Republicans have given up on healthcare

[Matthew]

Healthcare is in the top 3 of concerns for Americans.

For you Canadians, here's how it works in the US. Through my employer I pay about $1500 per month to an insurance corporation for a mediocre family health insurance plan. In the event that i need some kind of medical treatment, I must pay about $5000 out of my own pocket before the insurance pays anything. It doesnt cover dental or many eye expenses.

Increase in these insurance costs has been steady and linear for many decades. To try to address this, in 2010 democrats passed the ACA, which required everyone to buy insurance, created a subsidized insurance marketplace for lower income people, and made many very popular restrictions on what insurance corporations can no longer do to their insurance customers.

Meanwhile, since the 1960s through Medicare, older Americans (who are mostly republican, by the way) can just go to the doctor and the government pays for most of it. This is the model that most democrats would like to see expanded for everyone. In 2010 democratic party leaders went with an existing republican market-based plan in a doomed hope of getting some of them on board with the legislation.

Since 2010, the ACA is widely appreciated for what it does do, but it has shortcomings. Republicans have long vowed to end the ACA. When they controlled the entire congress and the presidency from 2016-2018 they had an easy pathway for doing anything they want to do to change or improve healthcare, but did not do so. They attempted a straight repeal of the ACA, it failed, and that was it.

Today, the republican platform has just this minimal and vague 3-sentence statement on the subject of healthcare:

Is it now safe to say that Republicans have no major ambitions for trying to do anything with Healthcare?

Edited August 17, 2024 by Matthew

[NAME REMOVED]

Republicans look at people over 65 as burdens on society, and want them to die quickly. 

[ironstone]

Shouldn't they have gotten more of this sorted out when they controlled both the Senate and the House? 

[herbie]

1 hour ago, Matthew said:

Through my employer I pay about $1500 per month to an insurance corporation for a mediocre family health insurance plan. In the event that i need some kind of medical treatment, I must pay about $5000 out of my own pocket before the insurance pays anything

Back in the 1990s a friend visited from LA. She was a nurse practioner at a major hospital and told us how she had 'the best' medical coverage and it only cost about $5000 out of pocket to have her baby (minor complications).
We just had my daughter the year before. Born by C-section and they tied the wifes tubes at the same time. She had an optional private room, we paid for a TV and a phone for the 3 day stay.
We paid $81 for those non-covered options.

We elected a horrible, evil socialist NDP govt in 2014 and it eliminated the $125.00 a month family medical premium with no deductibles that we had to pay as I retired and she was on medical unemployment insurance. and the employer didn't anymore.
So if your employer must pay that $1500 a month for you, it seems a bit of an advantage here when employers had to pay only $150 a month. MOF this came up in the 1990s as an 'unfiair advantage' during the original NAFTA talks.

BTW the same evil socialists also eliminated a bridge toll on the TransCanada highway that was costing my brother in law's company over $3000 a month. The toll was placed by the previous 'free enterprise' BC govt and the wimps in Harper's Tory national govt said not a peep about the Province imposing a toll on our main national highway.

At the time they removed the MSP premium, it was the last province to charge one, so that is not unique.
So it appears to every Canadian (and the rest of the civilized world) that Americans tightly hold onto your freedom to choose who can rip you off for the most over a sensible single payer plan like Bernie has talked about for ages simply because someone brainwashed you into believing that it is socialist, which it can't possibly be if every other country does it.

Kind of like clinging to the Imperial measuring system, as something that must define the USA as unique.

[Matthew]

1 hour ago, DUI_Offender said:

Republicans look at people over 65 as burdens on society, and want them to die quickly. 

I wouldn't take it that far. Actual ordinary republicans in real life are nice people. Their range of opinions consist of thoughts about the transgenders, presidential horse race, abortion,  and whatever else they learn that they are supposed to have an opinion on that week (which conveniently never includes criticizing the system of health insurance companies controlling their medical decisions). They kind of just assume that their party must have some very reasonable plan for healthcare.

The insurance companies on the other hand definitely want you to die if you're very sick, and have a long history of denying coverage to people as a matter routine business practice.

Edited August 17, 2024 by Matthew

[gatomontes99]

In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment. This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.

Supply v Demand will always prevail. If cost can't be changed, something else must be sacrificed. The sacrifice is going to be availability or quality.

The country's health-care system is suffering from an acute shortage of doctors — even as hundreds of qualified Canadian physicians trained abroad are turned away each year because of a tangle of red-tape and bias, experts say.

Sure, you can say that it doesn't cost much to have healthcare in Canada...but do you have health care? There is a severe shortage of doctors.

