"Everyone hates it" because it's been politicized.

From an economics perspective I like it more than I hate it. It should help to reduce costs over time which are dramatically out of control due to periods of deregulation and lopsided regulating after that.

At one point I had to learn about the technological systems and processes behind our health care in this country for work. They are just about the worst. It's not the government's fault either. It's kind of due to the nature of how the marketplace came to be and the early days of technology.

The tangled mess of systems that providers and insurers created during the deregulated periods was designed to do a few different things on the insurer side - automate claims denial and limit the amount awarded from claims. This led to absurd requirements for provider submissions and no standardization. You have systems and standards that can not talk to each other without intermediaries and manual processes which means more cost due to higher administrative headcount. Additionally, on the provider side it necessitated overbilling for procedure charges since insurers constantly attempt to negotiate them lower.

These things have caused the astronomical administrative costs we see and an overflow of those costs into the care process so that it doesn't look quite so bad. Now, administration personnel are heavily in demand and often highly compensated in senior and executive level positions. The growth of this administrative structure to deal with all of the mess of billing and insuring is parasitic and expensive.

...

This was recognized to some degree. The end result was the HIPAA and HITECH laws, but they're not enough and trying to undo years and years of absolutely horrendous practices by industry and providers.

We have to do something to force insurers and providers to follow some kind of standard process. They just continually diverged into a sort of technological and process chaos when left to their own devices.

If you see here - Affordable Care Act - Centers for Medicare & Medicaid Services Some of the things on the law that they don't talk about in common media presentations are actually regarding process and technology standards.

Anyway, I wrote a lot of nerd crap but it's important and one of the things we should be talking about if we're concerned about health care costs in the US.