Nobody ever said that all doctors across the country charge the same gor the same proceedures. And while it is nice to think that having insurance or not having insurance is a matter of personal freedom that breaks down when people can't pay or don't pay and the cost is paid for by the rest of us. Back in the bad old days when preexisting conditions were not covered I had a big problem that cost over two hundred thousand dollars. Now I doubt many people could do that so for most the cost would have been paid by others with insurance or by the government. So while it is fun to pretend that having insurance is a matter of choice the choice actually being made is to pay for your own care or to foist the bill off on others. Not having insurance is only a valid choice if you can pay for whatever you need or are willing to go without. Anything else is just planned mooching.
Actually, you did say all the doctors charge the same thing, it was the insurance payout that was a variable. But whatever, you misspoke, and that's not the point of the discussion. What, exactly, do you think paying for insurance for 'everybody' actually is? Everybody paying for those who can't pay... but for a vehicle that does not actually provide CARE. That people may or may not use, because, in reality, walking into an ER or IMC is a whole lot more convenient for some. At least paying for it when they actually receive care is more efficient and makes better use of my contribution to the societal pool. Note I said MY..... because I don't believe in mandating how you (generic) spend your money, and I don't believe leaving it in the hands of the Federal Government is an efficient use of anybody's money. You apparently also sidestepped my statement regarding catastrophic coverage, but selective reading makes for an interesting discussion, eh?
No catastropic coverage is just a joke. That is basically what you get now when you determine what deductable you want. For most Americans a five thousand dollar medical bill is catastrophic. Heck a lot of Americans live paycheck to paycheck. And if you read my statement in response to your claim that the same doctor charges different payers differently you will find my statement was perfectly correct. You have to learn to read in context.
Catastrophic coverage is not a joke. It doesn't cover the annual visit to the doctor, or basic services. It covers major medical. A High deductible plans is just that- a high deductible. It still covers all the little frills that the PPACA feels are 'necessities', but you pay a large amount out of pocket before it will pay for most things. Catastrophic coverage is for Major Medical, not preventative. Some people are able to fund their preventative, and have a lower premium for it. As I mentioned before, do the math. Some insurance plans, even those under the PPACA, end up being more expensive than paying for it directly. Yes, any number of people live paycheck to paycheck. Point being? Not every health plan is right for everybody... but the government mandating certain requirements, hell, involving themselves at all in healthcare is a huge overreach. There are many people who do not live paycheck to paycheck, and can afford to have catastrophic coverage. Exactly why do you think the government has the right to say 'we know what is better for you' then people who are well educated on the subject? For those who aren't well versed, and would prefer someone else make the decision for them, that's their choice, but do not take my choice from me. Not a whole lot to take out of context, but there you have it.
The reason the government needs to be involved in healthcare is because the current system and the ppre ACA system have not and are not working. America spend approx 18% of it's GDP on healthcare which is about twice most other developed countries and delivers arguably inferior results. So we know beyond any doubt that " free enterprise" healthcare does mot work. And If someone choose not to have health insurance but then expects me to pay for their care then I have every right to take the decision from them. Now if you want to advocate for a system where the only healthcare you get is what you or your insurance can pay for or what a charity provides that will be a separate issue. But that isn't really what you want. You want the illusion of free choice while maintaining the right to leech off the rest of society when the consequences of your decision turn against you.
Well, they never actually had a replacement plan. So once the dog caught the car it didn't know what to do. More importantly, the reality is that the implementation of the ACA made it very hard to ever go back. The GOP doesn't have an alternative, much less one that can achieve results comparable to those the ACA has. Medicare’s cost surprise: It’s going down Health Spending Growth Slowing, More on Pace with Economic Growth Employers’ Health Care Cost Growth Has Plateaued Since Obamacare Became Law, 20 Million More Americans Have Gained Health Insurance How the Affordable Care Act Drove Down Personal Bankruptcy: Expanded health insurance helped cut the number of filings by half Baby Survival Rates Improved in States With Affordable Care Act, Data Show Out-of-hospital cardiac arrests fell under the Affordable Care Act Medical care, health have improved for low-income adults under ACA Affordable Care Act Increased Rate of Early Cancer Diagnoses Uninsured cancer patients saw increased coverage for care following Medicaid expansion ACA credited with earlier diagnosis of gynecologic cancers in young women Fewer Patients Have Been Dying From Hospital Errors Since Obamacare Started
You do realize you are paying for those who can't/don't already, correct? So instead of pre-paying by providing them with health 'insurance', why not pay for it when they actually receive care? Less expensive, more efficient. But you get the government involved, then its not less expensive, more efficient. The government has proven this with a multitude of programs that they have FUBAR. Let's make one thing clear here. This is not about 'me' but you keep trying to direct it that way. I have health insurance which I pay for, Dr's who accept direct pay, and I work and pay my own way. Not everyone is that fortunate, and those are the ones we (should be) are addressing. Just because a program is not functioning at optimum, doesn't mean you have to go nuclear option. First and foremost, WHY is healthcare so expensive in the US? Funny how most government driven ideas to 'fix it' don't bother to address the underlying reasons why something is dysfunctional, but pastes a band-aid on the symptoms. We let the government into healthcare fully, and the band-aids will only get bigger, and the underlying problems will only get worse.
Sorry but the US healthcare system was a mess even before the ACA. Systems in other countries that have government involvement work just fine. The problem isn't government involvement it is the fact that while free enterprise may work well where there is actual competition providing healthcare is not competitive nor is healthcare insurance competitive. Sooner or later healthcare is going to have to be rationed. It may be by lifetime caps. Or by limiting spending where there is no hope for saving a life. Or by limiting the procedures the government will pay for.
While I agree that US healthcare is a mess, everything else in your post is predicated on the government being involved, and that is what I have been saying since post one.
Of course but the government is already massively involved in healthcare in the US. Medicare, Medicaid, drug approvals, hospitals, insurance company regulation, etc,etc. The only real issue in my mind is what has caused the American system to be such a mess. Was it the government or the insurance companies, or too much regulation or too little. Just a side note. I had massive surgeries in India at a total cost including airfares and months of residency for a total cost of about forty thousand. Cost in US would have been over two hundred thousand just for the hospitals and surgeries. Oh, and as a side note the hospital and competancy of doctor's were amazing. The fact is that systems in other developed countries work much better than our system and some are totally government systems and some are hybrids.