Over the summer, physicians, politicians and policy experts have rang the alarm bells, warning Canadians about the beleaguered state of our health-care system. While many of the proposed solutions focus on individual issues (the physician shortage, for example), few address the systemic nature of the problem. In reality, Canada’s health-care system has been on the verge of collapse for years, and its long past time to consider the sort of meaningful reforms needed to repair it, if not outright save it.

[Matthew]

38 minutes ago, ironstone said:

Shouldn't they have gotten more of this sorted out when they controlled both the Senate and the House? 

Quite right. The democrats could have done a more bold system back in 2010. But even the milquetoast conservative program they did implement was thrashed as being hardcore Stalinism.

Or if you mean republicans taking care of it in 2016, its true they could have. But it turns out since Dems enacted the republicans own healthcare idea, they didn't really have anywhere to retreat and a full repeal was not popular.

[robosmith]

43 minutes ago, ironstone said:

Shouldn't they have gotten more of this sorted out when they controlled both the Senate and the House? 

Like with the BORDER, they wanted the ISSUE more than a SOLUTION.

And it was STUPID for Trump to PlSS on John McCain.

[robosmith]

10 minutes ago, Matthew said:

I wouldn't take it that far. Actual ordinary republicans in real life are nice people. Their range of opinions consist of thoughts about the transgenders, presidential horse race, abortion,  and whatever else they learn that they are supposed to have an opinion on that week (which conveniently never includes criticizing the system of health insurance companies controlling their medical decisions). They kind of just assume that their party must have some very reasonable plan for healthcare.

The insurance companies on the other hand definitely want you to die if you're very sick, and have a long history of denying coverage to prior as a matter routine business practice.

People who support a PATHOLOGICAL LIAR for POTUS who wants to reimplement junk policies and pre-existing condition EXCLUSIONS, are NOT nice people.

[Matthew]

35 minutes ago, herbie said:

Back in the 1990s a friend visited from LA. She was a nurse practioner at a major hospital and told us how she had 'the best' medical coverage and it only cost about $5000 out of pocket to have her baby (minor complications).

Oof! In fairness to my insurance overlords, birthing expenses on my plan are their own sepatate category and i did not have to do the massive $5k deductible. I probably paid a couple hundred in misc expenses and the quality of the services we received were top notch.

 

42 minutes ago, herbie said:

So if your employer must pay that $1500 a month for you, it seems a bit of an advantage here when employers had to pay only $150 a month.

To be clear, i pay $1500 per month directly out of my paycheck. Insurance companies sell group negotiated discount deals to employers and the government makes it so you can pay for your insurance on a pre-tax basis. Each region of the US have different insurance companies that dominate and have their own negotiated pricing agreements with healthcare provders in that region. So via my insurance im allowed to use doctors within a certain network, but not some competing. It's basically like high tech feudalism. 😄

[robosmith]

17 minutes ago, gatomontes99 said:

In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment. This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.

Supply v Demand will always prevail. If cost can't be changed, something else must be sacrificed. The sacrifice is going to be availability or quality.

The country's health-care system is suffering from an acute shortage of doctors — even as hundreds of qualified Canadian physicians trained abroad are turned away each year because of a tangle of red-tape and bias, experts say.

Sure, you can say that it doesn't cost much to have healthcare in Canada...but do you have health care? There is a severe shortage of doctors.

Over the summer, physicians, politicians and policy experts have rang the alarm bells, warning Canadians about the beleaguered state of our health-care system. While many of the proposed solutions focus on individual issues (the physician shortage, for example), few address the systemic nature of the problem. In reality, Canada’s health-care system has been on the verge of collapse for years, and its long past time to consider the sort of meaningful reforms needed to repair it, if not outright save it.

wiki

Quote

The Fraser Institute is a libertarian-conservative Canadian public policy think tank and registered charity.^{[1][2][3][4][5][6][7]}

IOW, extreme right wing bias.

 

[gatomontes99]

1 minute ago, robosmith said:

wiki

IOW, extreme right wing bias.

 

What does that say about you when factual data (i.e. 198% increase in wait times) is considered an extreme right wing bias.

 

To put it another way, you consider the facts (aka reality) to have an extreme right wing bias.

[Matthew]

18 hours ago, robosmith said:

Like with the BORDER, they wanted the ISSUE more than a SOLUTION.

Yeah, basically. They did dozens of theatrical repeals of the ACA in the house under Obama. They ran on overturning it as like their #2 main issue. And then poof, not an issue anymore at all.

But the basic problem of healthcare costs hasn't gone away for Anerican voters. Certainly some republican somewhere still wants to try to address it.

18 hours ago, robosmith said:

And it was STUPID for Trump to PlSS on John McCain.

For real. Though even if trump had played nice I'm not sure mccain would have actually supported its repeal without anything to replace it with.

