# Trumpcare **URL:** \ **Category:** Politics & Elections\ **Created:** [March 7, 2017, 3:57pm UTC](https://boards.straightdope.com/t/trumpcare/781625 "2017-03-07T15:57:35Z")\ **Posts on this page:** 20\ **Page:** 12
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 14, 2017, 11:03pm UTC](https://boards.straightdope.com/t/trumpcare/781625/221 "2017-03-14T23:03:29Z")
> [@adaher](#): > > So we have to get pricing for young people down to a more realistic level. No, we have to deal with the fact that we’ve been making some major mistakes these past few decades, suck it up, and change to single-payer like the rest of civilization - or admit that we really are that stupid and that cruel to our own people. And accept that NO, we do NOT have the “best” medical system in the work, our medical system sucks. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 14, 2017, 11:10pm UTC](https://boards.straightdope.com/t/trumpcare/781625/222 "2017-03-14T23:10:12Z")
The rest of civilization does not have single payer. I think what you mean is that there should be a public option, but with private options still there for whoever wants them. That’s what most countries actually do. But that’s multi-payer. The only true single payer countries I know of are Britain and Canada, although I’m sure there are a few others. But most other famous systems are either single payer with a very low floor, such that most people have to buy supplementary, or true multipayer where you can go with the government system or a private option. My own favored plan is single payer for catastrophic costs only. If Democrats have the political support and can pay for it, they can easily expand it to cover more and more later on. But it probably wouldn’t be necessary. If castatrophic costs are covered by the government, then all anyone needs is a health plan for routine costs, which shouldn’t be too expensive and for most would be a benefit of employment. The primary problem with health care is, “What happens if you get sick or injured and incur hundreds of thousands in costs?” A castrophic plan fixes that problem. ---
**Author:** ![jshore](https://avatars.discourse-cdn.com/v4/letter/j/b5e925/32.png) [@jshore](https://boards.straightdope.com/u/jshore)\ **Post date:** [March 15, 2017, 12:00am UTC](https://boards.straightdope.com/t/trumpcare/781625/223 "2017-03-15T00:00:25Z")
> [@adaher](#): > > My own favored plan is single payer for catastrophic costs only. If Democrats have the political support and can pay for it, they can easily expand it to cover more and more later on. But it probably wouldn’t be necessary. If castatrophic costs are covered by the government, then all anyone needs is a health plan for routine costs, which shouldn’t be too expensive and for most would be a benefit of employment. > > The primary problem with health care is, “What happens if you get sick or injured and incur hundreds of thousands in costs?” A castrophic plan fixes that problem. At the very least, it should also cover preventative care too. Even if people can afford it, it makes more sense to take their money in tax dollars and then make it free to entice them to do it. People often make stupid choices about health care…I know I might have a tendency to do so if I knew it might cost me several hundred dollars. Better to take my money up front if you want to encourage me to do things I should do. Basically, the free market sucks for health care in so many ways that it is hard to delineate them all, which is why the whole Republican solution is so f-cked. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [March 15, 2017, 3:53am UTC](https://boards.straightdope.com/t/trumpcare/781625/224 "2017-03-15T03:53:17Z")
I used to purchase catastrophic coverage and it was fairly cheap ($3000/year in 2011 at age 62). Would have been really cheap for a 20-something. I wonder how the numbers would crunch if “free government healthcare” covered all a defined set of routine, preventative care (including mental health & addiction). The stuff that could really improve the health of the nation as a whole. The individual would then be responsible for buying catastrophic coverage. _Freedom_ to roll the dice on a major accident, cancer or coronary - the stuff that can kill you. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 15, 2017, 3:58am UTC](https://boards.straightdope.com/t/trumpcare/781625/225 "2017-03-15T03:58:44Z")
> [@jshore](#): > > At the very least, it should also cover preventative care too. Even if people can afford it, it makes more sense to take their money in tax dollars and then make it free to entice them to do it. People often make stupid choices about health care…I know I might have a tendency to do so if I knew it might cost me several hundred dollars. Better to take my money up front if you want to encourage me to do things I should do. > > Basically, the free market sucks for health care in so many ways that it is hard to delineate them all, which is why the whole Republican solution is so f-cked. There could be some types of preventive care that are a great idea, but given the cost of screening entire populations I’d really want to see evidence that this was cost effective. So far the evidence is mixed on whether preventive care saves money or not. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 15, 2017, 4:04am UTC](https://boards.straightdope.com/t/trumpcare/781625/226 "2017-03-15T04:04:11Z")
