# Republicans: Please Define Health Care Reform **URL:** \ **Category:** Great Debates\ **Created:** [January 21, 2010, 1:17am UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777 "2010-01-21T01:17:04Z")\ **Posts on this page:** 20\ **Page:** 6
**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:** [January 21, 2010, 8:11pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/101 "2010-01-21T20:11:29Z")
> [@magellan01](#): > > We agree on emergency care. That’s it. And this is one of the reasons (not the only one\*), why you spend more per capita than any other country, for outcomes that are not better than many countries with UHC. Paying for only emergency care for a significant portion of society will cost you more in the long run than if you agreed to pay for preventative medicine and longer term care. The poor person who does not get their ACL tended to because it’s not an “emergency” will likely be unemployed or under employed, and may become a drain on society by going on welfare. Whereas with a system that pays for more than “emergent” care, we get that same person on their feet, so to speak, with a better chance of being independent and contributing to society. Pre-natal checkups and “well baby” visits will end up saving money in the long run. It leads to fewer emergency room visits. In a UHC environment, the focus is on “making everyone well” In a for-profit insurance environment, the focus will necessarily be on “making our good clients well and kicking our non-profit making clients to the curb” \*other reasons why the US system costs more would include insurance company profits (yes, not huge, but present), Insurance company costs (salaries for executives, employees to check, double check and deny claims) inefficiencies due to doctors having to hire staff to deal with multiple insurance companies, advertising for private health concerns, duplication of services at competing hospitals, litigation costs with the insurance companies and more. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [January 21, 2010, 8:16pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/102 "2010-01-21T20:16:33Z")
> [@kunilou](#): > > I’m a little surprised at your dodging the issue, **Bricker**. I’m personalizing the issue just like you personalized the issue when you said “I don’t believe there’s a right for society to pay for your care if you’re sick.” That’s a philosophical position, not a dispassionate cost-benefit analysis. Yes, that’s true. > [@](#): > > You choose to throw up a straw man – what if my daughter could live for two extra years at a cost of $20, so I’ll throw a straw man right back: what if my daughter has a treatable but chronic illness like diabetes or MS? Instead of living two years, she could live a normal lifespan and continue to work. I think you and your daughter are responsible for her heatlh care, not me. I’ll handle mine and my wife’s and my son’s. ---
**Author:** ![magellan01](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@magellan01](https://boards.straightdope.com/u/magellan01)\ **Post date:** [January 21, 2010, 8:17pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/103 "2010-01-21T20:17:19Z")
> [@ElvisL1ves](#): > > I was indeed making fun of **John** ’s pouting. > > But you did stumble across a good point, that “health care” is not a single concept and that there can be gradations as to what types of it we as a society have agreed to provide. It’s certainly good to see you part ways with the GOP on that. > > There has been a very interesting debate over the decades as to how to implement that commitment more efficiently and effectively. The immediate topic, though, is how and why a minority party has been able to get away with simple obstructionism rather than substantive participation. I think that by “substantive” you probably mean something along the lines of “Okay, what’s the best way to institute a public option of sort”. And that starts the conversation too far down the road. I’ll ask you, why not FIRST institute a bunch of small changes, like tort reform, buying insurance over state lines and not tying it to an employer, having the government help fund a catastrophic illness insurance pool, etc. These things _may_ work. If they don’t, I, for one, would be MUCH more open to the ides the dems are advocating. Why, oh why, is this not a better route to go? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 21, 2010, 8:18pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/104 "2010-01-21T20:18:02Z")
So a child’s health should depend on her choosing to have wealthy parents, huh? :dubious: ---
**Author:** ![magellan01](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@magellan01](https://boards.straightdope.com/u/magellan01)\ **Post date:** [January 21, 2010, 8:20pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/105 "2010-01-21T20:20:31Z")
> [@Euphonious\_Polemic](#): > > And this is one of the reasons (not the only one\*), why you spend more per capita than any other country, for outcomes that are not better than many countries with UHC. > > Paying for only emergency care for a significant portion of society will cost you more in the long run than if you agreed to pay for preventative medicine and longer term care. > > The poor person who does not get their ACL tended to because it’s not an “emergency” will likely be unemployed or under employed, and may become a drain on society by going on welfare. Whereas with a system that pays for more than “emergent” care, we get that same person on their feet, so to speak, with a better chance of being independent and contributing to society. > > Pre-natal checkups and “well baby” visits will end up saving money in the long run. It