# Health care proposal: can we afford this? **URL:** \ **Category:** Factual Questions\ **Created:** [August 12, 2009, 2:40pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182 "2009-08-12T14:40:42Z")\ **Posts on this page:** 12\ **Page:** 1
**Author:** ![sweeteviljesus](https://avatars.discourse-cdn.com/v4/letter/s/898d66/32.png) [@sweeteviljesus](https://boards.straightdope.com/u/sweeteviljesus)\ **Post date:** [August 12, 2009, 2:40pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/1 "2009-08-12T14:40:42Z")
As this is in GQ, I wanted to stick to numbers. We have incurred a huge debt and are going to be running a record deficit and in 2019 funding for Medicare/Medicaid will run out (I think). How much extra is the proposed health care plan going to cost? ---
**Author:** ![SanDiegoTim](https://avatars.discourse-cdn.com/v4/letter/s/85e7bf/32.png) [@SanDiegoTim](https://boards.straightdope.com/u/SanDiegoTim)\ **Post date:** [August 12, 2009, 3:08pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/2 "2009-08-12T15:08:09Z")
One of the reasons there is so much angst over cost is that nobody really knows what it will be. Further, those promoting any one of the three bills floating around congress frequently contend the net cost will be offset by savings to be realized after implementation (sure). How many times have you heard that one from congress whenever snake oil is being sold? Until such time as one of these bills is in final form, there’s no way to say what “health care reform” will cost. Suffice it to say, however, it won’t be cheap. ---
**Author:** ![sweeteviljesus](https://avatars.discourse-cdn.com/v4/letter/s/898d66/32.png) [@sweeteviljesus](https://boards.straightdope.com/u/sweeteviljesus)\ **Post date:** [August 12, 2009, 3:11pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/3 "2009-08-12T15:11:25Z")
Do we have any ballpark numbers to work with? ---
**Author:** ![intention](https://avatars.discourse-cdn.com/v4/letter/i/e95f7d/32.png) [@intention](https://boards.straightdope.com/u/intention)\ **Post date:** [August 12, 2009, 4:55pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/4 "2009-08-12T16:55:56Z")
> [@sweeteviljesus](#): > > Do we have any ballpark numbers to work with? Sure we do. The problem is that they all look like this: > [@](#): > > When Medicare was debated in 1965 (the year it was signed into law), business and taxpayer groups were concerned that program expenditures might grow out of control. However, single-payer advocates assured them that all seniors could easily be covered under Medicare with only a small increase in workers’ payroll taxes. The federal government’s lead actuary in 1965 projected that the hospital program (Medicare Part A) would grow to only $9 billion by 1990. The program ended up costing more than $66 billion that year. > > Just three years after Medicare was passed, a 1968 Tax Foundation study found that public spending on medical care had nearly doubled in the first few years of Medicare. In subsequent decades, Medicare payroll taxes and general taxes have continued to rise to pay for skyrocketing health care costs. In other words, while we have numbers from the Government, they have not proven especially accurate in the past. Rather than “ball-park numbers”, they tend to morph into “solar system-park numbers” within a few years. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [August 12, 2009, 5:20pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/5 "2009-08-12T17:20:51Z")
The answer to this question only makes sense when compared against the cost of not doing anything. That is hard to calculate, since it has to include not only the healthcare inflation rate - rather large, the social costs of the uninsured and underinsured, and the costs from the uninsured not paying for care which hospitals and doctors pass on to those who do. You also have to factor in changes to the system. If nothing is done differently, the cost would be large. If something like a public option forces private insurers to cut overhead, and if evidence-based medicine reduces the number of unnecessary procedures, the cost would be much reduced. If we can somehow go to a per capita cost of the European countries, the costs would actually be reduced. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [August 12, 2009, 5:35pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/6 "2009-08-12T17:35:05Z")