> [@jasg](#): > > I used to purchase catastrophic coverage and it was fairly cheap ($3000/year in 2011 at age 62). Would have been really cheap for a 20-something. > > I wonder how the numbers would crunch if “free government healthcare” covered all a defined set of routine, preventative care (including mental health & addiction). The stuff that could really improve the health of the nation as a whole. > > The individual would then be responsible for buying catastrophic coverage. _Freedom_ to roll the dice on a major accident, cancer or coronary - the stuff that can kill you. Depends on what problem you’re trying to solve. If you want to improve the health outcomes of the public, then health care actually a pretty low priority. Getting Americans to adopt lifestyle changes does a lot more good, if it can be done. In regards to health care, it seems to me that the primary problem is that it’s fairly easy to get into a situation where you have to come up with more money than you could make in 10 years to pay for lifesaving treatment. and the advantage of a catastrophic-only single payer plan is that it would focus the government like a laser beam on lifesaving care, whereas when single payer covers routine care it can be tempting to stop paying for the really expensive stuff. Britain’s NICE has to make tough choices. Do we pay for this spiffy breast cancer drug, or do we pay for mammograms for every citizen? This is actually the opposite of what insurance is supposed to be. Ask anyone with an ounce of sense whether they’d take free Herceptin if they needed it vs. free mammograms and they’d take the Herceptin contingency. The prospect of running up huge bills is the only problem that most Americans can’t solve on their own. Access to routine care is only a problem for the poor and elderly, and we’d still keep Medicare and Medicaid for their situations. Americans 27-64 mainly just need protection from big costs. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [March 15, 2017, 4:33am UTC](https://boards.straightdope.com/t/trumpcare/781625/227 "2017-03-15T04:33:12Z")
> [@adaher](#): > > The prospect of running up huge bills is the only problem that most Americans can’t solve on their own. Access to routine care is only a problem for the poor and elderly, and we’d still keep Medicare and Medicaid for their situations. Americans 27-64 mainly just need protection from big costs. Yes, but isn’t individual responsibility the conservative solution? Clearly we are a conservative nation. I that case, either saving for those huge bills or buying catastrophic coverage seems to be the individual freedom that should be honored. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [March 15, 2017, 7:26am UTC](https://boards.straightdope.com/t/trumpcare/781625/228 "2017-03-15T07:26:13Z")
> [@jasg](#): > > I used to purchase catastrophic coverage and it was fairly cheap ($3000/year in 2011 at age 62). Would have been really cheap for a 20-something. > > I wonder how the numbers would crunch if “free government healthcare” covered all a defined set of routine, preventative care (including mental health & addiction). The stuff that could really improve the health of the nation as a whole. I posted this upthread: > [@Quartz](#): > > I happened to lunch with Malcolm Wright, the Chief Executive of NHS Grampian, today. He said that the NHS budget per person is £1850 per year (~$2250). That’s for everything from the local GP to surgery to end of life hospice care. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 15, 2017, 4:59pm UTC](https://boards.straightdope.com/t/trumpcare/781625/229 "2017-03-15T16:59:02Z")
That’s not “free” though. That budget is enforced through denial of expensive drugs and treatments, and while it’s mainly Britain’s right-wing press that alleges this, seems to strongly encourage patients to not seek aggressive treatments towards end of life, which is a large part of our own Medicare’s costs. I’ve never understood why Britain is so often cited as an example to be emulated by liberals. No country in the Western world has sought to copy Britain’s model. If anything, they’ve steered very clear. Spending a little more on health care is worth it. We obviously spend too much, but spending as much as Switzerland is not unreasonable. ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [March 16, 2017, 1:26am UTC](https://boards.straightdope.com/t/trumpcare/781625/230 "2017-03-16T01:26:39Z")
[Atul Gawande](https://twitter.com/Atul_Gawande/status/841757044852035587): “Annual opioid overdose deaths now exceed the peak of deaths in the worst year of the HIV/AIDS epidemic.” Making it hard for middle-aged rural men to get health insurance isn’t gonna help that. Also, as someone who remembers the 1980s quite well, I await with bated breath the deluge of evangelical preachers describing this as God’s judgment on rural white America. ---
