Why Do Republicans Oppose A Public Healthcare Option?

[Truck Fump / h1b]

I agree. FEMA's flood insurance response in Katrina was absolutely awful. Worse, FEMA because they lost so much paying out in the last few years for claims colluded with the USGS to redraw flood plain maps nationwide and enlarge them massively. What this resulted in was tens of thousands of new home buyers and tens of thousands more homeowners suddenly finding out that they were now magically in a flood plain where they never were before and were now required to buy flood insurance as part of their mortgage. This allowed FEMA at a single stroke to make billions in new policy payments to cover their losses.

This is the sort of thing you can expect from a national health insurance program. Since the government has no one to check them they can and will increase taxes / rates on such a program as they wish to cover costs. There will be little in the way of forcing them to be efficient or cost effective. As with Medicare and Medicaid, they can also force providers to take payments below actual costs leading to providers leaving the market and resulting in shortages and lower quality of care.

do you think insurance companies are doing a good job in allowing the price discovery mechanism of free markets to set prices in the health care field?

 

[PostmodernProphet]

because government should not compete with private business......

 

[PostmodernProphet]

do you think insurance companies are doing a good job?

I like mine......my Medicare Advantage plan is run by Priority Health Insurance.......it costs me an additional 8.22 a month over the Medicare premiums........that covers my prescriptions and even my health club membership......

 

[Truck Fump / h1b]

because government should not compete with private business......

yeah, private businesses don't like that.

plus, human desperation keeps wages low.

 

[IBDaMann]

Those numbers for "medical Tourism" are the same year after year.

Sure. In any industry, you can find cheaper quality for a lower price.

Everyone is allowed to "shop around" for a lower price for their medical procedures. Of course they assume all associated risks.

I know people from other countries who schedule medical procedures to coincide with their visits back home. There is nothing wrong with that. Of course the same standards are not maintained, the currency requirements aren't the same and there really is no recourse if something goes wrong, especially if a problem develops after the patient has returned to the US.

But as long as the risks are known and accepted, yes, lower prices are sought elsewhere every day.

 

[Truck Fump / h1b]

Sure. In any industry, you can find cheaper quality for a lower price.

Everyone is allowed to "shop around" for a lower price for their medical procedures. Of course they assume all associated risks.

I know people from other countries who schedule medical procedures to coincide with their visits back home. There is nothing wrong with that. Of course the same standards are not maintained, the currency requirements aren't the same and there really is no recourse if something goes wrong, especially if a problem develops after the patient has returned to the US.

But as long as the risks are known and accepted, yes, lower prices are sought elsewhere every day.

do you think insurance companies are doing a good job in allowing the price discovery mechanism of free markets to set prices in the health care field?

 

[T. A. Gardner]

do you think insurance companies are doing a good job in allowing the price discovery mechanism of free markets to set prices in the health care field?

Not particularly. Try this on one of those price comparison sites for auto insurance... Put in different zip codes for the area you live in and see what pops up. Health insurance companies use somewhat different criteria but they too charge differing rates depending on the state and location within that state you live.

Of course, one of the biggest contributors to health care costs is that the supply of physicians and other providers is kept artificially low. There are only so many schools of medicine in the US and graduates from foreign schools may not have accepted credentials for practice in the US. This means that there is a perpetual doctor and other provider shortage driving prices up. Dentists are actually the worst offenders for this. When you toss in that many health care jobs require a gross amount of overkill in education, it doesn't help a bit either.
The education industry is the same way. Why does a 4th grade teacher (say grades 1 to 6) need a master's degree other than a high school diploma is no longer a guarantee that you actually have anything close to a high school education?

 

[IBDaMann]

it's just that military black budgets alone could buy healthcare for all 10 times over.

Whoever told you that has led you astray.

If you had just run a few quick rough numbers, e.g. 320,000,000 Americans x $60K = $19.2 Trillion whereas entire 2019 DoD budget < $700 Billion. If we drill down further, SOF budget is < $17 Billion and let's add the entire budget for the Intelligence Community (for which there is overlap) at roughly $60 Billion ... $77 Billion isn't going to cut it.


This is why socialized medicine doesn't work. You end up with what Canada has, i.e. waiting lists measured in years, closed clinics and very little healthcare actually available.

 

[Truck Fump / h1b]

Whoever told you that has led you astray.