Edited August 18, 2024 by Matthew

[CdnFox]

20 hours ago, Matthew said:

I wouldn't take it that far. Actual ordinary republicans in real life are nice people. Their range of opinions consist of thoughts about the transgenders, presidential horse race, abortion,  and whatever else they learn that they are supposed to have an opinion on that week (which conveniently never includes criticizing the system of health insurance companies controlling their medical decisions). They kind of just assume that their party must have some very reasonable plan for healthcare.

The insurance companies on the other hand definitely want you to die if you're very sick, and have a long history of denying coverage to people as a matter routine business practice.

Well you're a bit of a better person than many we see here or publically on the dem side who insist that all republicans and conservatives are monsters who want to see people (especially children) die violently.    As just expressed by one of our resident nutbars. 

ANy discussion has to start off with the premise that neither dems nor republicans want people to suffer. That's a given. If either side could wave a magic wand and everyone had good health all the time both sides would waive it with equal vigour. 

The question is how best to get there.  And it's complex 

SUre - you pay about 1500 a month and get healthcare coverage.  In canada we mostly pay a small amount on top of our employer and the rest is covered by the gov't.  I mean like maybe 50 bucks a month 

 But. the average us family pays about 18,000 dollars in taxes in a year - all levels.  Canada - who has almost the same average income incidentally but in canadian dollars,  pays about 28,500  in taxes.  AND we have worse wait times, etc etc. 

It's not all that cut and dry. And the us system produces more in the way of medical advances etc.  It's a long discussion

[Matthew]

1 hour ago, CdnFox said:

ANy discussion has to start off with the premise that neither dems nor republicans want people to suffer. That's a given.

I absolutely agree. There is a lot of needless demonizing of opponents. It is also pretty easy to get people to just not care about the misfortune experienced by large segments of one's own society who they don't actually see. But 100% of the politically minded people I know IRL of either party are quick to care about actual problems of others who are right in front of them.

1 hour ago, CdnFox said:

the average us family pays about 18,000 dollars in taxes in a year - all levels.  Canada - who has almost the same average income incidentally but in canadian dollars,  pays about 28,500  in taxes.  AND we have worse wait times

I made about $73k US last year and paid about $14k in state and federal taxes (including Medicare and Social Security tax). Then i paid about $24k to health insurance per year ($18k out of my pocket and $6k contributed by employer as an employee benefit). So that's $38k in taxes and health insurance out of $79k in compensation.

At my income level, if I lived in, say, Ontario, and we convert that $79k to your monopoly money (1:1.37), I would be making $108,000. According to the ontario income tax calculator on turbotax, my total Canadian taxes would be $29,229 ($16k federal, 8k provincial, 5k CPP/EI). By comparison, the taxes+health insurance I pay in the US is equal to $52k in canadian dollars.

And a third of my health spending is just going to corporate shareholders and not to anyones healthcare. If i have a complaint I have to deal with corporate lawyers rather than dealing with a government service where I have clear rights as a citizen.

As far as wait times, I guess I'd need to see how big of a problem that is in canada. I live in a place in the US that is considered to have really good health services available, but if I need to go to a specialist like an endocrinologist or dermatologist for any non-urgent reason, the wait is often like 3-6 months.

But my mom is on chemo right now and there is big big money to be made with that,  so they started that up for her within a few days of her cancer diagnosis.

 

Edited August 18, 2024 by Matthew

[herbie]

22 hours ago, Matthew said:

To be clear, i pay $1500 per month directly out of my paycheck.

That's equivalent to a MORTGAGE payment!

[Matthew]

10 minutes ago, herbie said:

That's equivalent to a MORTGAGE payment!

Yup.

[gatomontes99]

1 hour ago, Matthew said:

I absolutely agree. There is a lot of needless demonizing of opponents. It is also pretty easy to get people to just not care about the misfortune experienced by large segments of one's own society who they don't actually see. But 100% of the politically minded people I know IRL of either party are quick to care about actual problems of others who are right in front of them.

I made about $73k US last year and paid about $14k in state and federal taxes (including Medicare and Social Security tax). Then i paid about $24k to health insurance per year ($18k out of my pocket and $6k contributed by employer as an employee benefit). So that's $38k in taxes and health insurance out of $79k in compensation.

At my income level, if I lived in, say, Ontario, and we convert that $79k to your monopoly money (1:1.37), I would be making $108,000. According to the ontario income tax calculator on turbotax, my total Canadian taxes would be $29,229 ($16k federal, 8k provincial, 5k CPP/EI). By comparison, the taxes+health insurance I pay in the US is equal to $52k in canadian dollars.

