Americans already pay for the uninsured — we do it through emergency rooms, which are already very expensive, much more so than the ACA. We don’t turn away dying people for lack of funds, and we haven’t since 1986, and I don’t think America is likely to go back to that, and if you think we should, well, I don’t know how to talk to you.
“The Emergency Medical Treatment and Active Labor Act (EMTALA) is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospital Emergency Departments that accept payments from Medicare to provide an appropriate medical screening examination (MSE) to individuals seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay. There are no reimbursement provisions. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.”
As a doctor friend told me over lunch the other day, a likely consequence of the ACA is that emergency room costs are going to continue to rise, until they get to the point that hospitals either break under the financial pressure or they *do* start turning away dying people, who then end up dying in the street in front of the hospital, and maybe that will finally get through to the general public.
“Financial pressures on hospitals in the 20 years since EMTALA’s passage have caused them to consolidate and close facilities, contributing to emergency room overcrowding. According to the Institute of Medicine, between 1993 and 2003, emergency room visits in the U.S. grew by 26 percent, while in the same period, the number of emergency departments declined by 425. Ambulances are frequently diverted from overcrowded emergency departments to other hospitals that may be farther away. In 2003, ambulances were diverted over a half a million times, not necessarily due to patients’ inability to pay.”
The main reason some people’s costs went up under the ACA was because their states refused the subsidies that would have made the insurance affordable for them. The whole point was that it was meant to be affordable, hence the name.
Since the passage of the ACA, the cost of health care has continued to rise, but MUCH SLOWER than it did before the ACA. Getting rid of the ACA is almost certainly going to cause health care costs to rise sharply. Going in the other direction, to single-payer (Medicare-for-all), is likely to significantly slow the rise in health care costs. Single-payer will both be much lower cost to the nation AND will provide better care overall to all of us.
Some insurance companies will go out of business, if they can’t switch over quickly enough to insuring other things, like houses and cars; I’m okay with that.
Correct me if I’m wrong, but I’m pretty sure this is all accurate, and are the basics that Americans need to understand. This Vanity Fair article lays it out in much more detail, with the numbers.