I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment. Insurance is similar in concept to chips as a casino in this -- by creating distance from the actual cash transaction, people are less likely to question the cost of something because it doesn't have a direct impact on their wallet.

> I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment.

The rate of increase in per-capita costs has decreased under the ACA. So, while it perhaps hasn't yet solved the problem, its certainly hard to argue that its been thing worse than the system in place before it was adopted.

We need a period of time that isn't coincident with a huge recession before we celebrate this too much.

> We need a period of time that isn't coincident with a huge recession before we celebrate this too much.

The most recent recession ended the same year the ACA was passed, the annual average cost growth rates, for private insurance and both major public programs, after the ACA are lower than the 5 year period containing that recession and the passage of the ACA, and even moreso lower than the 5 year period before that (during which there was no "huge recession".) [0]

[0] Figure 4 in TFA.

It also allows us to pool money and average it in case unknown and expensive procedures are required. We also want to encourage people to get cheaper preventative care instead of avoiding it due to short-term costs. Insurance programs benefit from incentivizing that behavior as much as ordinary people do.

"People are less likely to question..." seems to be placing the blame at least one notch too far down. Try asking how much something will cost and no-one can tell you—insurance or provider. Medical billing at all levels is batshit insane, and it's not the fault of "consumers" (patients) that they can't figure it out. Even trying is mostly pointless.

Which is why insurance, unlike casino chips, has cash deductibles.

The uninsured rate has decreased from 16% to 9%, so there are now a significant more number of people insured that were not before.

The good parts and the bad parts are related. The ACA effectively forces rates to go up for people who can afford it to increase or extend benefits to people who can.

There was a slight increase in 2010, but (overall) not a significant change to the growth in premium contributions made by single workers and families between 2005 and 2015 - http://i.imgur.com/KCiwoEJ.png