[GenuineRisk]

Rupert, I just read the article you linked to and, probably due to your ODS (Obama Derangement Syndrome), I don't think you understood it. It wasn't a gloom-and-doom-catastrophe-is-imminent piece at all. I took from it that there's going to be a scuffle over rate increases in 2017 as companies look to make a profit (as the resident of a rent-stabilized apartment in NYC, I experience this scuffle every year between the city and the landlords), but nowhere in the article does anyone say collapse is on the near horizon.

Basically the article says the program is new, and it's got kinks. One of the kinks, which no one really discusses, is that OF COURSE individuals seeking coverage are going to, on the whole, be sicker than those who get insurance through their jobs. To have employer-covered insurance, you have to be healthy enough to work a 30-40 hour a week job, so by tying insurance to work, the market is already filtering out the chronically and severely ill (especially because it's ridiculously easy for an employer to drop an employee who gets too sick to work). Which makes capitalist sense, but is morally bankrupt. This new program is going to naturally attract people who need care more urgently, and many of them are going to be catching up on years of health issues that were neglected while they couldn't get insurance, which have since snowballed into bigger health problems. That difference won't entirely disappear, but as more people get coverage and regular medical care, including getting chronic conditions like diabetes, treated early, when it's cheap, as opposed to waiting and having to get a limb amputated later, which is not cheap, the level of "sick" versus "healthy" customers will start to even out a bit.

The ACA, until such time as the nation wises up and does Universal Medicare, will continue to be the "until something better comes along, meaning employer-provided health insurance" option. It's up to the government to keep tinkering with the regulations to find the balance that keeps large companies like BCBS in the game (because no one cares if the smaller ones drop out; they were victims of competition, and that's capitalism for you) and provides decent coverage for the majority of Americans. But hey, Social Security was not an effective program when it started, either, and decades later, it keeps millions of seniors out of poverty. But it needed time.