"It a failure, and told everyone it was the GOP's responsibility to fix it."
Not exactly correct. I said Obama Care was bad legislation moving in the right direction. I said the Republicans did everything they could to make the act Obama's failure instead of fixing the problems in it and the American healthcare system.
Every patient who pays for their medical care, whether thru insurance or direct cash payment pays for no-pay patients. You are paying more for the benfits you receive than it would cost did everybody have some means of repayment, insurance or whatever.
The system is designed to continue that way. If a provider accepts any social medical coverage, then they are prohibited by law to adjust fees for cash payment. Check around, you will find practices that are cash only and charge 20% to 25% of the fee schedule that an office that accepts medicare/medicaid. Often, the cash only fee will be less than the required copay of coverage accepted in offices that use insurance.
An office, on average, will collect about 40% of fees charged. Consider that insurance billing itself costs the practice and the paper overhead in this model and 25% and out the door is considered a winner.
A single payer system might improve that by mandating coverage or requiring a bonded assett against failure to pay- my recollection is that Georgia's mandatory auto insurance law was waived for those who could post a hundred thousand dollar cash bond in 1968 dollars, almost a million now. And I say 'might improve that' because I know that the providers will scream at the losses and lobby for improvement, eventually resulting in a sustainable system.
Obamacare's requirement of mandatory coverage or a penalty was a step towards overhauling the half-assed health care system we have now which benefits only the insurance companies- they don't half to cover anybody outside of a contracted group. Period. There is no 'assigned risk' in place as there is in other insurance markets.
America has socialized medicine. It's run by and for the insurance companies, who dump the high risk and no-pays on the tax-payer. Hospitals threatening to shut-down for finances are deemed 'necessities' and their losses are covered by various state and municipal governments. Then the practices, associations running the hospital post record profits....
The gummint is happy, they can point to "Mammoth cardiac/trauma/oncology" hospital that 'they' brought to the citizens.
The insurance companies are happy, they can point to benefits paid and increase premiums to assure profitability.
The uninsured are happy, they can walk into any emergency room and receive free treatment.
The cash-cow citizen thinks he's getting healthcare even though he and his provider can't select the most appropriate treatment, and the treatment provided is double, triple any reasonable scale based on all the patients paying. You're often overpaying for your own insurance companie's substandard but covered treatment option; and you're also paying for the no-pays who availed themselves of the treatment.
Not to mention the negotiated prices of each procedure, which may be delivered at a loss so the provider can continue to submit for coverage on other procedures. It's kinda like the cliche "I lose money every time I do that, but I make it up in volume...'
Obamacare was extremely flawed, a real POS that we're still suffering from because Congress hasn't fixed most of it. Anybody who loses their employer coverage needs a case of KY jelly to continue their coverage until the next Obamacare open-enrollment period, for instance.
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