And a third of my health spending is just going to corporate shareholders and not to anyones healthcare. If i have a complaint I have to deal with corporate lawyers rather than dealing with a government service where I have clear rights as a citizen.

As far as wait times, I guess I'd need to see how big of a problem that is in canada. I live in a place in the US that is considered to have really good health services available, but if I need to go to a specialist like an endocrinologist or dermatologist for any non-urgent reason, the wait is often like 3-6 months.

But my mom is on chemo right now and there is big big money to be made with that,  so they started that up for her within a few days of her cancer diagnosis.

 

Where do you even find a plan that is that expensive? You have to be lying.

[Hodad]

29 minutes ago, herbie said:

That's equivalent to a MORTGAGE payment!

Yeah, in some places it is. I pay about $1300 a month to insure a family of 4 on a high deductible plan with another $500 a month into a pre-tax health savings account that can be used to cover any out -of-pocket costs. 

And same situation for wait times. General care is really available, but if you need a specialist or non-urgent surgery you're looking at wait times in months. 

It's a broken system. Insurance companies as nothing to the quality of health care but take tens of billions in profits (more?) out of the system. 

[Hodad]

6 minutes ago, gatomontes99 said:

Where do you even find a plan that is that expensive? You have to be lying.

Seriously? Lol. That's actually below average cost for a family of 4.

In 2023, the average cost of health insurance for a family of four was approximately $23,968 per year.

[Matthew]

5 minutes ago, gatomontes99 said:

Where do you even find a plan that is that expensive?

It's common for middle-tier family plan in the US. I get it through my employer. I'm rounding up, the actual monthly cost is slightly less than $1500.

[gatomontes99]

2 minutes ago, Matthew said:

It's common for middle-tier family plan in the US. I get it through my employer. I'm rounding up, the actual monthly cost is slightly less than $1500.

So 12 X 1500 = 38000?

 

[Matthew]

18 minutes ago, gatomontes99 said:

So 12 X 1500 = 38000?

 

2 hours ago, Matthew said:

paid about $14k in state and federal taxes (including Medicare and Social Security tax). Then i paid about $24k to health insurance per year ($18k out of my pocket and $6k contributed by employer as an employee benefit). So that's $38k in taxes and health insurance

 

[CdnFox]

2 hours ago, Matthew said:

 

I made about $73k US last year and paid about $14k in state and federal taxes (including Medicare and Social Security tax). Then i paid about $24k to health insurance per year ($18k out of my pocket and $6k contributed by employer as an employee benefit). So that's $38k in taxes and health insurance out of $79k in compensation.

At my income level, if I lived in, say, Ontario, and we convert that $79k to your monopoly money (1:1.37), I would be making $108,000. According to the ontario income tax calculator on turbotax, my total Canadian taxes would be $29,229 ($16k federal, 8k provincial, 5k CPP/EI). By comparison, the taxes+health insurance I pay in the US is equal to $52k in canadian dollars.

 

Great! Now add on GST  and PST (hst in ontario). Carbon tax.  Municiple tax. other taxes . 

Canadians pay about 45 percent of their gross income in taxes.  If you earn 101 k in income - your taxes will be around about 45 thousand dollars when the dust settles.  We have taxes you yanks have never even heard of people having so it's not surprising you'd miss some but they add up pretty fast    And then we still pay a grand or so a year for our medical benefits through work. 

I've seen a lot of studies and papers. Granted most will be a few years old  by  now but i doubt much has changed.  There ARE advantages to the Canadian model but there are serious disadvantages as well. People die here fairly regularly waiting for critical surgeries that they'd have gotten in a week in the states.  Emergency rooms close because the province mishandles the medical system or the feds bring in too many people too fast and there's no private money to build new facilities fast enough. 

During covid people were denied life saving medical treatments just because the surgical board didn't like that they hadn't gotten the vaccine. Even tho they'd already had covid and had proof they had the antibodies.  And there's NO option to go to 'another' hospital, in the states it would have been "Sure we'll take  your money if htey don't want it".   

She died btw. 

As far as wait times goes for serious operations it's often more than 3-6 months wait just to see the doctor who will assess you and let them book you a date - which is FREQUENTLY another 6 months till you even get the date, and then you better hope you're available that day or else.  My family has gone through this recently. 

It is NOT cut and dry. The us tends to pay slightly more, but they get better access to service.  They do get less consistency in quality, but they get more access to choices. 

The very poor get much better access but at the cost of the middle class getting worse access and service. Is that fair? some would say the person paying for it deserves at least to get what they pay for. 

 Honestly there are strong arguments both ways. It's not cut and dry. 

[gatomontes99]

42 minutes ago, Matthew said:

 

 

Ffs, you can't count state and federal taxes or SS tax. Medicare is sketch since you aren't using Medicare.