>>> I doubt too many people are going to stop working because they qualify for ACA subsidies
Equivalent of 2.5 million workers is too many or not too many?
>>> I see the ACA subsidies as a way to make people more proactive about their health and keep them out of emergency rooms which is significantly more costly to the system.
This is also proven not to be true. Having insurance, actually, raises usage of emergency rooms by 40%. See: http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/02/s...
It was a nice theory, too bad it's not true. But repeating it now, when it is disproven by experiment, is just substituting ideology for facts. It is not going to get us in any place that is good.
>>> As far as older folks working less because they are not tied to their employers for healthcare I think this is a good thing.
What is special in older people that them not working is good? Is that that we want the most experienced workers to be removed from the workforce, so that the productivity would drop, because lower the productivity, richer we are? And when replacing experienced and productive workers with unexperienced workers with much lower output and who also are paid much less, while moving the experienced workers from productive work to tax-sponsored welfare (which the younger workers now have to support with their salary, which is lower to begin with but now becomes even lower from having to support older folks too) - so tell me again, where the good part starts in all this? Because I kind of fail to see it.
I have to agree with you here. The problem with insurance for routine care (the system we have in US) is that it makes the information asymmetry problem worse: since it's someone else's job to negotiate the price of routine day-to-day items, there's no incentive for individuals to make sure they're getting a good deal. This is equivalent to going through automobile insurance for oil changes and other routine maintenance.
The fact is if you have health insurance you are likely to engage in preventative care activities (eg regular primary care visits) that you would otherwise avoid without insurance, however you look at it, this is a good thing.
The fact that people may run to the ER unnecessarily even with insurance is perhaps a reflection of other problems (maybe too many hypochondriacs Googling :)? ), but that isn't a reason to not make healthcare accessible.
If the choice is between people over say 60 desperately holding on to jobs because they can't afford health insurance on their own, versus young people getting opportunities to start their own lives then the choice for me a rather simple one.
PS: I have no ideological axe to grind in this matter. If we are going to live in a modern society, these are problems that have to be dealt with somehow.
I grew up in a place and a time where people died in gutters (no exaggeration) from hunger and disease, that is the difference between a modern civilized society and one that isn't so. It is a choice that has to be made. The dignity that is afforded to people by social programs is a dignity consequently bestowed upon all of us.
The reason those insured by the government go to ER's is because the regular clinics TURN THEM AWAY. The government program doesn't pay enough to the clinics and doesn't force the clinics to accept the patients. Judging by the 3rd degree my wife got from a dermatologist a few weeks ago, those covered by coveredca.gov are going to be in the same situation.
And by "clinics" I mean all those non-ER businesses that purport to offer treatment to the public for a fee, such as private-practice doctors.
Equivalent of 2.5 million workers is too many or not too many?
>>> I see the ACA subsidies as a way to make people more proactive about their health and keep them out of emergency rooms which is significantly more costly to the system.
This is also proven not to be true. Having insurance, actually, raises usage of emergency rooms by 40%. See: http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/02/s... It was a nice theory, too bad it's not true. But repeating it now, when it is disproven by experiment, is just substituting ideology for facts. It is not going to get us in any place that is good.
>>> As far as older folks working less because they are not tied to their employers for healthcare I think this is a good thing.
What is special in older people that them not working is good? Is that that we want the most experienced workers to be removed from the workforce, so that the productivity would drop, because lower the productivity, richer we are? And when replacing experienced and productive workers with unexperienced workers with much lower output and who also are paid much less, while moving the experienced workers from productive work to tax-sponsored welfare (which the younger workers now have to support with their salary, which is lower to begin with but now becomes even lower from having to support older folks too) - so tell me again, where the good part starts in all this? Because I kind of fail to see it.