leads to fewer emergency room visits. > > In a UHC environment, the focus is on “making everyone well” In a for-profit insurance environment, the focus will necessarily be on “making our good clients well and kicking our non-profit making clients to the curb” > > \*other reasons why the US system costs more would include insurance company profits (yes, not huge, but present), Insurance company costs (salaries for executives, employees to check, double check and deny claims) inefficiencies due to doctors having to hire staff to deal with multiple insurance companies, advertising for private health concerns, duplication of services at competing hospitals, litigation costs with the insurance companies and more. I had an accident and tore my ACL. With therapy and exercises I was able to get to the point where I could do pretty much everything except certain sports. I had the operation in order for me to do those things. It had nothing to do with work. Why should you pay the $40,000 it cost (there were complications) for me to be able to ski? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 21, 2010, 8:21pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/106 "2010-01-21T20:21:51Z")
> [@magellan01](#): > > I think that by “substantive” you probably mean something along the lines of “Okay, what’s the best way to institute a public option of sort”. And that starts the conversation too far down the road. No, I’m asking for anything more than the simple “No” that the Republicans have limited their “contribution” to. Anything at all other than that would be substantive. > [@](#): > > I’ll ask you, why not FIRST institute a bunch of small changes, like tort reform, buying insurance over state lines and not tying it to an employer, having the government help fund a catastrophic illness insurance pool, etc. Why not first implement a bunch of small changes like expanding coverage and ending denials of coverage, while reducing the deficit in the bargain? IOW, why do you oppose the Senate bill? > [@](#): > > These things _may_ work. And so may those things. So which set should we try first, hmm? > [@](#): > > Why, oh why, is this not a better route to go? Because, essentially, your proposal is imaginary. Your party has refused to advance it or even consider it. Maybe you should try convincing the other party to include it and promise to support the package as a result? ---
**Author:** ![magellan01](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@magellan01](https://boards.straightdope.com/u/magellan01)\ **Post date:** [January 21, 2010, 8:22pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/107 "2010-01-21T20:22:03Z")
> [@ElvisL1ves](#): > > So a child’s health should depend on her choosing to have wealthy parents, huh? :dubious: Well, you shouldn’t have a child if you can’t afford to take care of him/her. But I could see _some_ basic care extended to the children of the irresponsible. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [January 21, 2010, 8:24pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/108 "2010-01-21T20:24:17Z")
> [@ElvisL1ves](#): > > Competition between more providers has resulted only in very rapid price increases. How is tightening an oligopoly going to reverse that, Mr. Common Sense? It would not be an oligopoly if competition across state lines is allowed. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 21, 2010, 8:26pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/109 "2010-01-21T20:26:22Z")
As already stated, they’d all rush to the minimum-regulation state, just as the credit card industry has. Any who didn’t would be priced out of business, similarly. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 8:28pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/110 "2010-01-21T20:28:21Z")
> [@tacoloco](#): > > Are you confused about what “uninsurable” means? > > Are there any facts in evidence that indicate that someone who is considered to be uninsurable would, in fact, be eligible for insurance through an employer? I would assume, since a medical condition cannot be disclosed during hiring, it would be discriminatory for someone to be hired with insurance as a benefit, then denied that benefit after a medical condition is disclosed. Are there any facts in evidence that indicate that someone who is considered to be uninsurable would, in fact, not be eligible for insurance through an employer? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 21, 2010, 8:29pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/111 "2010-01-21T20:29:53Z")
You assume entirely incorrectly. Have you ever applied for insurance yourself? ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 8:31pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/112 "2010-01-21T20:31:01Z")
> [@ElvisL1ves](#): > > So a child’s health should depend on her choosing to have wealthy parents, huh? :dubious: Again, we’re dealing with the margins. Being wealthy isn’t a requirement for paying for your own health care. We’re far from wealthy, and we have our regular medical costs in hand without a regular insurance plan. If you’re concerned about a catastrophic medical problem, then how do you feel about the gov providing catastrophic coverage, and leaving insurance companies to sell gap insurance? ---
