IMHO, there would be some budget caveat emptor options made available. Policies like used to pop up in small employers in the late 70s and 80s that would have fine print of the things it did NOT cover like pre-natal and gynocology, diabetes, cancer etc.
It would be fine for the flu, just don't get really sick.
Hi fender,
Right. That's what was happening with the health insurance industry before the ACA. A lot of companies were offering 'cheap' policies, but they didn't cover much and if someone were to really get sick, they'd still be left with a lot of bills that their insurance didn't cover that they'd be on the hook for. The ACA came about because there was a real problem in the medical care issue of Americans.
It used to be that it was a general part of one's employment that they would be covered for medical costs through an employer provided health plan. They were generally fully paid by the employer as just a part of the cost of having employees, just like employers paying half of one's SS taxes.
However, beginning in the 80's many employers stopped offering fully paid medical insurance as a part of one's employment. They did this because the premiums were becoming heavy for them to carry. Gone were the days when a company could provide health insurance for an employee, and likely his family, for just a couple of hundred dollars/month. They were feeling the pressure, just as we do today, of having premium increases year upon year. Some of the larger companies would offer buy in policies that got group rates because of their employment, but the employee was getting stuck with paying most, if not all, of the premiums.
What this led to was more and more people just opting not to have health insurance. Great...until someone got sick. Then they would often opt to go to the ER where they knew they had to be seen without any out of pocket cost. Hospitals began to cry out that they were now having to foot huge losses because of all the uninsured that they were having to pay for. Naturally, this created a domino effect to the cost of medical care for the rest of us. In order to cover their losses, they had to increase the prices of care for those who did pay. So, we were not only seeing price increases just because medical care was becoming more and more expensive due to our 'modern technological improvements', but also because somebody has to pay for losses.
Retailers tell us the same thing. Because of theft, what's called 'shrinkage', the cost of goods is higher than it really needs to be. Losses suffered by retailers have to be made up somewhere if they're going to stay in business and be able to pay their employees to be there when you get in your car to go out and buy something. Medical care is no different. Losses suffered in one area, have to be made up somewhere. It isn't like there's a 'loss fairy' that just goes around throwing money in the tills of businesses that are suffering losses.
All of this hue and cry went up to Washington and it was decided by the powers that be at that time, that this was as much a crisis in that day as immigration is said to be today. So, President Obama encouraged the legislature to take up the cause and cobble together a comprehensive medical care law that would, in the best way possible for all concerned, get everyone to carry insurance and make it as affordable as possible. Now, I think we need to understand that 'affordable as possible' isn't likely to ever mean that we're ever going to see the days when medical insurance is only a couple of hundred dollars/month. Those days are gone. We've built, what we believe to be, a 'gold standard' medical system in the U.S. that isn't going to paid for by everyone just throwing in a couple of hundred dollars here and there to pay for it.
So, as I understand it, and I did quite a bit of research at the time, that's why we wound up with the ACA. Now, a lot of people are covered that weren't covered before. Yes, the premiums did adjust, but I'd be willing to bet that if we just completely did away with the ACA, medical insurance premiums aren't going to go back to what people want them to be. The days of free medical insurance because you have a job are just gone for the majority of Americans and that's not coming back.
So, once again, I think most Americans are fairly reasonable people. If someone would offer up a bill in the legislature that handled the issue of having most Americans covered by some sort of quality medical insurance, that is better than what we have now, I believe it would pass and we could all go merrily along our way. Or, the law could be changed and ER's not required to see everyone, but they too, could be like private doctor's practices and turn away those who don't have the ability to pay up front, either with an insurance plan or cash. Unfortunately, I don't think the majority of the American people are willing to go there. We'd be like ye olde England, with people just dying in the streets because any medical care was outside of their reach (that is, of course, before the NHS).
However, I'll also make this prophecy. No matter how we decide to handle medical care insurance, there will always be complainers. There will always be those who aren't happy with whatever the current plan is. Those same people will be unhappy when they start getting huge medical bills because they chose not to carry medical insurance, if we go back to the old system. It's just the way a society of over 300 million people is always going to be. So the legislature just needs to come up with a plan that suits the majority of people that offers reasonable health care of reasonable quality. Make it law and be done with it. Which is exactly what they did when the ACA was voted into law by our legislature.
God bless,
In Christ, ted