If you had just run a few quick rough numbers, e.g. 320,000,000 Americans x $60K = $19.2 Trillion whereas entire 2019 DoD budget < $700 Billion. If we drill down further, SOF budget is < $17 Billion and let's add the entire budget for the Intelligence Community (for which there is overlap) at roughly $60 Billion ... $77 Billion isn't going to cut it.


This is why socialized medicine doesn't work. You end up with what Canada has, i.e. waiting lists measured in years, closed clinics and very little healthcare actually available.

I said black budgets.

 

[Truck Fump / h1b]

Not particularly. Try this on one of those price comparison sites for auto insurance... Put in different zip codes for the area you live in and see what pops up. Health insurance companies use somewhat different criteria but they too charge differing rates depending on the state and location within that state you live.

Of course, one of the biggest contributors to health care costs is that the supply of physicians and other providers is kept artificially low. There are only so many schools of medicine in the US and graduates from foreign schools may not have accepted credentials for practice in the US. This means that there is a perpetual doctor and other provider shortage driving prices up. Dentists are actually the worst offenders for this. When you toss in that many health care jobs require a gross amount of overkill in education, it doesn't help a bit either.
The education industry is the same way. Why does a 4th grade teacher (say grades 1 to 6) need a master's degree other than a high school diploma is no longer a guarantee that you actually have anything close to a high school education?

but insurance companies are pure, of course. they work strictly on a cost plus basis.

 

[T. A. Gardner]

but insurance companies are pure, of course. they work strictly on a cost plus basis.

Depending on the insurer, they are anything from good and trying to make a reasonable profit to horrible and just short of illegally scamming you.

 

[Truck Fump / h1b]

Depending on the insurer, they are anything from good and trying to make a reasonable profit to horrible and just short of illegally scamming you.

maybe the unnecessary middleman is just stupid. maybe articifially fucking up the market is part of the eugenics program.

 

[BattleofHodow]

Whoever told you that has led you astray.

If you had just run a few quick rough numbers, e.g. 320,000,000 Americans x $60K = $19.2 Trillion whereas entire 2019 DoD budget < $700 Billion. If we drill down further, SOF budget is < $17 Billion and let's add the entire budget for the Intelligence Community (for which there is overlap) at roughly $60 Billion ... $77 Billion isn't going to cut it.


This is why socialized medicine doesn't work. You end up with what Canada has, i.e. waiting lists measured in years, closed clinics and very little healthcare actually available.

Yeah, well the USA, spends 11,000 dollars a year, and Canada 5,000 dollars a year on healthcare.

https://www.pgpf.org/chart-archive/0006_health-care-oecd

Imagine, how fast wait times would be if the USA had the same government funding put into the system Canada has.

 

[T. A. Gardner]

Yeah, well the USA, spends 11,000 dollars a year, and Canada 5,000 dollars a year on healthcare.

But in the US you get what you pay for. In Canada you get to stand in the healthcare line, sort of like the bread lines in the old Soviet Union or the toilet paper line in Venezuela...

Imagine, how fast wait times would be if the USA had the same government funding put into the system Canada has.

I don't have to imagine. Military medicine is like Canada. You are told to report at 0800 for say a yellow fever shot because your record says you need one. You show up at 0800. They put you in the queue. If you are an officer or senior NCO (E-7 to 9) you get head of the line privileges so your wait is only an hour or two. If you are lowly enlisted scum they see you around 1400 and take all of two minutes to give you the shot and send you on your way.

That's scheduled, routine, care. You are a "walk-in" for sick call or something, you will be seen by "knock off" at 1600--maybe. If not, they tell you to come back tomorrow.

The funding doesn't make a rat's ass difference in wait times. If you have X number of providers the process is based on that number not the cost. In Canada the major problem is the government cost controls the pay of providers so there is a shortage based on how many will work for that pay. Those that know they can make more leave Canada and come to the US (or go elsewhere) and make more. They don't stay in Canada.
The same goes for stuff that requires expensive equipment. In the US you can go to a private company and get a CAT scan for relatively cheap.

https://www.mdsave.com/t/imaging-radiology/ct-scan

That company offers various CAT scans for $162 to $400 if you need one. You walk in, get your scan, pay and walk out.

In Canada wait times for a "free" CAT scan is anywhere from 5 to 25 weeks.

https://www.todocanada.ca/wait-time...t,(MRI) scan, and 3.4 weeks for an ultrasound.

You get what you pay for.

