Republicans - What's your answer to rising healthcare costs/lack of coverage?
To all republicans/conservatives on WSO,
I'm curious what your suggestions are towards combating this issue (contrary to what the leftists believe, I don't think all republicans are douchebags that don't care about the average person).
I'm pretty moderate but I've definitely started leaning more "left" when it comes to healthcare, and believe every american should have some sort of government option (NOT medicare for all). What do you all think?
This question always seems to end up with person a saying “if Canada can do it so can we!” and person b saying “bro, my aunt is from Canada and refuses to do anything but cross the border into the US for healthcare”. it’s a trade off. Do you want a system where everyone is guaranteed a minimum viable product? Or do you want a system whose incentives facilitate the world’s leading drugs and care? If the latter, you may find yourself 75 and SOL when you can’t afford a million dollar gene therapy to cure your terminal cancer. If the former, you may find yourself SOL when you can’t afford to fly to the country where you can get said therapy - and you’ll be triaged out in the socialized system because younger patients are prioritized. Maybe the dumbest argument you could have in this day and age; it’s a completely ideological / emotion driven conclusion whichever you choose to arrive at.
Canada has a smaller population than California
I think you have to set aside some of the core false premises that claim the U.S. health system is bad or broken. It's not only not bad, it's the best system in the world. When you adjust life expectancy for car crashes and murder, the U.S. leads the world in life expectancy, this despite the fact that the U.S. is a world leader in obesity (which is an issue with culture, not health care). You see ridiculous claims about the U.S. falling behind in infant mortality, but they won't tell you that infant mortality is a calculated statistic that varies widely throughout the world, with the U.S., unsurprisingly, having among the most conservative of methodologies for calculating infant mortality. The U.S. has the leading cancer survival rates. When you get sick, you sure as hell better hope you have private U.S. health insurance.
Also, when you eliminate from the statistics illegal aliens, people temporarily uninsured (i.e. for a month or 2 between jobs), people who can afford insurance but actively choose not to get it, and those who are covered by public programs who don't know about it so don't sign up, there are only about 5 million people, in a nation of 330 million, who are structurally uninsured. There is simply not an epidemic of the uninsured in the U.S.
That said, health care, like housing and higher education, has been badly harmed by government intervention. The very fact that employers often provide insurance is a fact of WW2-era gov't wage controls. Next to banking, healthcare is the most regualted industry in America. The regulatory regime must be unwound or health care costs will continue to skyrocket.
Also, consumers don't understand how health insurance should work. All insurance--homeowners', renters', car, life, tornado, flood, etc.--operates under the premise that the beneficiary is covered only in the event of catastrophic incidents (catastrophic relative to the value of the underlying asset); health insurance should--but often doesn't--get treated like this. Nearly every single consumer (with maybe some rare exceptions) should carry catastrophic insurance with a low ($~100/month) premium and a $5,000+ deductible. Consumers should pay for everything below that in cash and should take the time to thoughtfully consider their health purchases--shop providers, shop and negotiate prices. Consumers should max out their health savings accounts, if available.
I do all those things--carry a low premium, high deductible, max out my HSA, and shop my services and negotiate prices. My health coverge is relatively inexpensive and is platinum--I'd put my access to top providers and excellent cost against anyone in the world.
As an aside, next time you get a procedure done, ask what the cost is when you pay with insurance. Then ask the cost if you pay in cash. I assure you the cost will be WAY lower if you pay in cash. I got an ingrown nail removed from my toe in fall 2019--the cost was HALF when I paid in cash rather than submitting the claim through my insurance company. HALF.
The solution is cash. Not more regulation. Not a gov't takeover of health care.
Interesting. I’ve been on the side of socialized healthcare from reading various stats. Your comment gives me a lot to read about whenever I find the time. Good content and good stuff.
Normally you and I disagree politically but I’ll concede, if the stats and data back up what you’re saying I’ll switch my viewpoint.
Great response. I'll add an aside: part of what complicates discussions of efficacy of health care policy is treating price and cost as interchangeable concepts. They're not.
If someone goes to the doctor for the sniffles in a country where their care is covered by their government, then the price to them is zero. The costs still exist - the patient goes to a facility, which is maintained and staffed, and seen by a doctor, who had to go through a mandated level of training, who then has to be paid for that experience, and supplies or tests or other ancillary procedures are performed that each have their own material, development, and processing costs.
It's easy to develop per-unit (in this case, per-patient or per-procedure) cost models in systems that are deregulated and relatively open, because there will be some relationship between cost and price (and their delta, profit). We can argue all day about how much profit would/should exist in a well-performing system, but we do know that economic reality would at least force those concepts to be tied.
We don't have that today in any healthcare system that isn't overwhelmingly cash-pay. We see it in elective medicine all the time - I guarantee that LASIK surgeons know exactly what their costs are, and adjust their prices appropriately. Other semi-elective practices aren't far behind - dentistry, ophthalmology, orthodontia, fertility, and others are moving toward a model that far better understands costs.
Any price-setting (which is what Medicare & Medicaid do) destroys the relationship between cost and price, and eliminates the ability to use the price of items as any sort of proxy for their underlying aggregate cost. Hospitals do their best to figure out which procedures lose them money and why, but when their line items show that band-aids cost $56, then that's not a very effective proxy.
There are some actions that very clearly take cost out of the system. Loosening regulatory restraints on practice is one - if your state mandates that you have to see an MD for the sniffles (who had to go through 4 years of med school and a 3-year residency and is a more expensive resource because of it) instead of seeing a physician's assistant (who went to a 2-year post-bac program, is half the cost, and shows absolutely no difference in patient outcomes), that reduces the cost burden on whoever is paying. Mandating interoperability of information systems between pharmacies enables consumers wider choice for where to buy their medications and to understand how much it will cost them. Setting drug prices doesn't do a damn thing to the underlying costs of the system.
Tl;dr: Look under the hood when someone shows you healthcare cost data - it's likely pricing data, which isn't the same thing.
Sb'ed - great response. Definitely gives me a lot to think about.
Lol glad you do not think all republicans are douchebags, that would be a little simple minded. Most of us would love if we could all have free healthcare and actually get good treatment. The problem is the cost, if we all get it for free you will not get good care. For instance right now a lot of the cost comes from subsidizing. To think one side does not care for people because they call out a system cannot function is a emotional viewpoint that’s not logical.
You essentially with the options given have to choose better healthcare or significantly worse and free. Someone above me posted a more in depth post showing actual stats on it .
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I am generally very well-read on most major policy issues and can articulate a rationale one way or another on most. HOWEVER, health care policy is incredibly complex and I would have to expend a significant amount of time and effort in order to truly understand it . . . I'm talking studying for the CFA amount of time. I'm not going to do this, so when healthcare policy is discussed I just admit my own ignorance and listen.
One thing I will say is that I have a couple of broad beliefs that would make me highly unlikely to support any plan that ran counter to them:
Healthcare is not a human right. It is a good thing and we should assist the less fortunate in obtaining it. But anyone that claims it is a "right" has no fucking clue how the real world works and is a big dum dum.
There has to be skin in the game. If there is no out-of-pocket cost for healthcare, then unnecessary treatments/visits/whatever will drive aggregate healthcare costs higher. The exact details can be fine-tuned, but consumers must pay something out-of-pocket.
Yes and yes. Skin in the game is huuuugeee and nobody has a right to someone else's labor.
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