# I despise Trump but would vote for him over someone who wants to take my family's insurance away

**URL:** <https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357>\
**Category:** Politics & Elections\
**Created:** [September 17, 2019, 2:00am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357 "2019-09-17T02:00:10Z")\
**Posts on this page:** 20\
**Page:** 14

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**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\
**Post date:** [September 29, 2019, 7:14am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/262 "2019-09-29T07:14:51Z")

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> [@Banquet\_Bear](#):
>
> How much did the CT scan cost me out of pocket? Zero. How much did parking in the hospital overnight cost me? Zero: because I was an overnight-emergency patient I was given a parking voucher.

Excellent post, **Banquet Bear** , and I suggest that everyone read it in its entirety because stories like that happen all over the world every day, where health care is a service available to all as a matter of principle, delivered at little or no cost to the individual. I’m just amused about the parking voucher – here in Canada hospitals are a lot more mercenary, perhaps because of the geographical proximity to the mercenary US health care system; not being allowed to extort patients for health care services, hospitals extort them for parking! 😃 An overnight stay in ER would have cost me anywhere from $15 to $25 for parking, though of course zero for actual health care.

I had an experience similar to yours a couple of years ago, which I won’t repeat in detail because I think I’ve talked about it before. I drove myself to the ER as a precaution because I’d been having chest pains for several days. I left some wine and cheese on the counter figuring I’d be back in a couple of hours at most. It was five days before I was back because it turned out I was having a heart attack! The two basic messages I want to leave here about that are these:

[ul]  
[li]Various procedures were considered including the recommendation of bypass surgery – the classic open-heart surgery – or stenting (PCI) instead. The important thing here is that medical considerations and my own preferences were the only criteria – costs were irrelevant, nor was any consideration of what would be “covered”, because there was no insurance company involved, only a universal health care system.[/li][/ul]  
[ul]  
[li]The entire experience did not cost me one dime. Nothing. Literally zero.\*[/li][/ul]

- Just don’t ask about the parking cost! I should have taken an ambulance, for which the maximum out of pocket cost is $40.

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**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\
**Post date:** [September 29, 2019, 9:09pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/263 "2019-09-29T21:09:52Z")

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> [@bump](#):
>
> AFAIK, it’s a mandated thing in the occ health insurance world, so the real trick is finding the one that was at the right price point and who can handle your case volume within whatever your regulatory agency’s time frames are. I don’t know that the determination rates are public knowledge; at any rate, the real concern was that they stayed consistent, not that they were particularly low or high.
> 
> In general, the occ health world is rife with fraud; that’s another reason for these third party reviews; it gives the insurance company another layer of protection from some jackass doctors who are using their patients to try and milk the system by doing unnecessary treatments or very costly procedures without actually trying more conservative stuff first.
> 
> Remember- there’s usually not a dramatic amount of discretion on these- there are treatment guidelines, the doctors read them, and then look at the case, and decide whether the treatment(s) adhere to those guidelines or not.
> 
> Here’s an example of a case:
> 
> \*Patient presented with knee pain after a slip & fall. Initial treating physician diagnosed a knee sprain (S83.402A), with edema and pain. Treating physician prescribed rest, immobilization and 80 mg oxycontin. \*
> 
> The triage nurse at insurance company or third-party administrator would look at that and think “Hmm… oxycontin for a knee **sprain**? And 80 mg? That’s for opioid resistant patients.” So they’d put it out for third-party review.
> 
> Reviewer gets the case, and reads the facts of the case. He reads the relevant treatment guidelines for a knee sprain of that type and severity, and notes that it calls for rest, ice, immobilization and something like 400mg of naproxen. He calls the treating physician to ask him why he prescribed oxycontin. Now at this point, it could go different ways- if the treating physician says something like “Well, last time she had an NSAID, she went into anaphylactic shock, Tylenol isn’t very effective, and she’s a opioid addict, so there wasn’t much else I could do”, then the reviewer might certify it. But if the treating physician says something less than kosher, or he can’t get hold of the treating physician, he probably won’t certify it.
> 
> I want to point two things out here- first, the point isn’t to deny claims as such, but rather to identify situations where the treatment given doesn’t conform to accepted treatment guidelines- for example, homeopathy would probably never get certified if used in a worker’s comp context. Second, this is all done under the auspices of an [accreditation body](https://www.urac.org/programs/independent-review-organization-accreditation) to ensure independence and fairness.

