The GOP's Amusing Fixation On Health Care "Choice"

[eniwetok]

The obvious problem with the GOP's claim about wanting more "choice" in health care is

1: Having numerous options to be under insured or to have access to plans with outrageous deductibles is NOT a choice worth having

and..

2: CHOICE IS EXPENSIVE. It's expensive to administer all those health care plans each with its own pool of cash, different coverage and exclusion rules, different networks, and billing procedures.

Sometimes it's cheaper just to have one plan that covers everything for everyone.

But then the GOP would rather see ALL that money pissed away on needless administration costs, high CEO pay, advertising, profits to shareholders, etc than to see that same money be used to provide real care to the American People.

Of course "choice" is also the only way the GOP can sell a disastrous and inefficient health care model as desirable!

[subterranean]

1. "Expanding choice," "empowering patients," "consumer-driven"

all of those are euphemisms that mean the same thing: shifting more of the cost burden onto health care users and more millions into the bank accounts of insurance executives.

[eniwetok]

3. you said it better than I did...

I think I may borrow that for another forum! LOL

and I did... http://www.wbur.org/onpoint/2017/03/03/sessions-russia-trump-congress#comment-3184713288

[taught_me_patience]

6. How do you figure?

In a competitive market, generally, expanding choice means that costs are driven down because consumers are free to shop around for products that fit their needs best and the lowest prices. The more competitors there are in a market, in general, the less "profit" will be made.


please note that I'm talking about within a market only, which is what we have now. Universal single payor would lower costs through economies of scale.

[eniwetok]

7. Single Payer does more than just "economies of scale"

Somewhere we got the idea that competition leads to efficiencies. This comes from seeing prices sometimes decreasing in the market. No one looks at how efficient an entire economic sector is. For instance... VHS and Beta competed... but from the consumer's point of view they only got to pick from two inferior products instead of a theoretical VCR that contained the best ideas from Sony and JVC. So the market had to support two design teams, two manufacturing streams, multiple distribution streams, and retailers offered less choice in movies because they were in two formats. Eventually those investing in Beta lost their bet... and all that was left was the other inferior choice: VHS. This was the furthest thing from an efficient market. Capitalism has great competitive overhead.

Single payer isn't like building widgets. It designed to get rid of administrative inefficiencies... and wasteful competitive overhead... profits, high exec pay.

[Demsrule86]

13. Insurance does not work in the market...and never will.

The only way to make money is to deny care or raise premiums. That being said we can't get single payer right now...so what we have must do. Tax credits are a non-starter because they only help those with money...without subsidies health care will not be affordable to most. I have a plan through hubs job high deductible they pay nothing until we meet it...paid out 16,000 out of pocket in two years. Wait until you get seriously ill for more than one calendar year and see how you like this plan you talked about on another post...or have an accident. The GOP is set to destroy affordable health care ...make no mistake.

[taught_me_patience]

19. Change your plan, then

That's what choice is all about. You're high deductable HSA is not working for you, so change to a more traditional plan. Your post proves that more choice is better for the consumer.

[Demsrule86]

21. Hubs was forced out of his job two years ago at 53 and

has retirement insurance but it is a shitty plan...But we have it...we could never get subsidies and without that insurance is not affordable...the jobs he gets though temp agency would cost $1200.00 a month. But if you have insurance available, you are not able to get subsidies... thus I have looked at 'market' insurance and it is bull shit... there is no way it would ever work for most people. You seem willing to let thousands of poor folks die without insurance... as long you get what you want.

[eniwetok]

25. Sorry Einstein... there is NO choice for Single Payer...

So if all your "market" approach can offer... are plans that either exploit, underinsure, or gouge consumers... THAT'S NOT A CHOICE!

[eniwetok]

16. so let's look at the hard numbers...

According to the OECD which calculated the per capita costs in current US dollars... We spend $8714.90 where Canada spent about 50% of what we do: $4289 and THEY COVER EVERYONE.

Obviously Canada has wrung the inefficiencies out of their system while we haven't. Any weaknesses in the Canadian system critics complain about could easily be fixed if they just went to 60 or 70% of what we spend.


numbers here: http://www.democraticunderground.com/10028683904

Claiming that competition guarantees efficiency is a ludicrous claim. Competition may be a motivator to create efficiencies internally, but it's just as likely companies that have patents use those patents to create virtual monopolies... or as the NYTimes documented artificial hip manufacturers have gone so proprietary that they've created special tools for their products and often company reps sit in on operations. The net result is the replacement hip alone in the US alone costs as much as the entire operation in other nations.

[taught_me_patience]

17. You have completely missed my point and clearly did not read my post

where I said that single payor would be more efficient than what we have now. However, within a market, which we have and will have for the forseeable future, more choice and more competition will tend to drive prices down.

[eniwetok]

20. sure I did...

You basically regurgitated right wing pro-market rationale for competition... even if it's pretty clear competition did NOT bring down health care costs. And then your misrepresented the savings from Single Payer coming only from economies of scale. It's YOU who seems not to understand my critique of your claims. The basic dynamic at work here is in a competitive market companies will eat up every available dollar... where a huge percentage will be diverted to competitive overhead, and only the government can reign that in. Even the public option... designed to bring competition to the market, would not be able to reign in the dysfunction in our health care sector... one where Big Pharma pisses away more on promotion than actual R&D.