**Author:** ![saoirse](https://avatars.discourse-cdn.com/v4/letter/s/5daacb/32.png) [@saoirse](https://boards.straightdope.com/u/saoirse)\ **Post date:** [January 21, 2010, 8:32pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/113 "2010-01-21T20:32:07Z")
> [@yorick73](#): > > Economics? Common sense? "Common sense is usually just another way of saying “unsupported assertion.” > [@](#): > > I’m not sure I buy this. According to those opposed all insurance companies will move to the state that has the least regulation. Many will not be able to compete and the number of companies will be smaller. Yes, the companies we can choose from will be larger and competition will be greater. This just might result in lower prices. Many not-for-profit insurers are locally-based and unable to move. Many for-profit ones would register in another state while keeping their operations local. In any case, if there aren’t at least dozens of different insurers competing, then how is competition supposed to improve affordability? If the market remains three or four companies, how will consumers have more choices? Also, there is really no way for a consumer to exercise informed choice in the health insurance market, since there is no way to predict what sort of coverage he will need (aside from that gender reassignment surgery thing) during the time he has the policy, unless of course the consumer actually has a pre-existing condition. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [January 21, 2010, 8:32pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/114 "2010-01-21T20:32:30Z")
> [@ElvisL1ves](#): > > As already stated, they’d all rush to the minimum-regulation state, just as the credit card industry has. Any who didn’t would be priced out of business, similarly. That certainly doesn’t equal oligopoly. And I’m sure you can imagine the bizarre scenario that companies will offer extras for a price? ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 8:33pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/115 "2010-01-21T20:33:38Z")
> [@ElvisL1ves](#): > > You assume entirely incorrectly. > > Have you ever applied for insurance yourself? I thought we were talking about employer insurance, not an individual policy. Did I miss something? And, yes, I have. My family is currently covered under an HSA/catastrophic policy, which I put together completely on my own. Prior to that, I worked with both my employer and my husband’s employer re: insurance coverage. Do you have any numbers about how many uninsured are turned down, after being hired, based on being uninsurable? ---
**Author:** ![saoirse](https://avatars.discourse-cdn.com/v4/letter/s/5daacb/32.png) [@saoirse](https://boards.straightdope.com/u/saoirse)\ **Post date:** [January 21, 2010, 8:34pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/116 "2010-01-21T20:34:58Z")
> [@Sateryn76](#): > > I would assume, since a medical condition cannot be disclosed during hiring, it would be discriminatory for someone to be hired with insurance as a benefit, then denied that benefit after a medical condition is disclosed. > > Are there any facts in evidence that indicate that someone who is considered to be uninsurable would, in fact, not be eligible for insurance through an employer? You would be wrong about that. This is the whole controversy about pre-existing conditions. You could eliminate this discrimination with a national law, but of course then no one would get insurance until they needed it, which would mean they wouldn’t be paying into the system until they were already drawing from it, substantially. ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [January 21, 2010, 8:36pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/117 "2010-01-21T20:36:27Z")
> [@Shodan](#): > > -So I posted [this link](http://www.healthtransformation.net/cs/newt_gingrich), which says right on the front fucking page that it is a foundation founded in 2003 by Newt Gingrich to bring about health care reform. Newt Gingrich is certainly a Republican, he is certainly a leader, he has said a great deal more than “nothing” about health care reform, there isn’t a fucking word about “death panels” anywhere, 2003 certainly qualifies as “the last few years” and, far from voting No on everything, it lists a number of initiatives that Newt was instrumental in bringing about. I grant you, you have to scroll down two whole paragraphs to see it, but is that so tough? Actually, it is so tough. Exactly where in this mush is the meat? > [@](#): > > Since retiring from Congress, Newt Gingrich has worked extensively on the issues of health and healthcare, devoting the majority of his time to advocating a transformation of the entire system. In 2003, he founded the Center for Health Transformation, a collaboration of public and private sector leaders dedicated to the creation of a 21st Century Intelligent Health System that saves lives and saves money. > Honored most recently by Modern Healthcare’s annual poll as the 5th Most Powerful Person in Healthcare for 2006, Newt Gingrich is widely recognized as a transformational leader, unparalleled in his ability to create and lead successful large-scale change. As the architect of the Contract with America, he led the Republican Party to victory in 1994, capturing the majority in the U.S. House for the first time in forty years. Under his leadership, Congress passed transformational legislation including welfare reform, the first balanced budget in a generation, funding to strengthen our defense capabilities, and the first tax cuts in sixteen years. > > During his twenty years in Congress, Speaker Gingrich was committed to improving America’s healthcare system, co-chairing the Republican Task Force on Health for four years prior to becoming Speaker. Under his leadership as Speaker, Medicare was improved, investment in medical research was dramatically increased, and FDA reform was enacted to allow for quicker approval and access to new medicines for those with terminal and degenerative illnesses. > > The Washington Times called him “the indispensable leader” and Time magazine, in naming him