Right, if that’s your experience with how claims work in the US for a government paid system (I assume that’s the case for occupational health and worker’s comp claims), I understand your earlier post about how you think a UHC system would operate similarly.

'cept it ain’t so.

As **wolfpup** and I have pointed out, in a UHC system cost control is done by the initial determination of how much the Medicare system will pay for each procedure. After that, it’s left to the professional judgment of each doctor. There’s no internal review or case-by-case treatment protocols like you describe here.

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**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\
**Post date:** [September 30, 2019, 12:33am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/264 "2019-09-30T00:33:41Z")

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> [@bump](#):
>
> At that point, he needs to go back to the ER doctors and sue them for negligence or malpractice if they diverged from the accepted treatment guidelines. One way or another, either the ER docs or the insurance company reviewer fucked up, and he needs to get that straightened out.

> [@Horatius](#):
>
> …because the one thing you really need after major surgery is an extremely complicated, probably years-long lawsuit involving multiple possible defendants, and all their lawyers, who are all pointing the blame at the other people.

As one of our Dopers has found out the hard way:

[Where’s davidm? In hospital recovering from a medical screw-up](https://boards.straightdope.com/sdmb/showthread.php?t=843266)

He’s been careful not to talk on the boards about the details of any discussions he’s had with lawyers, but has mentioned the medical bills, both from the initial treatment and the follow-up treatment for the treatment.

It shouldn’t be the case that someone who is going through a lengthy convalescence of over a year should simultaneously be worrying about paying the medical bills and dealing with lawyers to ensure the medical bills get paid. But, that seems to be the system of health “insurance” that Americans have and (at least some) defend.

And that doesn’t mean there’s no remedy for medical malpractice in countries with UHC. There certainly is. But, what you’re suing for is the damage caused by the medical screw-ups. You’re not suing to get coverage for the medical treatment for the screw-up.

(And, I would encourage any American who’s happy with their insurance to read **davidm** ’s tale about how his “insurance” has worked.)

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**Author:** ![MissTake](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/misstake/32/3189_2.png) [@MissTake](https://boards.straightdope.com/u/MissTake)\
**Post date:** [September 30, 2019, 1:55pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/265 "2019-09-30T13:55:37Z")

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Converse to **Banquet Bear** :  
Pay for medical insurance through my government employer, $375/mo.  
Have polycystic kidney disease. Rupture a cyst, extreme pain, go to ER: $125 out of pocket.  
Get follow up bill for $460 for random testing while in hospital for 4 hours. Oh, and $20 parking fee.  
Multiple nephrologist appointments: $50/each.  
Fistula placement for dialysis: $200 out of pocket, after $75 surgery appointment fee.  
Dialysis: After arguing with my insurance provider, pay $50 per treatment / $150 per week. They wanted to charge the surgery appointment fee of $75 per treatment.  
After three months, am eligible for Medicare Parts A/B as secondary insurance. Enroll. No more dialysis fees, no more doctor appointment fees; however, I pay $145 every three months for Medicare on top of the $375/mo insurance.  
(Note: all through this I’m also paying approximately $150/mo out of pocket for prescriptions)  
Discover kidney foundation will pay my Medicare fees. Sweet! Whenever I get the bill, I give it to the financial counselor at dialysis and they pay it.  
After three years on dialysis, Medicare becomes my primary insurer, employer insurance becomes my secondary insurer.

Fast forward to June 2019:  
Discover the financial counselor at dialysis has NOT been paying Medicare. Medicare terminated as of 06/01/19.  
June 20th, get “The Call” for a new kidney. June 21st, have surgery.  
Starting the following Monday, I’m back at the hospital daily for blood testing. The following week, blood testing is twice per week. There’s also multiple Dr’s visits. Each time, I pay $8 to park. 🙂  
August 9th, spent four hours at the local Social Security office, reapplying for Medicare parts A/B, as allowed by the government (kidney transplant recipients are eligible for Medicare for three years).

