Health insurance companies do not take anything. Unless I missed something, until Obamacare private insurance was OPTIONAL... Which means you were not forced to buy it.
Now that the government has stepped in and made it mandatory there is no reason for the insurance companies to cut costs.
My point is and will continue to be that private companies have less waste and more competition than some monolithic government buracracy. And the government admits 20-30% waste in medicare/medicaide so even your profit plus actually paying people to do their jobs at private companies ends up being much cheaper.
You know why healthcare is so expensive? Because the people who have an income already have to subsidize people who get free healthcare. And Obama just dumped another 30 million people into the system. You think that is going to make it cheaper??
Take a 6,000 dollar bill. Now, you are only 1 out of 3 people who has insurance. The hospital still needs to pay for all it's staff and costs so they triple the bill. Now the bill is 18,000. But they are not done yet. They know that the insurance companies and the government will only pay a fraction of the bill so they multiply it again *3. Suddenly a 6,000 dollar bill becomes a 54,000 dollar bill.
You are not going to make healthcare cheaper by adding in millions upon millions of people who by definition cannot pay....
I don't know where to begin here. Firstly, how can insurance companies make money? Firstly they can insure only those who will rarely require payouts. They can raise their rates so the payouts are significantly less than what is taken in. They can attempt to reduce the cost of their payouts, or they can increase the size of their pool, making it random enough such that those who require payouts are far less than those who do not. The last is the basis of the ACA. Having 100 20 year olds pay into the fund should offset carrying only a few 60 year olds. As a matter of fact, this is how the ACA is working it. Because barring pre-existing conditions or even raising their rates is no longer allowed, they simply base the premiums on age and let their actuarials work the magic of averages. I am 61 and in great shape. If I add up all of the premiums I have paid and subtract what I have gotten from my insurance companies they have gotten a damn good deal. But my brother has most likely used up what those insurance companies have saved on me.
Health insurance companies now have a problem. With auto insurance, I can get a lesser rate because I have not had a ticket or an accident, and of course a bad driver will have to pay more. Idealy, before ACA, I could get a break because I am in good health, now I cannnot - that is what comes with the prospect of covereing pre-existing conditions. Of course the insurance companies brought some of this upon themselves by cherry picking to the extreme. As I have said, when I took blood pressure meds - they could have accepted me and still made a long term profit.
And you are correct, there is no longer a reason for insurance companies to attempt to cut costs, all they have to do is pass the extra on to the rate payers and of course, ultimately to the government, more ultimately, to us yet again in taxes.
So I guess we agree so far (I hate that btw).
The inherent problem with insurance is that they divorce the actual consumer from actual cost. In my case I am not even allowed to shop for the best healthcare price because if I go out of network I get no help from my insurer. Admittedly we can't always shop, I would have a problem dickering with an ambulance company or the doctor at the ER while I am afibing on the table. The best way to see that though is by watching elective surgery. I recently went shopping for my wife's tummy tuck. She lost a lot of weight and looks great but there is some skin left - The prices and offerings are all over the map but none are outrageous.
Where we differ is on who pays what. Without the ACA, we all pay for the most expensive proceedures, for those who until recently did not have insurance. We pay through higher premiums, higher taxes and higher hospital bills. Now at least we can force at least some of those people to pay at least some of the cost. Though, again in agreement with you, if you examine the subsidies, they are HUGE - 3, 4 or 5 hundred dolars a month paid directly from the government to the insurance company - per person or per household. I can't see how even a larger pool can manage such a burden.
No, in my opinion, the ACA as it now stands, will not reduce the cost of care. That it has not gone up much in the last year, I believe, has little to do with the program. We will see though.