 

[BattleofHodow]

But in the US you get what you pay for. In Canada you get to stand in the healthcare line, sort of like the bread lines in the old Soviet Union or the toilet paper line in Venezuela...





I don't have to imagine. Military medicine is like Canada. You are told to report at 0800 for say a yellow fever shot because your record says you need one. You show up at 0800. They put you in the queue. If you are an officer or senior NCO (E-7 to 9) you get head of the line privileges so your wait is only an hour or two. If you are lowly enlisted scum they see you around 1400 and take all of two minutes to give you the shot and send you on your way.

That's scheduled, routine, care. You are a "walk-in" for sick call or something, you will be seen by "knock off" at 1600--maybe. If not, they tell you to come back tomorrow.

The funding doesn't make a rat's ass difference in wait times. If you have X number of providers the process is based on that number not the cost. In Canada the major problem is the government cost controls the pay of providers so there is a shortage based on how many will work for that pay. Those that know they can make more leave Canada and come to the US (or go elsewhere) and make more. They don't stay in Canada.
The same goes for stuff that requires expensive equipment. In the US you can go to a private company and get a CAT scan for relatively cheap.

https://www.mdsave.com/t/imaging-radiology/ct-scan

That company offers various CAT scans for $162 to $400 if you need one. You walk in, get your scan, pay and walk out.

In Canada wait times for a "free" CAT scan is anywhere from 5 to 25 weeks.

https://www.todocanada.ca/wait-time...t,(MRI) scan, and 3.4 weeks for an ultrasound.

You get what you pay for.

Canada's wait lines are higher, because of less funding for facilities, or staff.

At the same time, America's prices are higher, because of profit margins, and jacked up prices.

Canada's system, with a bit more funding, would definitely save us money & save lives too.

 

[T. A. Gardner]

Canada's wait lines are higher, because of less funding for facilities, or staff.

A result of government rationing of health care.

https://www.fraserinstitute.org/art...hortage-will-only-worsen-in-the-coming-decade
https://www.thecanadianencyclopedia.ca/en/article/canadas-doctor-shortage-worsening

Canada caps salaries for health care workers below market value. They have difficulty keeping people in their system because they can make more in the US and elsewhere. Funding is based on what tax burden the country can endure. So, for Canada they are doubly screwed. They can't afford more taxes to pay higher wages to health care providers not can they fund more equipment in facilities.

At the same time, America's prices are higher, because of profit margins, and jacked up prices.

Canada's system, with a bit more funding, would definitely save us money & save lives too.

Most of America's higher costs are due to providers having to cover the cost of unpaid billings by those that choose not to pay or cannot pay. In the case of pharmaceuticals, the higher cost of newer drugs is due to having to recoup the R & D costs within the patent period and being unable to spread that cost to many other countries that cap prescription drug costs.

Adopting the Canadian system might save some money but it will cost both lives and the quality of life for many Americans.

 

[Nordberg]

The old Canadian wait times thing again. A Candian feels shitty, he goes to the doctor the next day if he wants to. I call my doctor and get an appointment in 3 to 5 weeks.. If I feel really bad they say go to emergency. If I want an appointment with a specialist, wait times are much longer.
I live outside Detroit. When I go to Canadian family parties, I always jab their healthcare. Not once, have I ever met one who wants to trade for our system. They laugh and ask why we put up for this shit.
I know a Canadian who waited a long time for an operation. They tried several different procedures before they gave him a heart transplant. He got it 20 years ago. No cost, no copays, no fighting insurance companies. No 20 page hospital bills.

 

[T. A. Gardner]

The old Canadian wait times thing again. A Candian feels shitty, he goes to the doctor the next day if he wants to. I call my doctor and get an appointment in 3 to 5 weeks.. If I feel really bad they say go to emergency. If I want an appointment with a specialist, wait times are much longer.
I live outside Detroit. When I go to Canadian family parties, I always jab their healthcare. Not once, have I ever met one who wants to trade for our system. They laugh and ask why we put up for this shit.
I know a Canadian who waited a long time for an operation. They tried several different procedures before they gave him a heart transplant. He got it 20 years ago. No cost, no copays, no fighting insurance companies. No 20 page hospital bills.

Well, that explains that... You live outside Detroit...

Here in Phoenix if I need to see my personal quack the appointment is usually 2 to 3 days. If I feel bad and the like there's Urgent Care open most of the time and able to take care of it right now. Waits are usually no more than an hour or so. Specialist? That depends but its usually under a week for an appointment... at least it is for the wife-- I rarely go see a quack about anything.

