The good things about the Affordable Care Act (aka “Obamacare”) are that it seeks to get everyone insured, which not only lowers everyone’s financial risk & increases their access to health care, it also provides subsidies to pay the premiums & also keeps insurers from denying coverage to people who are sick, i.e., those who need care the most.  It also made insurers provide a more “legitimate” form of coverage & did away with so-called “catastrophic” coverage, i.e., coverage with high deductibles; I’m talking $5,000 to $10,000 per year.  Wealthy people can afford to accept that much financial risk in exchange for a lower premium, but most can’t.  It has problems, but it’s a step in the right direction.  There should have been a financial proof of responsibility that the insured must have been required to provide, like ample cash if the deductible is due.

What you’re not hearing is that many of the problems with the ACA are political.  The ACA could work if it was politically popular across the aisle.  Insurers don’t like it, Republicans don’t like it, and many people have taken sides because of selfish reasons.  Poor people can’t get Medicaid coverage because Red states won’t vote to expand it there, which are the states poor people need it the most.  They claim the back-end cost is too high, but the truth is, they can’t afford to NOT do it.  There are many small community hospitals that have & will fail due to lack of Medicaid funding.  Rich & powerful people don’t like helping poor people, but in doing so this time, they’ll be helping themselves & everybody in our society as well and we’ll all be better off physically, emotionally & financially.

The whole reason insurance of any kind exists is because the risks are spread out among a pool of people, which are the policyholders.  99 people are paying for the 1 person who also paid, but got real sick that year & needed financial help paying the bill from the insurance company, unlike the other 99 who didn’t get sick that year.

When you let people in who are sick, yet don’t get enough people in who aren’t sick, you’ll have problems as a risk pool.  What the ACA didn’t do is make the penalty for not having insurance big enough to warrant getting it if you were young and had little health risk, or you simply didn’t want to pay for it, as the penalty is way cheaper than the coverage.  If the penalty for not having insurance was more than the cost of it, we’d have over 99% coverage.  I’ve had health coverage of my own that I paid for from the time I was 19 years old to now many decades along, and I can tell you that it’s been mostly a waste of money until I got to my 50’s, but that’s only because I didn’t have an unforeseen incident or health problem.  I could’ve had one, and I was covered if I did.

Another big problem is that many people who are high-risk have health problems due to their own life choices.  Diabetes & heart disease & many cancers are typically caused by poor lifestyle choices, yet everyone in an insurance pool pays the cost unless you make those high-risk policyholders pay extra.  At least they can’t be omitted from coverage under the ACA.  Also take the really high-risk people out & put them in Medicaid.

The real answer to all this is a single-payer system where the government provides free or cheap insurance, and taxes are raised to pay for it.  Yes, you’ll pay more in taxes than you do now, but you won’t have any outrageous medical premiums, nor $40 copays every time you go to the doctor (which add up quickly), and since everybody will be covered, costs will come down & the increase in taxes will be cheaper than the former premiums & copays.  That’s the only system that really works, but rich people & poor people prefer the status quo, which is where they continue paying cheap premiums for coverage that requires them to accept a large amount of risk that they can handle, and lets poor people pay little to nothing, or go without coverage and show up at ER’s and stick the hospitals with the bill, who then pass the costs on to the insurers & the middle class, which means the middle class pays the brunt of medical costs anyway just like they do income taxes.

Wealthy people won’t be reduced to standing in like for health care.  Just as other services in other industries pop up for those who have the money to pay, premium health services will pop up where you can get what you want or need quickly if you have the cash to pay for it.  Don’t want to wait for a doctor who takes your gov’t insurance?  Go see a private care doctor who will see you for $100 out of your pocket, a heavy sum comparatively, but one you can afford since you no longer have to pay $500 to $1,000 a month in premiums anymore when single-payer takes over, and your taxes won’t be nearly as high as that.

You can try raising taxes on corporations instead, but they’ll simply pay off politicians to not support that effort, and even if they did get taxed, they’d simply pass off the costs to consumers in the form of higher prices.  No matter what you do, the middle class pays the bills, especially those in the upper middle, and those who aren’t poor enough to be poor, but need every dime they have.