But the ACA did provide a system to compare health insurance plans because these plans had to:
- Provide the same essential benefits, including maternity care, mental health and addiction care, as well as free wellness visits and screenings
- Were able to be compared in terms of deductibles and copays
- And you could even find which hospitals and doctors were part of an insurance plan's network.
Yes, there are definitely some points of comparison. But many people on high deductible plans either never meet their deductible or hit it late in the year. For these people, the negotiated rate for services is very important. Until you meet the deductible this is what you buying with your insurance premium. Try asking an insurance company for their negotiated rate for a service. They will not tell you (I have tried repeatedly). How can you effectively comparison shop if you do not know what your premium is buying?
Another big issue I have with ACA is that most (in some cases, all) available plans have extremely limited in-network service providers. If you travel outside a limited geographical area your coverage is useless except for emergency services. I looked into this pretty carefully because we would like to travel around the US now that we are FIREd.
Actually, I would love to see Medicare expanded into a single payer system for everyone. Yes, Medicare has its flaws and high profile abuse cases but overall it is one of the most cost efficient government programs we have. One big problem with Medicare is that service providers don't want to take it. Guess what, they don't like it because the "negotiated" rates for Medicare are very low. The service providers still make a profit but only a small profit. But, if Medicare was greatly expanded more providers would have to take it if they wanted to stay in business.
I am not excited about any "new" plan from either party. Both parties are too beholden to the medical industry to do anything but create a plan that helps the industry more than it helps the consumer. Both ACA and the failed Republican plan did nothing to fix the actual problem with healthcare in the US.
Is there a place for private insurance in addition to a single payer program? This is a harder question to answer. If the single payer program is big, strong and effective then private insurance has a place for the small percentage of people who want to pay for it. But if the single payer program is weak then too many people will use private insurance and single payer will die. This is what is currently happening with ACA, it is not strong enough to survive in the current environment.
The Republicans are right when they say ACA is dying. Anyone who thinks it is healthy has their head in the sand. The Freedom Caucus was right about the Trump/Ryan plan as well. It was "ACA Lite" and most likely would have fared no better than ACA in the long run.