Health Care Politics

[Anonymous]

I was under the impression that Obamacare was pure evil to Republicans. But look at this:

Gingrich supported a health care mandate (at least up until now).
Trump supported universal health care (at least he did in 2000, I don't know what his platform would have been).
Mitt Romney practically invented Obamacare but now has to shun it.

So you have the original creator of the Contract with America, and the two candidates with the most business experience in the entire slate, all supporting some form of mandated or universal coverage. All of them now appear to be walking away from these beliefs purely for the sake of politics.

Is it time for Republicans to re-think healthcare?

[Anonymous]

It's time for everybody in this country to re-think healthcare.

I've lived abroad for many years and never cease to be amazed at how inefficient and expensive (twice as much as other developed countries) our healthcare system is, without measurably better outcomes. But it's not surprising when you walk into any doctor's office here: Many practices have several offices among which the doctors share their time (why??). Each office has multiple exam rooms, many of which are empty a lot of the time. There's an army of subordinates, salaried, with benefits, to deal with before seeing the doctor: nurses, nurses' assistants, people to check you in, people to handle insurance issues, people to handle referrals, people to check you out...
As a comparison, when I took my kid to the ophthalmologist (top-notch guy, attending physician at one of the major hospitals in the city) in France, he had a two room practice (waiting room and exam room) with a part-time old lady as his assistant to schedule his appointments. The care we got was excellent. Here, when I take him to see an ophthalmologist, we go to this sprawling office, with, like I said, one person to check you in, one to do some preliminary assessments, one who exclusively pours drops into the kids' eyes, the ophthalmologist, and someone to check us out and I'm sure I'm not counting back-office people you don't see. You have to add to that the 30% average overhead of a private insurance system vs. one tenth of that for a public scheme (eg. 3% for Medicare). Does anyone think that in the end we're not paying one way or another for this?

The cost for the 2 minutes or so spent putting drops in my kid's eyes: $96. When my other kid had to have outpatient surgery to remove a mole, they charged $55 to give her an ibuprofen.

And then there are the doctors pleading poverty due to exorbitant loans they have to pay for medical school to justifiy salaries that are much higher than those in the rest of the OECD. Well, they have a point about the loans. Why doesn't medical school start when you enter college (as it does in most other countries) instead of forcing them to waste four years getting a B.A. before studying what they actually plan on doing for a living? That might give an incentive to those who aren't in it just for the money to actually go into general practice and less of an excuse to those who are in it strictly for the money to charge exorbitant rates.

[Anonymous]

And the Ryan plan is completely shafting our kids.

I know Medicare spending is unsustainable and the system needs to be changed, but his plan to leave it as it is for people 55 and older means that, assuming these people live into their late 80s or 90s (as opposed to mid-80s now) due to medical advances, my 10-year old will be paying for all these old people's healthcare expenditures well into her 40s, at a time when she ought to be saving for herself.
Seriously, Republicans? You want a wholesale handout from a shrinking generation of little kids to their bulging cohort of baby boomer grandparents?
NO. If you want to cancel Medicare, cancel it right now, for everybody.

[Anonymous]

I"m all for borrowing a page out of the foreign handbook on health care. But considering how successful Rs were in riling people up against the pretty limited changes in Obamacare, that won't happen anytime at all soon.

The depressing part is that there is no way out of our budget problem without tackling the spiraling health care costs and that demands a really fundamental re-think of our medical system. Personally, i'd say part of it needs to be to begin to allow cost-benefit (yes, "cost") to be part of the decision of what Medicare covers rather than letting it cover anything anyone comes up with. That drug that extended life by 3 months at a cost of many many tens of thousands of dollars is a great example of what seems wrong w/ Medicare's coverage decisions.