As of today, I have over $80K in bills sitting on my table, as Medicare and my employer based insurance will not pay until Medicare decides whether I’m eligible for part B (Part A was immediately approved to pay for the actual transplant and hospital stay). Those daily to biweekly blood tests? $2k/each. I’ve spent over 20 hours on the phone with providers, my employer insurance and Medicare. I am now receiving threatening phone calls and my credit has been dinged.

I have no idea whether Part B will be approved, it’s still pending. If it’s not approved, my employer insurance has a $5k yearly deductible. And now I’m paying over $200/mo for prescriptions (which ONE of my anti-rejection drugs retails for over $7k/mo, so I can’t complain too much)

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**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\
**Post date:** [September 30, 2019, 2:06pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/266 "2019-09-30T14:06:08Z")

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To x-post something I wrote in another thread. T’was a lot of work, so…

> [@I get the argument for Medicare for all, but what is the argument for abolishing private insurance?](https://boards.straightdope.com/t/i-get-the-argument-for-medicare-for-all-but-what-is-the-argument-for-abolishing-private-insurance/838057/5):
>
> **Mathematically** : Insurance is a pooled risk program. _For the insureds_, the pool works better the larger it is and the more representative of the population of a whole. In the arena of health care, where there does seem to be a general consensus towards the necessity of universal health insurance coverage (100% of the population covered), having private insurance breaks these pools apart, decreasing their financial stability, increasing the costs on the enrollees, and imposes additional costs by the duplication of effort - from staff to executive - needed to run 6+ major insurance organizations instead of 1.
> 
> **Personal** : Delores Claireborne works at The Texas Mental Health Association, a non-profit which is the major mental health services provider for a three-county area in Texas centered around Cotulla. Delores gets paid 26 times per year, has 1 child, and per her divorce agreement from that drunken bastard, has to provide the child with health insurance.
> 
> Delores has the following employee+child options (Plan, per paycheck cost, annual premium, deductible, Out of Pocket Max, amount paid out of pocket before insurance covers 100% of medical expenses)
> 
> 1. High Deductible, $234.06, $6,085.56, $5,000.00, $5,000, $11,085.56)
> 2. Medium Deductible, $295.34, $7,678.84, $2,500, $5,500, $13,178.84)
> 3. Low Deductible, $362.57, $9,426.82, $1,000, $4,000, $13,426.82)
> 
> Oh, in addition to this, her employer covers $4,919.78 for her medical and life insurance. Group life is $20/month/enrollee (it’s cheap), so the employer pays, _in addition to the 2nd item in each of the rows above_, $4,679.78.
> 
> Total cost of insurance if Delores never goes to the doctor and has the cheapest plan: $10,765.34 ($6,085.56 out of Delores’s pocket)  
> Total cost of insurance if Delores has $5,000 of expenses: $15,765.34 ($11,085.56 out of Delores’s pocket)  
> Total cost of insurance if Delores has $700,000 of expenses: $15,765.34 ($11,085.56 out of Delores’s pocket)
> 
> Median household income in Cotulla is $34,567 - Delores earns $40k pre-tax, $37,500 after tax.
> 
> Out of pocket health insurance premium as a % of take-home income: 16.22%  
> Out of pocket health insurance as a % of take-home income, assuming Delores hits the out of pocket max: 29.56%
> 
> Notes:
> 
> 1. These are real numbers. Names are made up, I mixed and matched clients, we do business in Cotulla but not with anything called “Texas Mental… whatever”. But the numbers are real.
> 2. This is, in no way, unusual for small business group medical insurance rates for the state of Texas.
> 3. The employer is rather generous here - they effectively pay for the employees insurance\*, meaning _this is the cost to cover her 1 child_.
> 4. The most expensive plan: $763.20 per pay period, $19,843.20, annually for employee, $24,522.98 total annual premium
> 
> The above is repeated… [4.7 million times](https://www.sba.gov/sites/default/files/advocacy/2018-Small-Business-Profiles-TX.pdf)… across Texas.
> 
> That’s my argument against.

