ACA Repeal/Replace: Progressives Face Moral Dilemma

[Bob Butler 54]

(03-12-2017, 04:01 PM)Mikebert Wrote:

(03-11-2017, 06:08 PM)Kinser79 Wrote: We have to be clear here.  When you say health care you mean the actual provision of care.  That is to say going to the doctor.  I'm fine with viewing that as a right.  Honestly I want sick people to go to the doctor--mostly so they don't make me sick if their disease is infectious.  Enlightened self-interest there.

That being said if we're talking about the paying for the provision of health care then the answer is simple.  Make a deal.  When I was faced with the choice of making a deal with a private doctor or going to the VA I made the deal. 

This is the view of a young person. He says just make a deal. For some things you can make a deal.  When I was young I went without insurance for some years during which time I received injections for allergies and had all four wisdom teeth extracted. Both of the treatments I received were simple things that have been done for a long time, since before the advent of widespread employer-paid insurance.  Thus when insurance came along there was a well-established price for these services and since insurance pays the "reasonable and customary" fees the amount this was set at was reasonable*.  So I paid cash--about a thousand bucks for each, out of my savings. 

But medicine has advanced since the forties.  And the treatments developed since then have big price tags. Had I developed cancer I would be SOL.  The typical initial treatment for cancer is surgical and they are going to want $50K for that, and if first line of attack doesn't work and you need chemo and/or other expensive treatments.  You can rack up a lot more in no time. 

And no, you can't just go to the emergency room.  They only have to treat you if you are at risk of imminent death. By that time you have long been a goner.  But once you show up in that state, the hospital duly provides tons of expensive care to a soon-to-be corpse. 
Makes no sense, but hell we are Americans and stupid is how we roll.    

Also Medicaid is a program for some poor people. Able-bodied guys in my state were not eligible for Medicaid before our Republican governor opted for the ACA Medicaid expansion against the wishes of the Republican legislature.  And when the expansion goes away under Trumpcare they will lose eligibility.  Kids get coverage, and I believe pregnant women and women with small children but I am not certain of this.

*This is why your primary care doctor's fees are so much more reasonable than what specialists charge. People did go to the doctor (i.e. a GP) back in the day.  They generally did not go to a specialist and had procedures done.

Kinser

My experience has been similar to Mikebert's.  As an example, I'm a diabetic.  For many years in my youth I had no health problems.  My company paid into the corporate insurance, which other than a hyperextended knee from playing ultimate frisbee, went essentially unused.  I got an X ray and a pair of crutches out of it.  These days, early in the year, before the deductibles have been paid off, I end up paying $1,000 plus for less than a month's worth of insulin.  The cost of these drugs has tripled in the last few years.  I don't anticipate making a deal with the big pharmacy companies.  They are too much into soaking lots of cash out of the ill.

I was once among the healthy and wealthy.  I remember that feeling of delusional immortality, and might have chosen an out of pocket approach if it was a choice.  It wasn't.  Given I had a full time engineering job, a good health plan came with it.  It wasn't an option to take risks and collect the cash.  I'm also too chicken.  Even then, I'd worry about such things as car crashes and out of the blue severe illness.  Out of pocket, to me, seems too large a risk.

I think one of Heinlein's favorite sayings applies.  "There is no such thing as a free lunch."  Expecting to go out and make a deal seems a silly expectation.  The GOP is optimizing their plans for the healthy and wealthy.  Their supporters are still buying into the "I've got mine, up yours" approach to health care.  I'm still thinking health care is a basic right, that politicians shouldn't look at less healthy parts of the population and proclaim 'drop dead'.  I'd as soon start with an assumption that most everybody should be covered, and try to find as even a way of paying for it as possible.  From my perspective, your father is going in the wrong direction.