The last few years the repubs have stated that health care would bankrupt the country in the future if we did not fix it. The cost of health care has been on an up escalator for decades. Something has to change. So when Obama actually tries to ,they talk about the cost of fixing it as prohibitive. It will cost some money to set up the agencies. That has to be done. But long term , it will be an attempt to fix what is wrong. My fear is the powerful Pharm. and health care lobbyists will screw it up .They are spending a ton to fight the changes. The fact is we can not afford to allow the system to go on looting the customers and leaving poor and weak uncovered. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [August 12, 2009, 5:37pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/7 "2009-08-12T17:37:52Z")
> [@sweeteviljesus](#): > > How much extra is the proposed health care plan going to cost? As health care is something we all need, it will represent zero ‘extra’ cost. Luxuries such as secret torture prisons, or wars of choice cost extra, but the cost of pills to keep granny alive when she gets the flu is not an ‘extra’ cost, it’s a necessity. ---
**Author:** ![HorseloverFat](https://avatars.discourse-cdn.com/v4/letter/h/8e8cbc/32.png) [@HorseloverFat](https://boards.straightdope.com/u/HorseloverFat)\ **Post date:** [August 12, 2009, 6:03pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/8 "2009-08-12T18:03:29Z")
The real question is what does healthcare cost now? How can we weigh the bankrupcies of families or how much the prices goes up because of fraud, greed, malpractice, etc? How do we figure out how much is lost in collections too? How do we put a price on denying someone coverage? My understanding is that these invisible costs (to the government, that is, but real to me and other healthcare buyers) are conveniently dismissed in this debate. The idea behind this reform really isnt to cut costs per se, but to fix large systemic problems like being denied coverage for previous conditions, establishing a public insurer to compete, regulating healthcare practices, etc. As far as cost goes, well, if the richest country cant afford something Europeans and Canadians can afford then we’re not doing it right. Obama has already floated a tax increase on those making over 250k a year, thus returning them to pre-Bush levels to help pay for this. ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [August 12, 2009, 6:44pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/9 "2009-08-12T18:44:01Z")
> [@HorseloverFat](#): > > The real question is what does healthcare cost now? How can we weigh the bankrupcies of families or how much the prices goes up because of fraud, greed, malpractice, etc? How do we figure out how much is lost in collections too? How do we put a price on denying someone coverage? Also, aren’t our health insurance already paying for medical care for the uninsured? There are people who go bankrupt due to medical bills (i.e. those bills never get paid), or unable to pay for the emergency room care. Those costs must get added to the bills for people who do have insurance. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [August 12, 2009, 7:23pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/10 "2009-08-12T19:23:05Z")
> [@scr4](#): > > Those costs must get added to the bills for people who do have insurance. No, those costs are added to the bills of people who _pay_, whether it be through insurance or personal check. ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [August 12, 2009, 8:30pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/11 "2009-08-12T20:30:41Z")
> [@Squink](#): > > No, those costs are added to the bills of people who _pay_, whether it be through insurance or personal check. Fair enough. But it still means those who can pay for health care (through insurance or otherwise) are subsidizing the health care for those who can’t pay for it. So I don’t see why the financial burden would be increased significantly if we need to subdidize _insurance_ for those who can’t afford it. The main difference is that the currently uninsured would be going to regular family practice rather than clogging up the emergency rooms. ---
**Author:** ![sweeteviljesus](https://avatars.discourse-cdn.com/v4/letter/s/898d66/32.png) [@sweeteviljesus](https://boards.straightdope.com/u/sweeteviljesus)\ **Post date:** [August 12, 2009, 9:02pm UTC](https://boards.straightdope.com/t/health-care-proposal-can-we-afford-this/506182/12 "2009-08-12T21:02:22Z")
If you want to debate whether this is needed, there is a fine board next door. I just want to know the impact to the budget and it looks like the answer is that it is anybody’s guess. I agree that something needs to change, but I am not sure what makes the most sense.