**Author:** ![Johnny\_Ace](https://avatars.discourse-cdn.com/v4/letter/j/6bbea6/32.png) [@Johnny\_Ace](https://boards.straightdope.com/u/Johnny_Ace)\ **Post date:** [March 16, 2017, 1:36am UTC](https://boards.straightdope.com/t/trumpcare/781625/231 "2017-03-16T01:36:55Z")
> [@RTFirefly](#): > > Also, as someone who remembers the 1980s quite well, I await with bated breath the deluge of evangelical preachers describing this as God’s judgment on rural white America. LOL I wish. But, like all Republicans, evangelicals know better than to alienate their base. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 16, 2017, 5:32am UTC](https://boards.straightdope.com/t/trumpcare/781625/232 "2017-03-16T05:32:55Z")
> [@RTFirefly](#): > > [Atul Gawande](https://twitter.com/Atul_Gawande/status/841757044852035587): “Annual opioid overdose deaths now exceed the peak of deaths in the worst year of the HIV/AIDS epidemic.” > > Making it hard for middle-aged rural men to get health insurance isn’t gonna help that. > > Also, as someone who remembers the 1980s quite well, I await with bated breath the deluge of evangelical preachers describing this as God’s judgment on rural white America. Well, that really doesn’t matter since having insurance and a prescription for opioids doesn’t mean you’ll actually be able to get them, which means going to the street to fill your Rx. ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [March 16, 2017, 7:08am UTC](https://boards.straightdope.com/t/trumpcare/781625/233 "2017-03-16T07:08:38Z")
> [@Johnny\_Ace](#): > > LOL I wish. But, like all Republicans, evangelicals know better than to alienate their base. Trust me, that was sarcasm on my part. I figure that’s about as likely as all of them waking up one morning and realizing, “hey, you know all those stories in the Bible about Jesus and the Pharisees? What the _hell_ are we doing, being the fucking _Pharisees?_” and repenting _en masse_ and totally changing their ways. ---
**Author:** ![Folacin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/folacin/32/3195_2.png) [@Folacin](https://boards.straightdope.com/u/Folacin)\ **Post date:** [March 16, 2017, 12:39pm UTC](https://boards.straightdope.com/t/trumpcare/781625/234 "2017-03-16T12:39:58Z")
> [@jasg](#): > > Yes, but isn’t individual responsibility the conservative solution? Clearly we are a conservative nation. > > I that case, either saving for those huge bills or buying catastrophic coverage seems to be the individual freedom that should be honored. But then you run into one of two problems: 1. I’m doing the ‘save for huge bills’, but get sick when I’m 25 or 35, before I have the chance to save $1,000,000 for the first round of treatments. Are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? 2. I’m an idiot, and don’t save or buy insurance. I get sick - are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? Even with me being an idiot, most American’s are uncomfortable with the ‘let him die’ answer. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 16, 2017, 12:45pm UTC](https://boards.straightdope.com/t/trumpcare/781625/235 "2017-03-16T12:45:11Z")
> [@Folacin](#): > > But then you run into one of two problems: > > 1. I’m doing the ‘save for huge bills’, but get sick when I’m 25 or 35, before I have the chance to save $1,000,000 for the first round of treatments. Are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? > > 2. I’m an idiot, and don’t save or buy insurance. I get sick - are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? Even with me being an idiot, most American’s are uncomfortable with the ‘let him die’ answer. That’s the thing that most health care ideas put out by most conservatives ignore. It’s all well and good to say “You shouldn’t have done that.” But given that people do that, what then? Saying “We shouldn’t have to pay for you” is fine, as far as it goes (though it ignores the fact that some people have no choice). But they always forget the second half: “We shouldn’t have to pay for you, but we know we’ll have to one way or another, so let’s make it as painless as possible for all of us.” ---
**Author:** ![quimper](https://avatars.discourse-cdn.com/v4/letter/q/7c8e57/32.png) [@quimper](https://boards.straightdope.com/u/quimper)\ **Post date:** [March 16, 2017, 3:44pm UTC](https://boards.straightdope.com/t/trumpcare/781625/236 "2017-03-16T15:44:31Z")
The CBO prediction of 24 million additional uninsured under Trumpcare is a major stumbling block and the situation is edging closer to [full-blown hot potato time on Capitol Hill](https://origin-nyi.thehill.com/homenews/senate/324220-nervous-gop-senators-rooting-for-ryan-to-fail). > [@](#): > > Another Republican senator who requested anonymity to discuss the House bill candidly said, “There are no good options.” > > The lawmaker acknowledged that not fulfilling the party’s campaign promise to repeal and replace ObamaCare would be politically painful in the short-term but worried that voting for bad policy could have negative reverberations for the GOP over the next decade. > > “The best thing may be to kill it early so it doesn’t come over here,” the GOP senator said. > > “One option may be for it to fail and for ObamaCare to continue to implode so that it drives us,” the senator added. ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [March 16, 2017, 4:03pm UTC](https://boards.straightdope.com/t/trumpcare/781625/237 "2017-03-16T16:03:54Z")
