berchman Loc: South Central PA

[Taken from Quora]
Tim Froese B.A. Political Studies from University of Saskatchewan (Saskatoon)

Why aren’t Republican v**ers more upset about the terrible healthcare system we have in America? Do they get an absurdly expensive medical bill and think, “Yeah, this is fine”?

They think there are no better options.

In the early 1990s in very conservative Bakersfield California, a close co-worker told me that an expensive medical bill broke up his marriage. His daughter, who was about 12 at the time, was born with a medical issue and stayed in the hospital for 2 weeks after her birth. Thankfully, she was okay and would go on to grow into a bright little girl.

Worrying about a sick child is more than any new parent should have to bear. But in his case, the financial stress made it far worse. He could not take time off work as a trucker while his daughter was in the hospital, but his boss gave him short-haul routes so he could be at the hospital every evening.

Then they got the bill. It was pages long and almost $100,000, with everything itemized down to the last q-tip. This would have been in 1980, and he would have been 22 years old. He didn’t have insurance. He couldn’t pay the bill and eventually had to declare bankruptcy. Worse, his marriage could not survive that level of financial and personal stress and they divorced when their daughter was learning to walk.

It was the early 1990s when he told me this, at the time the Clintons were trying to push their healthcare reforms. I was a young Canadian living in the US, and although I wasn’t particularly politically-conscious, I often got into discussions about health care, taxes, and military spending - most often because conservative Californians were vocal about those being Canada’s biggest faults

So I asked my co-worker why he remained so dead-set against government-funded healthcare after for-profit healthcare derailed his life. He said “Because it’s socialist.” That was it. End of story.

He didn’t say the expensive bill was fine. He was bitter about it. But socialism was worse.

It was such a sore spot that I was careful not to challenge his beliefs. But I tried to figure this point out in my other conversations on the topic, including with the owner of a moving company who could not afford health or disability insurance but was always one slip away from a serious injury.

Why are publicly-funded roads and schools fine, but not hospitals? Who pays for the fire department - insurance companies and people whose houses are on fire? No. (Maybe in some places, but not in Bakersfield.) The public (aka taxpayers) pays for roads, schools, fire and police departments because that works best for everyone. Why is healthcare different?

I never got a good answer to that question.

sb Loc: Florida's East Coast

The most vocal critics of a single-payer US government health system are those who get their medical care through our existing large single-payer government health care system, which is available to all Americans over 65 (unless they have lived overseas and never paid into the system) called Medicare. Other very vocal critics get their health care through the second-largest US single-payer government health system, called the Veterans Administration. Go figure.

anotherview Loc: California

As a cost, medical care and infrastructure differ. Infrastructure presents a one-time capital expense providing for public, commercial, and private benefit and use. Maintenance expense later falls to government budgets whose revenue comes primarily from taxation.

Medical care recurs. It serves individuals in that capacity. It receives revenue from several sources: private, public, insurance, and government. Its cost varies presently and over time. Actuarial tables describe probable cost and account for variance.

Advocates of single-payer (government-funded) medical care modeled on Medicare conflate the nature of this continuing medical expense with upfront capital spending.

Spending for medical care also involves about 1/5th of the U.S. GDP. Replacing or otherwise overturning this colossal spending would risk economic distortion during its implementation which nobody can reliable predict.

That said, two large socialist programs already exist in the U.S.: Medicare and Social Security insurance. They both work as designed and intended. SSI actually pays for itself, although socialist in practice, via employer and employee taxes. The central government funds Medicare.

Note that other social programs exist; for example, Medicaid provides medical care for low-income people. Powerful interests stand behind these programs defying change. Critics typically rest their arguments in dogma, deflection, and self-interest. They all start from flawed assumptions.

dpullum Loc: Tampa Florida

yes, many said that Socialism Word when Ike Eisenhower set up the interstate highway system. A collective we all use, a Socialist thing, just like free high school education. Was Ike a Democrat... No, a Conservative Republican in the Classic sense.

Part of what Benchman said: a close co-worker told me that an expensive medical bill broke up his marriage.
I had a coworker who had to divorce his wife in Florida... they move to Tennessee, she was so poor that she was given care and he bought a home and that lived together an occasional day a month and she died without their losing everything. The USA is not civilized like the rest of the industrialized countries!

Triple G

Add education to that list. It’s a public service to have a healthy educated populace.

Wuligal Loc: Slippery Rock, Pa.

Many older people who are eligible for Medicare do not use it although they pay for it......they have supplemental insurance that costs about $200.00 a month for one person with no dependents. I'm one of "those" people. My medicare money is sent to my insurance company to help pay the premium. The cost of my "public" insurance is $210.00 a month. My co-pays run between $5.00 and $35.00 per appointment and the out of pocket cost of my drugs is well over $200.00 a month. Every hospital stay is an automatic $400.00 (apx).

Bottom line is I get great care but I have to pay for it. If I don't pay for it you will! Sorry to disappoint folks but the government is only the middle man who expects to take his share out of every t***saction. Unless he's printing funny money the only source of Uncle Sam's income comes out of your pay check. If you want to pay for my health care and college education that's fine with me but just send me a check. It would be a lot cheaper without the middle man.

Triple G

No, it wouldn’t. You would not get access to the 40 - 60% discounts insurance companies have in their contracts with hospital and doctor networks. For every service, you’d pay substantially more and probably need a loan for big ticket care depending on the timing of the incident.

Wuligal Loc: Slippery Rock, Pa.

Perhaps I did not make myself clear, my reference to a middleman was the government. The difference between what the hospital charged and what my insurance paid is not a discount. It's a prearranged agreement between the hospital and the insurance company because it gives them both a tax write off. I would prefer real figures with real charges and a better understanding of all of it but that wouldn't profit the medical industry.

Right now I'm dealing with orphan drugs, speciality pharmacies and Drug delivery grants-now there's a real thrill.

anotherview Loc: California

Eisenhower saw the autobahn in Germany, and he believed the U.S. needed a national road system like it. We now have the Interstate Highway System as a capital project serving the whole nation in various ways. Its one-time cost qualifies it as a project, not unlike, say, a system of firehouses. We may not all use the Interstate, but its function affects us all by its purpose.

A socialist program goes to the general welfare in its purpose while endlessly recurring as a cost.

Wuligal Loc: Slippery Rock, Pa.

Thank you for the clarification. Well put.

Triple G

It’s definitely discounted from what the hospital would charge and receive from a private payer without any kind of coverage. They pay full retail prices.

berchman Loc: South Central PA

The "supplemental insurance" is only available to people on Medicare. It supplements what Medicare doesn't cover.

berchman Loc: South Central PA

The interstate highways' recurring costs are to maintain the roadways. The recurring costs of fire protection are maintenance and replacement of the equipment, maintenance and repair of the firehouses, salaries of the firemen and women.

Triple G

From his description, it sounds like a Medicare Advantage plan and not Traditional Medicare

Wuligal Loc: Slippery Rock, Pa.

That's why we have license fees, turnpike fees, and gas taxes. I don't know how it works in cities but we have a volunteer fire department. The entire community works to raise money for them every year plus we also make donations. They also function as our EMT and ambulance service. I subscribe to the latter services.