\*The minimum an employer must contribute is 50% of the premium of the lowest-cost offered employee-only plan. So if there’s one “we don’t cover anything, but if you get in a situation where you have to pay $800k, you’ll be glad your max out of pocket was just $7,900” plan for, say, $249/month, in Texas, the employer can offer a mere _$125/month_ in benefit contribution to each and every employee and still be in compliance. If you need a $6,000 emp+child plan, in this situation your employer can pay $1,500 and you pay $4,500. **Just for the insurance!**

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [October 1, 2019, 4:39pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/267 "2019-10-01T16:39:29Z")

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> [@Banquet\_Bear](#):
>
> So to the OP: if the United States of America could start from scratch, if it were to re-write its healthcare system with universality at its core, that might result in an increase in taxes but virtually eliminate the need for you (or your employers) to pay for health insurance (leading to an overall reduction in costs), would you be willing to have your “health insurance taken away” if it meant that your neighbour would be able to get access to the same level of health care that you have?

I’m not the OP, but the premise of your question is flawed. We would still have to pay for health insurance no matter what system we have. The question is how we pay for it, either funded strictly through federal taxes or funded through premiums that come from multiple sources. If funded through single-payer, I’m still paying because I pay taxes.

And then, if we did switch to single-payer, i.e. Medicare for All, would the nation save money or spend more money? On that question, there are a wide variety of opinions. Economists and think tanks from the right and left have to make rough assumptions and those assumptions lead to different views on whether single-payer will save money or cost more money. See attached from the NY Times, where they compared a handful of cost estimates, some which forecast more cost, not less, if we go to Medicare for All. The Urban Institute is left-leaning for instance, and they think it will cost more:

> **[Would ‘Medicare for All’ Save Billions or Cost Billions? (Published 2019)](https://www.nytimes.com/interactive/2019/04/10/upshot/medicare-for-all-bernie-sanders-cost-estimates.html)**
>
> We asked a handful of economists and think tanks to find out.

But in any event, back to your question, I support a more robust ACA. From that more robust ACA, I expect my taxes to go up, and I don’t think I will save anything on my own employer-provided policy. However, it helps get more people insured, and I’m willing to do that. IMO, that’s selfless, because I’m not getting any benefit from it myself.

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [October 1, 2019, 4:52pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/268 "2019-10-01T16:52:17Z")

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> [@wolfpup](#):
>
> Excellent post, **Banquet Bear** , and I suggest that everyone read it in its entirety because stories like that happen all over the world every day, where health care is a service available to all as a matter of principle, delivered **at little or no cost to the individual**.

Oh yes, there is a cost to the individual. If they’re a taxpayer, there’s a cost to them. If we get Medicare for All in the US, we will have a cost.

Also, as I posted in response to BB, there’s also great divergence in the cost estimates of medicare for all. The costs might actually be more under single-payer in the US than under current law:

> **[Would ‘Medicare for All’ Save Billions or Cost Billions? (Published 2019)](https://www.nytimes.com/interactive/2019/04/10/upshot/medicare-for-all-bernie-sanders-cost-estimates.html)**
>
> We asked a handful of economists and think tanks to find out.

And these estimates aren’t from Donald Trump lovin’ right-wing economists. Some of these guys are left-of-center and not averse to the idea of government-provided UHC.

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**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\
**Post date:** [October 1, 2019, 4:59pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/269 "2019-10-01T16:59:56Z")

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> [@survinga](#):
>
> But in any event, back to your question, I support a more robust ACA. From that more robust ACA, I expect my taxes to go up, and I don’t think I will save anything on my own employer-provided policy. However, it helps get more people insured, and I’m willing to do that. IMO, that’s selfless, because I’m not getting any benefit from it myself.

Not directly, and not at the moment, at least. But, a robust ACA, and good, affordable individual insurance, would still be a benefit for you – it’d give you the assurance that, if you ever lose your job, or wind up working for yourself (or for a smaller company that doesn’t offer health coverage), that you’ll still have health insurance. It also potentially means that you won’t feel like you _must_ stay in a job you don’t like, because you need to keep your health insurance.