But I get it... you seem to LIKE the right wing approach to health care.

Fine!

[Demsrule86]

22. so right wing...why act like this shit works on DU...we all know it doesn't

I question the motives of this person.

[eniwetok]

24. leaving aside the matter of competition...

You wrote "However, within a market, which we have and will have for the forseeable future, more choice and more competition will tend to drive prices down."

Leaving aside the fact that competition has not reduced spending... WHY is the US unable to enact commonsense single payer? Even if we don't go down to Canadian spending levels... if we just cut the per capita spending down from $8715 a $1000 per capita to $7715 that would be 320 billion less in spending... still much higher than Canada's $4289.

And why does the US insist on an employer based system when I bet most employers would love to shed this cost.

Nothing makes any sense except the private health insurers don't want to give up the gravy train, and the GOP is in their pocket... and to accomplish that the GOP has to lie to its base that there's nothing wrong with our system.

[Demsrule86]

2. call your rep...link below...do not wait. We can stop them.

My Rep was very nervous and swore he will not vote for a plan like the one being leaked about...call.

https://www.callmycongress.com/

[eniwetok]

9. Dem or GOPer?

[Demsrule86]

10. I called everyone but I think that

the Dems are good on this issue...the GOP is who we should target...call house and senate...if your guys are all Dem...call districts near you. if they insist on addresses use the house for sale ads. I did call Sherrod Brown's office and said we need a filibuster unless it is one of those weird votes that don't need 60...budget stuff...I also called Portman..even though he just won...this is something he could lose the election on in six years...Ohio extended Medicare.

[Bayard]

4. I called Rep Brett Gutherie's office

And actually got a real person for once. I've called McConnell's office numerous times, you can't even leave a message. Rand Paul's line lets you leave a VM that undoubtedly goes straight into a black hole.

So whether the message actually gets passed on to my Rep is questionable, but at least I feel better about it.

[Demsrule86]

11. I could not leave a message for Ryan today either.

[taught_me_patience]

5. I disagree wholeheartedly

Different situations necessitate different levels of coverage. For example, a high deductable HSA works really well for me and my family. We save significant amounts of money by choosing an HSA and we are tolerant of the risk we are taking by having such a high deductable. HSAs, however, are not for everyone and others might benefit from a more traditional plan.

Even in countries with universal coverage, there are wide arrays of supplemental plans for people to tailor their coverage level to their situation.

[eniwetok]

8. We're running a 580 billion deficit...

TRANSLATION: Giving YOU a tax deduction we can't afford works well for you because your tax deduction is funded by money stolen from future taxpayers. It was so generous for the GOP to propose this.

[eniwetok]

12. the supplemental plans are NOT the issue

Why are you glossing over the universal health care part to focus on gap insurance?

[Demsrule86]

14. There is no chance of universal health for some years most likely.

[eniwetok]

18. and we have our antidemocratic system to thank

There's no LEGAL barrier in the Constitution to Single Payer... Congress is free to tax and spend for the general welfare. All the obstruction comes from the GOP. But the GOP would never have the power it does if not for the system giving them power they don't deserve democratically... or the power to obstruct what the large majority may want.

In that first category we now have the Trump Junta due to the antidemocratic EC which overturned the vote of the People... and the Senate would be in Dem hands if Senators represented people instead of states. Dem Senators represent 33 million more people than the GOP.

In the obstruction department... 18% of the US population now gets 52% of the seats in the Senate... and given Senate filibuster rules Senators that represent 10% of the population can maintain a filibuster and states with 4% of the US population can thwart any amendment.

[Demsrule86]

23. There is no question...single payer would work if done properly

It takes care...look at Vermont. However, the politics make it impossible to get it at this moment. And we can not lose the ACA...some think that would lead to single payer but it wouldn't...not for many years and thousands perhaps millions would die.

[TexasBushwhacker]

15. "Choice" in health INSURANCE has done nothing to reduce provider and drug costs

That's something I've never understood. If the insurance companies were better/more diligent at negotiating reasonable compensation to providers and pharmaceutical companies, then they could provide insurance at a lower cost. It makes no sense that a drug in Canada costs 20% what it costs here. Why is the cost of a routine hip replacement $11K in Birmingham, AL and $74K in Boston? I realize the cost of living and doing business is different, but almost 700% different?

Instead of doing their part to keep healthcare costs down, all the insurance companies have done is pass the costs onto consumers. That's what pushes us towards Medicare for all. Medicare sets the compensation rate, and the providers can either take it or only take private payers.

[dubyadiprecession]

26. If Trump and the GOP are going to try anything, it will be the privatization of medicare.

[Doreen]

27. These companies want money so they are going

to charge a lot more for a lot less. Now, where are they going to get their money when more than half of Americans can not afford health care at all? When supply is to expensive the demand is not going to get it and then the owner of the supply is going to lose a lot because it will just "sit on the shelf." It does not matter how many people die because the ones who are alive or being born still will not be able to afford it.