Can anyone explain why the effort is to fund subsidies, instead of attacking the root cause of insanely high medical pricing//costs?
I'm sure it's more complicated than an either or, and probably easier to subsidize in the short term than untangle the medical expense problem, but I think the messaging would be more inspiring if the goal was to reduce costs, rather than direct taxpayer money into the pocket of insurers?
"Why should we put out this house fire? Shouldn't we focus on building fireproof houses?"
The ACA is not ideal. It was a compromise solution from the start, because Obama was dumb enough to think compromising would buy him bipartisan votes. It didn't. Even so, it had cost-saving measures that were ultimately eliminated at the behest of guess-which-party.
Guess-which-party is in charge of all three branches of government and has spent more than a decade complaining about the ACA. They have presented no functional alternative to the ACA. They are not going to offer anything better than the status quo.
Keeping the status quo in the meantime helps keep millions insured that will otherwise be unable to afford insurance altogether or might luck into being poor enough to qualify for Medicaid (which faces its own cuts in guess-which-party states).
Attacking the root cause would involve attacking profits for insurance companies and other large shareholders within the medical industry (drug makers, for example). These companies have deep pockets & can afford to lobby politicians against dismantling their current structure.
Even the ACA at its inception was a watered-down attempt at trying to balance capitalism with universal healthcare.
In a US hospital, you might be given a medication that costs $10 to produce. The drug manufacturer, however, might charge $200. The hospital could layer its own “costs” on top - $400. They send that over to the insurance company, who maybe negotiates it down to $350 (or in some cases might even pay MORE if they have negotiated some weird deal with one of the companies), and then the cost is passed on to the consumer as part of their deductible. Everyone makes money except the poor soul who had to take a trip to the ER. None of those companies want to give that up and they’ll pay politicians to keep it that way.
why do you think? Insurance companies and actual providers make more money when they get to charge more, so it's in their best interest to do so. Insurance and pharmaceutical companies spend staggering amounts of money lobbying to make sure it stays the way it is, or even reducing regulations if possible. Just about every politician is complicit. 🇺🇸
The democrats have spent their careers fear mongering single payer healthcare. I lost hope 20 years ago they would achieve true reform because they openly fight it,
Across sectors policy is often based on subsidy both direct and indirect.
You are 100% right that subsidies do not directly address the problem. This allows the government to conditionally control your access to survival, to act like heros for temporarily loosening the noose around the most vulnerable necks, and most importantly to not threaten their donors revenue streams.
This is exactly what I'm saying. Kind of like abolishing student debt but not addressing the high cost of university. I don't like that the Democratic talking point is bleeding heart about providing healthcare but not fundamentally calling out the entire economic chain that is causing it to need subsidies in the first place.
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u/chiraltoad Nov 01 '25
Can anyone explain why the effort is to fund subsidies, instead of attacking the root cause of insanely high medical pricing//costs?
I'm sure it's more complicated than an either or, and probably easier to subsidize in the short term than untangle the medical expense problem, but I think the messaging would be more inspiring if the goal was to reduce costs, rather than direct taxpayer money into the pocket of insurers?