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**Author:** ![PatrickLondon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/patricklondon/32/4422_2.png) [@PatrickLondon](https://boards.straightdope.com/u/PatrickLondon)\
**Post date:** [October 1, 2019, 5:01pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/270 "2019-10-01T17:01:43Z")

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> [@survinga](#):
>
> And then, if we did switch to single-payer, i.e. Medicare for All, would the nation save money or spend more money?

Presumably the nation would have to go through a process of deciding what it wants to pay for, and what it’s willing to pay for it - and attempting to reconcile the two by one means or another. It can’t be beyond the wit of man, or woman.

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [October 1, 2019, 5:12pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/271 "2019-10-01T17:12:18Z")

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> [@kenobi\_65](#):
>
> Not directly, and not at the moment, at least. But, a robust ACA, and good, affordable individual insurance, would still be a benefit for you – it’d give you the assurance that, if you ever lose your job, or wind up working for yourself (or for a smaller company that doesn’t offer health coverage), that you’ll still have health insurance. It also potentially means that you won’t feel like you _must_ stay in a job you don’t like, because you need to keep your health insurance.

OK, I see that point. But keep in mind that the main benefit from a well-functioning ACA is for society as a whole, especially for people who are poor, working/middle-class who don’t have employer health insurance, or people have pre-existing conditions. These people would all benefit much more from the ACA than I will. My most likely outcome is almost no change to my status, except maybe I pay more in taxes.

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [October 1, 2019, 5:16pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/272 "2019-10-01T17:16:52Z")

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> [@PatrickLondon](#):
>
> Presumably the nation would have to go through a process of deciding what it wants to pay for, and what it’s willing to pay for it - and attempting to reconcile the two by one means or another. It can’t be beyond the wit of man, or woman.

Right. And reasonable estimates have said we will pay more than we currently pay. We can’t just assume authoritatively that the US will save money with single-payer. If only it were that simple.

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**Author:** ![Horatius](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/horatius/32/3572_2.png) [@Horatius](https://boards.straightdope.com/u/Horatius)\
**Post date:** [October 1, 2019, 6:13pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/273 "2019-10-01T18:13:09Z")

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> [@survinga](#):
>
> Right. And reasonable estimates have said we will pay more than we currently pay. We can’t just assume authoritatively that the US will save money with single-payer. If only it were that simple.

But here’s the thing: even if it cost you more, _it would be worth it._ Because “costs” include more than just the money out of your pocket.

No one would lose their insurance because they lost their job.

No one would lose their insurance because their company went bankrupt.

No one would lose their insurance because they decided to quit their job to start a new job, or run their own business.

No one would have to worry about coverage being denied.

No one would have to worry about going to the “wrong” doctor or hospital when they’re having an emergency.

No one would have to worry about covering “co-pays” or “deductibles” which might run into the thousands of dollars.

No one would have to worry about finding out the plan you chose years ago doesn’t cover the medical problems you’ve developed today.

Those costs, and more, would simply go away.

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**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\
**Post date:** [October 1, 2019, 11:25pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/274 "2019-10-01T23:25:26Z")

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> [@septimus](#):
>
> @ **Linden Arden** - Simple question: Suppose you know that the Democrat “wants” to take away your family’s insurance, but ALSO know that Congress will not approve of this, and that you WILL retain that insurance, at least for the next several years.
> 
> _ **Given those stipulations would you still vote for Trump?** _

I’m unsubscribing from the thread. Anyone: Please PM me if OP ever answers my question.

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**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\
**Post date:** [October 1, 2019, 11:46pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/275 "2019-10-01T23:46:05Z")

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> [@Horatius](#):
>
> But here’s the thing: even if it cost you more, _it would be worth it._ Because “costs” include more than just the money out of your pocket.
> 
> No one would lose their insurance because they lost their job.
> 
> No one would lose their insurance because their company went bankrupt.
> 
> No one would lose their insurance because they decided to quit their job to start a new job, or run their own business.
> 
> No one would have to worry about coverage being denied.
> 
> No one would have to worry about going to the “wrong” doctor or hospital when they’re having an emergency.
> 
> No one would have to worry about covering “co-pays” or “deductibles” which might run into the thousands of dollars.
> 
> No one would have to worry about finding out the plan you chose years ago doesn’t cover the medical problems you’ve developed today.
> 
> Those costs, and more, would simply go away.