Man of the Year for 1995, said, “Leaders make things possible. Exceptional leaders make them inevitable. Newt Gingrich belongs in the category of the exceptional.” He is routinely in Modern Healthcare’s Top 10 of Healthcare’s Most Powerful People in Healthcare, and regularly participates as a healthcare expert in both the National Journal’s Healthcare Expert Blog and as commentator on Fox News. > > Mr. Gingrich is currently a member of the Advisory Board for the Agency for Healthcare Quality and Research and sits on the Board of Regents at the National Library of Medicine. In addition, he co-chairs the National Commission for Quality Long Term Care. He has received numerous health and healthcare honors and awards, including: > > • 1995 March of Dimes Georgian of the Year > • 1996 Georgia Breast Cancer Coalition Honoree > • 1996 Mental Health Association Advocacy Award > • 1997 Juvenile Diabetes Foundation Advocate of the Year > • 1998 American Association of Endocrinologists Patients Advocate of the Year > • 1998 American Diabetes Association Charles Best Medal (highest non-medical award) > • 1998 National Association of Community Health Centers Diabetes Healthcare Advocate of the Year > • 2001 Science Coalition’s Science Pioneer Award > • 2005 NCQA Health Quality Award (National Committee for Quality Assurance) > • 2005 National Minority Health Month Foundation Award for outstanding contributions to elimination of diabetes > • 2005 Louis Sullivan Award for his leadership and advocacy for the rapid adoption of health information technology (WEDI, the Workgroup for Electronic Data Interchange) > • 2005 HIMSS Advocacy Award for his leadership advancing information and management systems for the betterment of human health > • 2006 National Hispanic Youth Initiative Award for Leadership > • 2008 Modern Healthcare’s 100 Most Powerful People in Healthcare > • 2008 “Indispensible Person of the Year Award” by Alliance on Aging > > Speaker Gingrich has authored numerous health publications, columns and books, including Saving Lives and Saving Money, which describes the vision and principles of the Center for Health Transformation. His book Winning the Future includes key chapters on health and healthcare, based on his work at The Center. Speaker Gingrich and Center for Health Transformation CEO and President Nancy Desmond published The Art of Transformation in 2007, and 2008 brings another publication, Real Change, which devotes a chapter to the necessary changes in today’s healthcare system. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 21, 2010, 8:40pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/118 "2010-01-21T20:40:09Z")
> [@yorick73](#): > > That certainly doesn’t equal oligopoly. Reducing competition by eliminating competitors and competitive advantages is quintessentially oligopolistic. > [@](#): > > And I’m sure you can imagine the bizarre scenario that companies will offer extras for a price? Huh? The competition would be between states, to offer the insurance companies the most profitable environment possible for them. There would be no incentive for them to reduce prices at all, just as there isn’t much now. Remember that their profits depend on minimizing services to patients, and that an individual rarely has an option anyway other than the single provider their employer contracts with. And, if they’re unemployed, effectively no option at all. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [January 21, 2010, 8:40pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/119 "2010-01-21T20:40:25Z")
> [@saoirse](#): > > "Common sense is usually just another way of saying “unsupported assertion.” And economics? Are you familiar with supply and demand? > [@saoirse](#): > > "Many not-for-profit insurers are locally-based and unable to move. Many for-profit ones would register in another state while keeping their operations local. In any case, if there aren’t at least dozens of different insurers competing, then how is competition supposed to improve affordability? If the market remains three or four companies, how will consumers have more choices? Also, there is really no way for a consumer to exercise informed choice in the health insurance market, since there is no way to predict what sort of coverage he will need (aside from that gender reassignment surgery thing) during the time he has the policy, unless of course the consumer actually has a pre-existing condition. Okay, for the last time, if you can purchase insurance ACROSS state lines then companies will have to compete and costs will decrease as compared to the system we now have. Why do you think there will only be 3 or 4 companies left? And, of course consumers can make informed choices concerning health insurance. What is the roadblock to this? Start with the basics and work your way up to what you can afford. Catastrophic coverage…check. Do I really need a plan that pays for my annual checkup? Nope. See, not that difficult. ---
**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:** [January 21, 2010, 8:40pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/120 "2010-01-21T20:40:32Z")
> [@Bricker](#): > > I think you and your daughter are responsible for her heatlh care, not me. I’ll handle mine and my wife’s and my son’s. Even if this will lead (or has led) to higher costs per capita for your society as a whole? Even if this will lead (or has led) to poorer health outcomes for your society as a whole? Does the good of the individual (i.e. you and yours) always trump the good of society? [Previous page](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777.md?page=5) [Next page](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777.md?page=7)