> [@Folacin](#): > > But then you run into one of two problems: > > 1. I’m doing the ‘save for huge bills’, but get sick when I’m 25 or 35, before I have the chance to save $1,000,000 for the first round of treatments. Are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? > > 2. I’m an idiot, and don’t save or buy insurance. I get sick - are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? Even with me being an idiot, most American’s are uncomfortable with the ‘let him die’ answer. > [@jsgoddess](#): > > That’s the thing that most health care ideas put out by most conservatives ignore. It’s all well and good to say “You shouldn’t have done that.” But given that people do that, what then? Saying “We shouldn’t have to pay for you” is fine, as far as it goes (though it ignores the fact that some people have no choice). But they always forget the second half: “We shouldn’t have to pay for you, but we know we’ll have to one way or another, so let’s make it as painless as possible for all of us.” This. I wish all the people preaching “personal responsibility” would show some personal responsibility and tell patients who can’t afford treatments X, Y, or Z why it’s their fault that they will die soon, or watch their kid die soon, or get to live in pain and misery with no hope of gainful employment. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [March 16, 2017, 4:16pm UTC](https://boards.straightdope.com/t/trumpcare/781625/238 "2017-03-16T16:16:41Z")
> [@jasg](#): > > Yes, but isn’t individual responsibility the conservative solution? Clearly we are a conservative nation. > > I that case, either saving for those huge bills or buying catastrophic coverage seems to be the individual freedom that should be honored. > [@Folacin](#): > > But then you run into one of two problems: > > 1. I’m doing the ‘save for huge bills’, but get sick when I’m 25 or 35, before I have the chance to save $1,000,000 for the first round of treatments. Are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? > > 2. I’m an idiot, and don’t save or buy insurance. I get sick - are you going to let me die? And even if your answer is yes, what do you think the public’s answer will be, particularly if I’m photogenic with a good story? Even with me being an idiot, most American’s are uncomfortable with the ‘let him die’ answer. > [@Blue\_Blistering\_Barnacle](#): > > This. > > I wish all the people preaching “personal responsibility” would show some personal responsibility and tell patients who can’t afford treatments X, Y, or Z why it’s their fault that they will die soon, or watch their kid die soon, or get to live in pain and misery with no hope of gainful employment. Agreed. My sarcasm flags weren’t flying high enough. I was arguing against a conservative proposal that seemed to ignore healthcare basics AND conservative principles. (FTR I am for universal, government mandated & supported healthcare like the rest of the western world) ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [March 16, 2017, 4:16pm UTC](https://boards.straightdope.com/t/trumpcare/781625/239 "2017-03-16T16:16:45Z")
> [@adaher](#): > > There could be some types of preventive care that are a great idea, but given the cost of screening entire populations I’d really want to see evidence that this was cost effective. So far the evidence is mixed on whether preventive care saves money or not. The best example of cost-justified preventative care is vaccination, vilified by the far left AND the far right\*. Basic dental could also go a long way, but no one’s talking about that. \*Clearly an issue for the FAR left and right, but creeping toward the center on the right side. The most recent Republican president is an anti-vaxer. The stiffest resistance amongst elected officials to anti-HPV vaccination is from the right. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [March 16, 2017, 5:09pm UTC](https://boards.straightdope.com/t/trumpcare/781625/240 "2017-03-16T17:09:48Z")
> [@Blue\_Blistering\_Barnacle](#): > > Basic dental could also go a long way, but no one’s talking about that. I’m reminded of an instance several years ago, in Washington D.C., I think, where a nine-year-old child needed a tooth extracted. The mother could not afford to go to a dentist, and due to circumstances her government assistance (Medicaid, I think) kept getting lost in the shuffle. Eventually the child’s tooth became infected, and the child went to the ER. The hospital spent $250,000 to save the child’s life. Which it didn’t. The child died. So $250,000 and a life could have been saved by a $90 preventative measure. [Previous page](https://boards.straightdope.com/t/trumpcare/781625.md?page=11) [Next page](https://boards.straightdope.com/t/trumpcare/781625.md?page=13)