainly having to do with removing enterprise markups from a retail market:

1) no one will pay 100,000+ annual prescriptions for medication with a COGS in the low single digits (or less). Expensive pharma pricing will drop to previously affordable levels. Diagnostic tests would see similar dynamics (and patients wouldn’t just accept docs crossing off whole blocks of panels just cuz it’s easier not to think about it)

2) people will seek care from actual doctors not intermediated by a card (things like direct primary care subscriptions or hourly rates for specialists) . Their level of service will go up and the actual cost will approach their current co-pays (and the docs won’t need 3 billing people and to spend time on the phone seeking prior authorization…clinical time could triple without the insurance requirements for paperwork or checkbox entries into a billing system (otherwise called a medical record system)

3) ideally: really sick people will get put into programs for really sick people. This has nothing to do with insurance (which is about payment) but rather about treatment meant to optimize outcomes. Most of this would be done better outside of today’s silos and could be optimized if not fragmented by icd and billing codes with little continuity of care

4) not sick people will realize they actually spend < $1000 / yr on health services. So spending $25k on insurance premiums that expire at the end of the year can actually give them back savings to pay for basic care + a reasonable catastrophic insurance policy

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