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I can't imagine that the level of subsidies they are offering will continue, and costs will probably rise. But, Medicare will still be taking care of the 65+ set, so that should keep some costs down for Obamacare at least.

Known and fairly-well-understood market forces have caused prices of many things (relative to, say, the price of an hour of moderately skilled, experienced, reliable labor) to decline substantially. And prices CAN decline because those same market forces cause COSTS to decline.

The main thing wrong with our medical-care system is that we have developed a system of third-party and fourth-party (and even fifth-party) subsidies that, taken as a whole, removes those market forces from a very large share of medical-care transactions. However, the incentives to make prices (and costs) INCREASE remain untouched.

Obamacare seeks to make the removal of those market forces even more widespread. Basically, it artificially forces the price of care down by providing even more third- fourth- and fifth-party subsidies to more people. This means that:
* the cost of any given unit of medical care will go up even faster
* there will be more people seeking those units of medical care than is currently the case.

If something is rising in unit cost and yet increasing in demand, the total amount that SOMEONE is paying for it must increase - or the amount of that something delivered to the customers must decline.

Medicare and Medicaid are already expensive enough that the government is trying to control total costs by arbitrarily setting the fees it pays doctors and hospitals low - too low, below the costs those doctors and hospitals have to pay in order to provide care. As a result, there is a movement among some doctors to not accept new patients who are on those programs, and occasionally even to fire existing patients on those programs.

There is absolutely no reason to believe Obamacare will be different - other than perhaps worse, because it is more universal and with more insertion of bureaucrats between doctor and patient.

Of course, some people believe that Obamacare is designed to fail, and then will be described as a "free market" (that has already begun), so that it can be cited as proof that a free market doesn't work in medicine and we have to have a complete government takeover akin to Britain's National Health Service - the most thoroughly socialistic and among the worst of Europe's "socialized" medical-care-payment systems.

However, that socialized system (if it occurs) will actually even FURTHER shelter medicine from the market forces that might force the cost of a unit of care down. Thus it will fail in the same way, as the NHS has.

You'd think that such massive systemic failures would be rare (outside of functions that are naturally purely government, such as police and military and judiciary), but there's another glaring example - for pretty much the same reasons: education.

And having the national government bail out state and local governments on the issue? The larger the population subsidizing a good or service, the easier it is to think that "someone else" is paying the subsidy. A progressive tax system also makes it easier to think that "someone else" is paying. In other words, further shelter from market forces.
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