Cost Controls in the PPACA aka “Obamacare”

I have seen some here claim that there are no cost control measures in the Patient Protection and Affordable Care Act. This is simply not true - although most of the cost control measures are indirect. AFAIK there is only one direct cost-control measure which I will include last on “my list”.

- The Mandate. Everybody in the pool! But it’s a lot more than just healthy people paying for sick people.
Sh1t happens! You may be young and healthy and feel invincible, but what if you get in a car wreck? What if you are one of those unfortunate few who develop a condition you didn’t expect? You may go bankrupt personally, but someone still has to pay for those expenses. Either they are used as tax exemptions (impacting all taxpayers) or the costs are spread out among those who can pay - I’m guessing that it’s usually both. If we can eliminate those costs by insuring everyone, then we can lower costs for individual bills.

- Preventative Care. It’s been proven time and again that early treatment is a lot cheaper. It has also been shown that people tend to wait until it’s “too late” because they couldn’t afford doctor visits earlier. This drives up health care costs. By making the costs of early detection negligible, we are driving down the costs the treatment.
Electronic records. I have experienced this myself, as I’m sure many have but just didn’t think about. I remember many doctors requesting my records and/or having me request my records from a separate source - which meant that I had to request records snail-mailed which required costs involved in the transfer of docs not to mention a separate visit which meant more costs.

- Direct Cost Control - the 80% MLR: MLR is a Health Insurance term which means “Medical Loss Ratio” - yes, that means exactly what you think it means. That means the amount that insurance companies actually paid for Medical care which they view as a “loss”. The lower the MLR, the higher the profits, which means they can pay their executives more. Thus, the “bean-counters” denied as much as they could to decrease the MLR so that the investors could make more. The new PPACA or ACA aka Obamacare limits them to 80% MLR (in some cases 85%) after which they have to send out a refund check to everyone they overcharged.

Of course, most of those would be totally moot points if we had a single-payer system. Oops! That doesn’t poll as well as “Medicare-for-all”. Just as many people wanted to swap Obamacare for the ACA. Which is why the Government (Public) Option died (because of Joe Lieberman, for those of you who don‘t remember the fight).

I still want Medicare-for-all; but I’ll settle for the ACA, even without the Public Option.

And, yes, it has cost-controls built into it.