Well yes, obviously.

But I don’t know those people, and probably would not like them anyway; they are probably undeserving. (for various definitions of “undeserving”)

---

<div class="post-metadata">

**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\
**Post date:** [October 1, 2019, 11:54pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/276 "2019-10-01T23:54:38Z")

</div>

> [@survinga](#):
>
> Right. And reasonable estimates have said we will pay more than we currently pay. We can’t just assume authoritatively that the US will save money with single-payer. If only it were that simple.

That’s certainly a fair comment. The US spends more per capital on health care now than any other country. While UHC provides lower cost in other countries, that higher US cost is currently “baked in” to the US health care system. Even with administrative efficiencies from UHC, it can take a while for systemic costs to drop.

---

<div class="post-metadata">

**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\
**Post date:** [October 2, 2019, 12:21am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/277 "2019-10-02T00:21:14Z")

</div>

> [@survinga](#):
>
> I’m not the OP, but the premise of your question is flawed. We would still have to pay for health insurance no matter what system we have. The question is how we pay for it, either funded strictly through federal taxes or funded through premiums that come from multiple sources. If funded through single-payer, I’m still paying because I pay taxes.
> 
> And then, if we did switch to single-payer, i.e. Medicare for All, would the nation save money or spend more money? On that question, there are a wide variety of opinions. Economists and think tanks from the right and left have to make rough assumptions and those assumptions lead to different views on whether single-payer will save money or cost more money. See attached from the NY Times, where they compared a handful of cost estimates, some which forecast more cost, not less, if we go to Medicare for All. The Urban Institute is left-leaning for instance, and they think it will cost more:
> 
> [Would ‘Medicare for All’ Save Billions or Cost Billions? - The New York Times](https://www.nytimes.com/interactive/2019/04/10/upshot/medicare-for-all-bernie-sanders-cost-estimates.html)
> 
> But in any event, back to your question, I support a more robust ACA. From that more robust ACA, I expect my taxes to go up, and I don’t think I will save anything on my own employer-provided policy. However, it helps get more people insured, and I’m willing to do that. IMO, that’s selfless, because I’m not getting any benefit from it myself.

…compare and contrast:

> [@Banquet\_Bear](#):
>
> Cost out of pocket? $4.00 for a car-park.
> 
> …
> 
> Cost out of pocket? Zero.
> 
> …
> 
> How much would it cost me out-of-pocket for an ambulance? [Zero](https://www.wfa.org.nz/).
> 
> …
> 
> Cost out of pocket for all of this? Zero.
> 
> …
> 
> Cost out of pocket for two doses of clexane? Zero.
> 
> …
> 
> How much did the CT scan cost me out of pocket? Zero. How much did parking in the hospital overnight cost me? Zero: because I was an overnight-emergency patient I was given a parking voucher.

> [@MissTake](#):
>
> C  
> As of today, I have over $80K in bills sitting on my table, as Medicare and my employer based insurance will not pay until Medicare decides whether I’m eligible for part B (Part A was immediately approved to pay for the actual transplant and hospital stay). Those daily to biweekly blood tests? $2k/each. I’ve spent over 20 hours on the phone with providers, my employer insurance and Medicare. I am now receiving threatening phone calls and my credit has been dinged.

I’ve got Universal Health Care. Myself and my family have universal coverage for healthcare based entirely on the fact that I live in New Zealand and I pay my taxes.

I’ve got no skin in the game. I’m entirely convinced that if you really wanted too, the most powerful and one of the richest nations in the entire history of the world could set up a Universal Healthcare system that would cost people substantially less out-of-pocket than it does at the moment. And even if America couldn’t (through sheer incompetence) make a system that would be cheaper, it could make a system that was universal.

