It's called the Affordable Care Act.

[jpgray]

It does many useful things. Some of which address costs. For example, it mandates 80% of premiums be used for medical care on pain of rebates. Existing exchanges, similar to those that will take effect pursuant to the law, experienced lower premium increases this year than an individual would have, on average.

And yet, Medicare overhead is 2% by in-house accounting and by any accounting far less than the 20-25% of private insurers. Premiums have increased 9% for 2011, and while the White House notes the specific fears on which this increase was grounded were mostly spurious, the increase will stand and any sane person will predict another large increase in 2012, perhaps also justified by spurious fears.

Wages are not going up 9% a year, 5% a year, or indeed at all. For the mandate to work, government subsidies must come into play. With its low overhead and mandated prices for certain procedures (not including the price of drugs), Medicare beats private insurance hands down for costs. Why aren't we seeing, then, an expansion of Medicare? Why are we talking about subsidies for private insurance that will cost the government and the individual far more? Perhaps it is because politicians and pundits isolate Medicare from the broader problem of rising health care costs, and pretend it is something inherent in the program that will balloon the deficit, unrelated to the larger problem that afflicts the entire market for health care.

We hear so much about the Medicare deficit crisis, but it is actually a health care costs deficit crisis. So long as we decide we have to care for seniors at current levels, Medicare actually has a positive impact on the deficit, since it is so much cheaper than the alternative of private insurance, which seniors simply could not afford. Were we to insure seniors via private insurance, the subsidies necessary to cover the premiums would increase the deficit far more than insuring them via Medicare. To say we will decrease the deficit by limiting Medicare eligibility or decreasing actual care (rather than addressing fraud, etc.) is simply impossible--unless we are to provide less care for seniors.

So why is the bill called the Affordable Care Act when it does so little to address the cost of care rising far faster than wages? Why should we speak of Medicare reform in terms of limiting access while at the same time we agree to insure millions more by subsidizing their premiums for more expensive private insurance? The problem with Medicare is not Medicare, it is the rising cost of care. A true Affordable Care Act could be as simple as a Medicare Expansion Act, no? An Affordable Care Act that subsidizes private insurers is perhaps affordable to the individual, but certainly not to a government that proclaims Medicare too expensive and will be responsible for subsidizing private premiums at greater cost.

(The below chart shows the factors affecting the growth of Medicare expenditures)

[slipslidingaway]

1. knr nt

[ProSense]

2. Because

"So why is the bill called the Affordable Care Act when it does so little to address the cost of care rising far faster than wages?"

...it hasn't gone into full effect yet.

WH: Health Insurance Premium Update

Think Progress: Health Premiums Increased By 9 Percent In 2011

[ThomCat]

3. None of what is in those links will address or correct the problems

discussed in the OP.

Fully implementing the act will slow the rate at which costs under private insurance continues to rise from its current position, which as the OP shows, is far more expensive than it justifiably needs to be compared to government provided care.

But that means that rate of costs will start from the very high rate, and if costs then only increase 8% for a year, and then 7% for year, and then 6.5% for a year, the rate at which the costs are increasing will indeed be decreasing as the act intends. This will be declared a success.

In no way will this ever possibly be able to match the low costs of medicare, which start out much lower, and increase at a much lower rate. In fact, the difference between private the cost of medicare and private insurance would necessarily increase rather dramatically over time.

[karynnj]

4. It is not hard to prove that Medicare for all is a better solution than the ACA

However that comparison ignores that there was and is NO WAY to legislate Medicare for all. Even in 2009, qt the height of Democratic power in the Senate and House (in recent times), there were only about 10 Senators who would have voted for it.

A fair comparison for ACA is with the status quo that existed before it passed.

That is where you and Prosense differ - She compares ACA with the previous status quo - you and the op compare the ACA with an unattainable alternative. So, she finds positives; you find negatives. An important reason for why the comparisons that Prosense posts are important is that if ACA is repealed, the result is a return to the status quo or possibly passage of the Republican plan that is based on vouchers and has no provision to lower costs.

ACA provides a possible path to single payer - a state may obtain a waiver from the exchange if they have an alternative that meets or exceeds the ACA standards. Vermont has already made it clear they will ask for a waiver for a state wide single payer system. If all we think is true, this will save Vermonters and the state money. It seems clear if this happens other states will follow.

[tweeternik]

5. K&R! n/t