Why Not Adopt a TRICARE model Rather Than ACA?
I understand that mandatory health care coverage helps a lot of people by evening out outliers in insurance company costs and keeping the general insurance premiums down. I previously served in the military which has as you may know Tricare. Tricare pays out to health providers at cost for the procedures provided and thus keeps the cost of premiums low.
From what I have observed civilian insurance companies charge the premiums they want to and also pay health service providers whatever inflated costs they also have making things economically more difficult than necessary for the consumer. I have not involved myself with Obamacare as of yet because I feel that this is an injustice. I may now be forced to participate not because I need health care but because of penalty fees. I don’t agree with government subsidies and I know i couldn’t afford insurance without, I just find it frustrating to be forced into contributing to the national deficit.
I know I’m beating around the bush here but why do we have to pay so much into an unregulated system just to live our lives?
Answer
TRICARE is government run healthcare, the benefits being a lack of middlemen. ACA is quasi-private (private insurers and public subsidies) plus expanding public Medicaid. Each insurance type private, public, subsidized, TRICARE, VA, Medicaid, Medicare, etc all have their pros and cons. There would be a lot of wisdom in a "single payer" system like TRICARE where a large group (America) used it's bartering power to get fair rates instead of having insurer, hospitals, and phrama set prices for each other. That being said the inflated healthcare costs drive a large $3 trillion healthcare economy and we aren't so sure that would be easy to ween off of over night. As much as it seems wasteful, it brings a lot of perks with it in regard to healthcare technology and the economy (in the short term). Downside of course is the nightmare of a deficit and public debt projected by the CBO. No real easy or simple solutions here, but your points are interesting and the discussion important.
When it comes time for you to shop for private coverage you should read our page on subsidies. This will help you get the best value on premiums and out-of-pocket costs in the current market. Generally we suggest a Silver plan (read our explanation why).
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ACA is throwing money into an unregulated series of private interest groups where the middlemen and subsidies leading to impressive corporate raises at the expense of deficit and public debt. I know it would be unwise to opt out entirely but could a Tricare based model be available in the future to compete with insurance companies? The Healthcare industry is important but if hospitals and pharmaceutical/insurance companies set their own costs arbitrarily them they are taking advantage of the weak with their inflated costs.
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There are a few things in the law that allow for “single payer” type systems to be implemented on smaller levels. Regions and even states can implement or band together to implement unique health insurance systems starting in 2017. The stipulation being it can’t increase federal debt. This means a state or region could set up a single fund and use the would-be profit to decrease costs for the users and to run the fund. It could also use the group bargaining power to, perhaps, get better deals regionally (as the fund, the people, and the providers would all reside in the same place.) There would need to be a solution for out-of-network and it could potentially involve partnering with one or more private insurers as well. The sky is the limit, but so far we haven’t seen any states or regions with intentions of doing this (currently in 2015, others had expressed interest earlier but retracted it).
Also future legislation could transform the ACA into a more public, or depending upon the politician, more private system.
Sec. 1332. Waiver for State innovation. Beginning in 2017, allows States to apply for a waiver for up to 5 years of requirements relating to qualified health plans, Exchanges, cost-sharing reductions, tax credits, the individual responsibility requirement, and shared responsibility for employers. Requires States to enact a law and to comply with regulations that ensure transparency. Requires the Secretary to provide to a State the aggregate amount of tax credits and cost-sharing reductions that would have been paid to residents of the State in the absence of a waiver. Requires the Secretary to determine that the State plan for a waiver will provide coverage that is at least as comprehensive and affordable, to at least a comparable number of residents, as this title would provide; and that it will not increase the Federal deficit.