So don’t debate me. I know it can work. All of us that don’t live in America? We know it works.

I didn’t share my personal story here for purposes of debate. I shared it here to show you that it **can be done**. My story wasn’t exceptional. It was boringly normal. This is what living under Universal Healthcare is like. You will get the same stories all around the world.

So don’t debate me. Your job isn’t to convince people like me that you are right. You have to convince people like MissTake or Broomstick that whatever plan you have is better than a universal one. They \*\*have \*\*skin in the game. They are at the mercy of their employers, of the insurance companies, of government bureaucracy. You explain to them how you plan to fix things.

I honestly hate this. I hate that this is even a debate. The system that you have, the way that you treat people, is disgustingly inhumane. As I said earlier in the thread: Universal Healthcare is premised on two things: one it is **universal** , and two that it provides **healthcare**. If your plan for fixing the US healthcare system isn’t based on those two fundamental premises then it is guaranteed not everyone will have coverage. Strengthening the ACA will still mean millions of people won’t be able to access the healthcare system. It will still mean we hear stories of people with over $80K in bills. That face medical bankruptcy. Don’t worry about arguing with me. What are you going to say to them?

---

<div class="post-metadata">

**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [October 2, 2019, 12:52am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/278 "2019-10-02T00:52:08Z")

</div>

> [@Banquet\_Bear](#):
>
> …  
> So don’t debate me. I know it can work. All of us that don’t live in America? We know it works.
> 
> I didn’t share my personal story here for purposes of debate. I shared it here to show you that it **can be done**. My story wasn’t exceptional. It was boringly normal. This is what living under Universal Healthcare is like. You will get the same stories all around the world.
> 
> So don’t debate me. Your job isn’t to convince people like me that you are right. You have to convince people like MissTake or Broomstick that whatever plan you have is better than a universal one. They \*\*have \*\*skin in the game. They are at the mercy of their employers, of the insurance companies, of government bureaucracy. You explain to them how you plan to fix things.
> 
> I honestly hate this. I hate that this is even a debate. The system that you have, the way that you treat people, is disgustingly inhumane. As I said earlier in the thread: Universal Healthcare is premised on two things: one it is **universal** , and two that it provides **healthcare**. If your plan for fixing the US healthcare system isn’t based on those two fundamental premises then it is guaranteed not everyone will have coverage. Strengthening the ACA will still mean millions of people won’t be able to access the healthcare system. It will still mean we hear stories of people with over $80K in bills. That face medical bankruptcy. Don’t worry about arguing with me. What are you going to say to them?

The NZ Healthcare system is totally irrelevant to whether or not your question was based on a wrong premise. The US system, if we go to single-payer, has a non-negligible likelihood (according to healthcare economists) of costing more than it does now. Don’t dismiss these estimates, because there is real thought and educated assumptions behind it. And the taxpayers, including me, will be paying for it, whether it costs more or less. We’re talking about the US system, which is based on US laws, US politics, and expectation of the voters, doctors, lawyers, hospitals, dems, pubs, you name it. We’re not talking about the NZ system.

I am willing to pay more taxes to insure that the US gets to UHC without losing my current policy. I’ll get nothing for it, except I’ll pay more taxes, and keep what I have. That’s as selfless as a person can be.

---

<div class="post-metadata">

**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\
**Post date:** [October 2, 2019, 1:17am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/279 "2019-10-02T01:17:52Z")

</div>

> [@survinga](#):
>
> The NZ Healthcare system is totally irrelevant to whether or not your question was based on a wrong premise.

…my question wasn’t based on a false premise.

> [@](#):
>
> The US system, if we go to single-payer, has a non-negligible likelihood (according to healthcare economists) of costing more than it does now.

> [@my premise](#):
>
> So to the OP: if the United States of America could **start from scratch, if it were to re-write its healthcare system with universality at its core** , that might result in an increase in taxes but virtually eliminate the need for you (or your employers) to pay for health insurance (leading to an overall reduction in costs), would you be willing to have your “health insurance taken away” if it meant that your neighbour would be able to get access to the same level of health care that you have?

