Medicare is a two-tier system which is why a majority of Medicare patients carry some type of supplemental insurance. In fact, most single payer systems are two-tier with single payer providing basic healthcare and the supplemental insurance providing add-on coverage. When the US adopts single payer, you can bet it will be two-tiered.
I don't think people running to doctor for frivolous reasons are a problem today and looking at Obamacare it's certainly not going to be one in the future. The days of no or low deductibles, coy-pays, and co-insurance are a thing the past. Deductibles have been rising for years and Obamacare is giving them another push up.
Actually, the higher deductibles that many people face under Obamacare does exactly what conservatives have been pushing for years, having the customer pay a larger share of their healthcare. Conservatives have long claimed that if the customer pays a larger share, they will be more prudent with their healthcare dollars and shop for services. In the long run, I think Republicans may actually become more supportive of Obamacare than Democrats.
If control of congress were evenly split, I think the Democrats would have pushed single payer and Republicans would have backed a bill that contains much of what is in Obamacare.
There are a couple of points I'll address, but this thread is about a moron named Paul Krugman talking out his ass and one of his (bigger) moron worshippers not understanding that what he cited was just more Krugman horseshyt.
So...I like the idea of higher copays or the idea of being able to manage more of my health care costs. When my company first started our HSA program, I jumped right on. I now have a significant sum of money in my HSA. My monthly premiums are lower.
Under Obamacare, deductables are going up and so are premiums...in many cases by a great deal. You can't spread more insurance onto people who don't currently pay it (and supposedly can't afford it) and then wonder why everyone else isn't going to pay more.
That is why they are forcing these more expensive plans on people.
The idea of pre-existing conditions didn't just suddenly appear under Obamacare. it is unfortunate that this crappy way of doing things had to be "solved" with a POS bill.
What really used to piss me off was that people could be dropped from plans if they got sick. Insurance commissioners in most states let that happen (you know...the government). Nobody could ever explain to me how insurance was insurance if it could be taken away.
There are things that needed to happen to fix some problems with the system.
Obamacare is a really sad commentary on America. We don't think we are smart enough to take care of ourselves...so we hand it over to some of "us..as in we" to do it for us. And look what we get.