The three main redistribution streams of Obamacare, at least as I understand the law, today:
- From healthy/quasi-wealthy insureds, who pay higher rates to cover the rates of less-healthy insureds.
- From taxpayers to the ranks of the subsidized, via the Medicaid expansion incorporated into Obamacare.
- From taxpayers to insurance companies, to compensate them for taking on insureds who have pre-existing conditions or are otherwise uninsurable, or have subsidized rates despite their high-risk factors.
It’s a bailout economy. First, through the nominally private insurance system, from healthy to unhealthy. Second, direct subsidies to the poor who qualify for explicit aid. Third, corporate subsidy, the most common understanding of “bailout.”
In no way do any of these revenue streams “decrease costs.” Each one, in its own way, increases the costs of the medical-industrial complex.
The first, of course, increases the up-front purchase price of insurance to the young and the otherwise healthy.
The second increases the burden of the already-insolvent Medicaid system directly. Further, by increasing medical service demand, will lead to systemic price hikes of services.
The third increases burdens on the taxpayers because of the corporate bailout, as well as likely increase pressure on medical service prices because of increased demand. And further (perhaps a bigger factor, yet) will lessen price-specific incentives on companies to cut costs, thereby contributing to cost-plus pricing practices, and their continuing upward spiraling.
If Obamacare had been proposed and promoted by Republicans (and elements of Obamacare were Heritage Foundation/Mitt Romney notions), at least a few more Democrats would have had the sense to reject such an ungainly system. The fact that Democrats unthinkingly support it, even now, suggests a degree of crazed partisanship the likes of which no sane person can respect.