I stand by my premise. My premise is based on **starting from scratch, re-writing its healthcare system with universality at its core**.

> [@](#):
>
> Don’t dismiss these estimates, because there is real thought and educated assumptions behind it.

I don’t give a fuck about those estimates. They aren’t relevant to my point.

> [@](#):
>
> And the taxpayers, including me, will be paying for it, whether it costs more or less.

AS THEY SHOULD.

> [@](#):
>
> We’re talking about the US system, which is based on US laws, US politics, and expectation of the voters, doctors, lawyers, hospitals, dems, pubs, you name it. We’re not talking about the NZ system.

The US system is fucked up. US laws are fucked up. US politics are royally fucked up. The expectations of voters, doctors, lawyers, hospitals, dems, pubs, you name it, are \*\*set \*\*by people who are invested in maintaining the status quo.

> [@](#):
>
> I am willing to pay more taxes to insure that the US gets to UHC without losing my current policy. I’ll get nothing for it, except I’ll pay more taxes, and keep what I have. That’s as selfless as a person can be.

Then explain to \*\*MissTake \*\*how you intend to rid them of their 80K debt. Explain how you get to UHC without actually embracing the fundamental premise of UHC, which are universality and healthcare.

---

<div class="post-metadata">

**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\
**Post date:** [October 2, 2019, 1:25am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/280 "2019-10-02T01:25:44Z")

</div>

> [@survinga](#):
>
> The NZ Healthcare system is totally irrelevant to whether or not your question was based on a wrong premise. The US system, if we go to single-payer, has a non-negligible likelihood (according to healthcare economists) of costing more than it does now. Don’t dismiss these estimates, because there is real thought and educated assumptions behind it. And the taxpayers, including me, will be paying for it, whether it costs more or less. We’re talking about the US system, which is based on US laws, US politics, and expectation of the voters, doctors, lawyers, hospitals, dems, pubs, you name it. We’re not talking about the NZ system.
> 
> I am willing to pay more taxes to insure that the US gets to UHC without losing my current policy. I’ll get nothing for it, except I’ll pay more taxes, and keep what I have. That’s as selfless as a person can be.

But your current policy is _shit_. I don’t know the specifics, but I know the industry, and your policy is 3rd-rate compared to what they have in New Zealand. Australia. Japan. Britain. France. Germany. Canada. And more.

So, why the need to keep a crap-assed policy?

And if you claim it’s not shit, tell us your plan design, costs (copays, deductibles, max out of pocket, annual employee-paid premium, and employer-paid premium), and more.

Because even the best plans nowadays, even for the largest companies, have devolved to the lowest common denominators. And what that means is you will be out of pocket thousands of dollars before the insurance company picks up a damned dime. And this is by design.

---

<div class="post-metadata">

**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\
**Post date:** [October 2, 2019, 11:32am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/281 "2019-10-02T11:32:32Z")

</div>

> [@survinga](#):
>
> I’m not the OP, but the premise of your question is flawed. We would still have to pay for health insurance no matter what system we have. The question is how we pay for it, either funded strictly through federal taxes or funded through premiums that come from multiple sources. If funded through single-payer, I’m still paying because I pay taxes.

Well, no. It is not given that you’d have to pay for **health insurance**. You’d have to pay for **health care.** Its not the same thing, and the difference has a bit to do with the cost differences. And your taxes already pay more for healthcare than an average UHC system for your population costs.

> [@survinga](#):
>
> And then, if we did switch to single-payer, i.e. Medicare for All, would the nation save money or spend more money? On that question, there are a wide variety of opinions.  
> There may be a wide variety of opinions, but there is plenty of practical experience, and no variety there: It is universally cheaper than what you currently do by a very large margin. Always. No variety there.

The laws of economics do not respect variety of opinion. The laws of economics do not care what think tanks say. The laws of economics do not pay attention to differing views. The laws of economics do not think you are special.

If you end up with a more expensive system it will be for one reason and one reason only: It was designed to be more expensive by people who wanted to benefit from that. Corruption, in other words. Regulatory failure.

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