Comment by altairprime

3 months ago

Year-over-year increase in GDP in the U.S. right now is almost exclusively “production” output from the healthcare industry, whose profits are stratospheric and rising. So there’s two useful datapoints here: first, the bill must be paid, or U.S. GDP growth year-over-year falters, not because healthcare costs this much; and second, household debt continues to increase year-over-year to permit continued wage stagnation. Whether insurers end up lowering their profits (and thus prices) as the subsidy expires centers around whether banks extend further debt as a household wages subsidy. As of right now, that seems to be continuing, even though some of that debt market is in the midst of a small crash, so insurers (who have no regulatory limits on profit levels) are unlikely to lower their profit targets as subsidies end.

So long as the political will of U.S. leadership supports that continued profit, and either government and/or banks subsidize worker wages to cover the increased profits, then we’ll continue seeing growth in costs on paper before subsidies. This growth in profits/prices could not be sustained on wages alone, given the continuing decline of inflation-adjusted worker earnings; and so to answer your question, yes: the act of subsidizing is what’s enabling the prices being charged; but, no: the costs of providing healthcare to any one person of a given age are not increasing due to subsidies; just the profits.

Commercial health insurers have relatively low profit margins. This is forced by the ACA minimum medical loss ratio. In theory Congress could increase that ratio slightly but it wouldn't do much to improve affordability for consumers.

  • That restriction is mysteriously absent from the actual published data showing their revenue growth rate spiking sharply when ACA was passed. There’s lots of sources for that data, but I liked this chart for its simplicity:

    https://images.jacobinmag.com/wp-content/uploads/2024/12/111...

    It presents nice easy datapoints: Cigna raised its profits by $40B/yr, an increase of 400% of its pre-subsidy profits, in just a decade — and one can safely assume that now that they’re accustomed to the new profit levels, there is no way they’ll voluntarily give them up. Whatever was intended with the medical loss ratio, Congress fucked up by not including a simple dollars-per-subscriber cap on net revenue.