 

[Mott the Hoople]

Because they cannot make money off it.

That’s not quite true. France has the best health care system in the world, in terms of outcomes, at about half the cost per GDP vs the US. France has a private system with a public option.

However to make those savings and achieve those outcomes they have made it mandatory that private health care operate as non profits. They have either reinvest profits in operational costs, capital cost or labor costs. Profits not reinvested are returned to premium purchasers.

So how does this work? Because there’s still competition between private sector insurance providers as salaries, raises and bonuses are tied into efficiency. An executive manager can still earn substantial bonuses and salaries.

Does this cost more than purely socialized systems? Yes, significantly so but far less than the insanity which is the US “Supply Side” Healthcare system in which costs and outcomes are secondary to profits.

I think that we will be seeing more calls for Healthcare reform as a fallout from the opiate crisis which is a prime example of why deregulation in healthcare is a real bad idea. With forethought and malice some pharmaceutical companies, solely due to greed, created the opiate epidemic and made over a hundred billion in revenue at a cost to our nation of several trillion dollars, not to mention the human cost.

The accountability stage has began as the corporations responsible for this crises and the loss of human life are being held accountable are getting their asses sued off. Purdue Pharmaceutical has already filed for bankruptcy protection and Johnson and Johnson and Cardinal Health are knee deep in the shit too. I’m not convinced though that they will be held fully to account as we all know that ultimately our system is rigged to protect these drug lords.

What the American public is waiting to see is if we see a repeat of what happened in 2008. Will these companies get bailed out from complete financial ruin by the government and will the executives at these companies responsible for the huge cost and loss of life be held criminally accountable? Fuckin Pablo Escabar was a rank amateur compared to these assholes.

So far not one major pharmaceutical executive has been arrested or criminally prosecuted and only a handful are looking at the financial loss of their ill gotten gains. So if we have a repeat of 2008 it will just be another example of just how badly our system has become rigged when these pricks with blood on their hands walk away scott free with their blood money while us taxpayers pay trillions of dollars to repair the damage they have done.

I’m so cynical now I doubt that a single one of those pricks does a day in jail when they should be tried as murderers and executed just like any other fucking drug lord.

Now that I’m off my soap box and getting back to your question is why the hell would they permit a private/public option when there’s so much money to be made and our system is rigged against by our emerging oligarchy?

Obama’s single greatest legislative legacy is also his greatest failure. At that time he could have implemented a public option with an existing and workable framework already in place that would have been hugely popular and a third rail for conservative politicians. That is a public option to by into Medicare via your payroll tax.

Instead Obama came up with this Rube Goldberg device, the PPAACA or ACA for short. Which is to be far to complicated. His rational was he wanted bipartisan cooperation from Republicans instead of just unilaterally having Democrats implement a public option via Medicare. Well that backfired on his ass as he couldn’t get any bipartisan support for the ACA so Dems had to implement the ACA unilaterally. Irony of Ironies.

So the answer to your question as to why Republicans (or Democrats for that matter) won’t support a public option is why should they? We have a system rigged in the favor of the powerful and wealthy and they don’t need to give two shits about us. Let us eat cake is the reality of the situation and we will never see any meaningful reforms to our healthcare system by either party until we’ve dealt with inequality and denutted the Oligarchs who now rule our nation.

 

[Truck Fump / h1b]

A result of government rationing of health care.

https://www.fraserinstitute.org/art...hortage-will-only-worsen-in-the-coming-decade
https://www.thecanadianencyclopedia.ca/en/article/canadas-doctor-shortage-worsening

Canada caps salaries for health care workers below market value. They have difficulty keeping people in their system because they can make more in the US and elsewhere. Funding is based on what tax burden the country can endure. So, for Canada they are doubly screwed. They can't afford more taxes to pay higher wages to health care providers not can they fund more equipment in facilities.



Most of America's higher costs are due to providers having to cover the cost of unpaid billings by those that choose not to pay or cannot pay. In the case of pharmaceuticals, the higher cost of newer drugs is due to having to recoup the R & D costs within the patent period and being unable to spread that cost to many other countries that cap prescription drug costs.

Adopting the Canadian system might save some money but it will cost both lives and the quality of life for many Americans.

how about corporate rationing of healthcare? don't care?