Hello Celticguy,
Pre existing is the only incentive that is effective in getting people covered. Do something to make care affordable to improve proper decisions regarding buy/dont buy.
When care got needlessly expensive the young and healthy stopped buying ins which even the ACA recognized as being vital.
You are correct in identifying a big problem in the USA. Low wage workers are unable to afford health insurance. Health care coverage has become a luxury only available to the richer classes. This is not a failure of socialism. This is a failure of capitalism. The health care industry has become more focused on profit-taking than on care-providing. The health care industry has become more about increasing profits than about providing health care where it is needed.
Capitalism caused this problem. Capitalism has no solution to this problem. The ACA was created to address this problem because capitalism couldn't do it.
The real lesson is that the capitalist profit-seeking approach is wrong for making health care available to everyone. The only way to provide health care to everyone is for it to be a socialized system.
Trump dangled a false promise in front of voters when he said “I am going to take care of everybody."
It sounded too good to be true. It was suspect from the start because there were no details. Trump had no plan, just empty words. But he correctly identified what the nation wants. The nation wants everybody to to be taken care of when it comes to health care.
Before the ACA rates were lower (they were still unaffordable to many) because people with pre-existing conditions were simply refused coverage. Insurance companies did not pay for their treatment, so they often simply died for lack of enough money to pay for care. Many Americans knew or were related to people caught in this capitalist nightmare, and were adamant that had to be fixed.
The ACA forced insurers to offer coverage to everybody. It also sought to provide financial assistance to those who still could not afford coverage. Understandably, this caused an increase in rates for others.
Republicans looked for any way to destroy Obamacare and make it fail. They found it by challenging the crucial part of it which required everyone to buy in. Without that part of the law the rates have risen and will continue to rise. This leads to a system which is not much better than before the law. Health care is still prohibitively expensive, and the powerful executives of big insurance and big pharma are still getting fabulously rich at the expense of everyday working Americans and tax payers.
This leads us right back to the premise that capitalism is simply not right for health care.
Health care needs to be a basic right, guaranteed by our country, and provided by government. Everyone should be taxed to pay for it, according to their ability to pay. By removing the big profit-takers from the equation, the cost will be as low as possible. Since health care will no longer be tied to work, more entrepreneurship will flourish. Without the need to provide health insurance to workers, small businesses will be freed up to become more competitive, especially with foreign companies which are not burdened with health care costs.
When everyone has health coverage, there will be fewer sick people, and a healthier more productive nation.
Sometimes the socialist approach is better and more appropriate than the capitalist one. Certainly on a national scale this is true.
Several candidates are promoting a Public Option for health coverage. This is the ultimate test of doing something for profit or seeing if government can do it better. If the profit motive leads to so much more efficiency that the profits can be paid for by the payers, and it still comes out cheaper, then they should have nothing to fear from a government-provided plan which will not be burdened by the need to turn a profit, and instead can operate at cost. But instead of putting their money where their mouth is, conservatives fear the Public Option, for obvious reasons.
It only stands to reason that two essentially identical systems, where one has to add in the cost of profit-taking, and the other does not, will show that the non-profit system is more affordable to the user.
That is what scares the capitalists, and why they fight so strongly against the Public Option. But if what they say is true, that the profit-motive leads to a much more efficient system, then they should be willing to let it stand the ultimate test. If they are unwilling, then it shows they do not believe their own words.