For someone making less than $100K, $460 a month is not fantastic, and $1800 for a family of 3 likewise total income less than $100K is an obscenity. I wouldn't pay these amounts for a car, why should I consider it reasonable to pay this much for health care? Insurance did not used to be this expensive. This is a product that's losing its usefulness compared to the cost.

And it's wrong to call this insurance. It's not insurance, it's a health care payment plan.

Before ACA I was paying 1/3 the price, and had 1/4 the deductible. These higher rates are basically a tax to subsidize others, which is fine in principle, I just don't like the idea that this is going largely to a massive for-profit private bureaucracy. My problem with ACA is the private insurance industry is shit, and ACA made the expansion of shit mandatory. It should have been single payer, destroy the perversion that is the private insurance industry who have lobbied for all the anti-competitive behaviors they engage in to ensure near monopoly status in the vast majority of counties in the country. But the political capital just wasn't there to see how treacherous the insurance industry has been.

I don't see how the next round of politicians actually fix this though. Preexisting conditions are made feasible by mandates, mandates are made feasible with subsidies, subsidies are made feasible by some people paying more under mandate. So you can't take away any single one of those without the whole system unraveling entirely. Even the insurance companies have said this. They just don't want to say it loud enough that the blowhard in chief gives them a tweetirade.

The US has the highest healthcare costs in the world. There's simply no escape in the US unless the government steps in a regulates medical fees like the rest of the western world.

This a million times!!

The US is the only modern country without cost controls. Providers set prices and insurance companies do little other than pass those costs onto consumers.

When will we get cost controls? Likely never. It's very anti-capitalism to restrain free trade. (Yes, there's some sarcasm there. This issue pisses me off.)

There are cost controls! It's usually the maximum that insurance companies or Medicare are willing to pay.

Until we treat healthcare like we treat our regional monopolies (electricity, education, etc.) the the government won't be able to set prices lower.

There are no cost controls like other nations have. Japan has a single book that details the costs of all medicines and procedures. It is agreed to by both sides, under threat that the government will step in if there is no agreement.

This is what we need in the US. I should not pay a different price if I have insurance or pay cash. People that pay cash are routinely charged far more than people with insurance.

That's misleading. First of all, medicare is set by the government, and healthcare organizations cater service only to what is covered for medicare patients.

Secondly, hospitals charge people with insurance more. Typically if a patient is uninsured and paying cash, the hospital will work out ways to charge them less, because they are personally liable for way more than what insured are. Hospitals still want to get paid, and charging a patient into bankruptcy is not a way to achieve that.

Here's an idea: Democrats agree to any Republican ACA change with a condition that existing insurance company shareholders and bondholders are destroyed and replaced by US citizens as the new shareholders/bondholders inversely proportional to their wealth (not income).

Haha fat chance. But there is the subsidy.

The ACA did, though, limit participating insurance companies to making 20% off premiums. If they have a good year and make more, they have to issue refunds. The insurance industry hated that, and the GOP proposes to get rid of that provision.

And here I thought the Netherlands was expensive.. 100 bucks a month + a 385 deductible. And our level of care is top of the world. Man do I completely un-envy Americans.

Without trying to defend or criticize the ACA, I would just say that this is too simplistic of a comparison. How much of your general taxes are redirected towards healthcare, for example?

One of the reasons that the ACA is broken from a financial point of view is that the Democrats didn't want to simply raise general taxes and redistribute to fund the program. Instead they played all sorts of games with the 'individual mandate' to try to force participation without 'raising taxes'. But this is just a way for healthy individuals to avoid participating in the insurance pool -- which is a great way to destroy the actuarial basis of insurance.

It is entirely possible to be for nationalized health care and still think the ACA is structurally unsound and needs to be replaced.

I rescind my gripes about my $1300/month for a family of 3 on an unsubsidized marketplace plan.

Wow, both of you are paying a lot, I am sorry. Basically your high premium payments are going to pay for other people's care. Not a fair system. Everybody is not paying their share, middle class is though.

You don't know that. You have no idea what kind of health issues their families face. And yes, sometimes you are just paying for other people's care, right up until the time that you need it. That is, after all, the point of insurance.

For years, I paid much more out in insurance than I would ever spend that year. Last year, I had a $35,000 surgery. Heck, I spent so much on medical care last year that I had a "luxury colonoscopy" in December, because I knew I'd hit my out-of-pocket cap for the year.

That colonoscopy was $6000, btw. This, for preventative care that could save hundreds of thousands of dollars from colon cancer (and quite possibly my life) down the road. In a well designed system, price controls would put preventative care like colonoscopies below actual cost (and make the money up elsewhere), to save money at the macro level.

I make much more than you and pay more in taxes than you. I'm paying more for national defense, police, roads, etc. I'm subsidizing you. Not a fair system.

In Australia, Medicare is 1-1.5% of your income tax.

On the assumption you're making ... $100K a year, this is 20% of your income.

Hard to imagine how it could be done less efficiently. Of course, the issue is then going to be "Say we reduce costs to even 5% of income", "think of the physicians/hospitals/etc"...

Your numbers don't make sense, so maybe there is a typo. Did you mean to say that Medicare is a tax amounting to 1-1.5% of your income, or ???

In the USA, income tax is a marginal rate, while Social Security and Medicare taxes are fixed rate (and therefore regressive).

Correct. Though it's now 2% (I moved to the US a decade ago):

"Medicare gives Australian residents access to health care. It is partly funded by taxpayers who pay a Medicare levy of 2% of their taxable income.

Your Medicare levy is reduced if your taxable income is below a certain threshold. In some cases you may not have to pay the levy at all.

If you don’t have private hospital health insurance, you may have to pay the Medicare levy surcharge (MLS) in addition to the Medicare levy. This depends on your income for MLS purposes."