Health care chaos

Donald Trump has suddenly discovered that reforming health care is not easy but, as is typical with narcissists, he thinks that his own prior ignorance and later realization of such an obvious thing must be the same for everyone, saying “I have to tell you, it’s an unbelievably complex subject” and “Nobody knew that health care could be so complicated.” Actually, everyone knew this.

Republican are quickly finding out that talk of ‘repeal and replace’ Obamacare was cheap but finding an alternative that is affordable and not appalling is not easy. As a result they have floated the idea of ‘repeal and delay’, saying that they would repeal Obamacare now and come up with a new plan sometime in the future but that idea is naturally facing strong headwinds.

The confusion surrounding the Republican plans for health care has spawned suggestions that California might go it alone and implement a state-run single payer plan. Vermont toyed with the idea a couple of years ago before abandoning it. We should remember that Canada’s single payer system was originally started in just one province before it was adopted nationwide.

John Oliver provides an excellent analysis of the current state of affairs and exposes the flim-flam behind the words used by the Republicans as they try to gut the provisions of Obamacare that have proven to be so popular.


  1. jrkrideau says

    I wonder if Californians understand what a single payer system means.

    It means that companies don’t have huge insurance payments, so a bit of extra tax is not likely to affect the bottom line. Actually it probably saves a lot of companies money.

    At least here in Canada it means no co-payments so sick people can go see their doctor before their condition is life-threatening.

    Because health care is totally portable (again here in Canada) , you can change jobs without having to spend hours or days negotiating a new health package. A plus for workers and employers.

    You are not bound to some HMO or set of medical clinics that your insurance company approves. In a non-life threatening emergency you just go see the nearest doctor, clinic or emergency department that is reasonable.

    As a personal example, I took a bad fall a few weeks ago when we were having an ice storm and sliced open my head. Ambulance to hospital emergency ward, checked in with no health insurance ID but I’d had hand surgery there a few years ago so I was known and accepted. They just said, “Oh yeah, we’ve got him”.

    I was treated, given a sandwich and juice, supplied with a donated jersey to replace my bloodstained shirt and sent home. Absolutely fantastic service.

    Total incidental costs: Seven dollars plus tip for the taxi home.

    My taxes help pay for this but it means that I don’t have to have fits worrying if I can afford to see my doctor if I think I’m seriously ill.

    If you’re an 18-old single mother with a child with a high fever, the same thing applies. She can take the child to the doctor or emerg any time.

    And if the clinic I attend is any indication, people will be leaping around to make sure the child’s vaccinations are up to date, checking weight charts and whatever. Again no charge.

    If the mother needs a flu vaccination, someone appears with a needle, no charge.

    Go California!

  2. says

    Actually it probably saves a lot of companies money.

    Especially small businesses. Of course the government would have to, you know, fairly tax the large corporations that cheat on their taxes (which is hard for small businesses) If you factor in the disproportionate expenses, single payer looks even better.

  3. Dunc says

    Republican are quickly finding out that talk of ‘repeal and replace’ Obamacare was cheap but finding an alternative that is affordable and not appalling is not easy.

    I suspect that the problem is not so much “finding an alternative that is affordable and not appalling”, since I don’t believe they particularly care about either of those factors. I would imagine that the real problem (for them) is finding an alternative that continues to funnel vast sums of cash to the insurance industry.

  4. jrkrideau says

    @2 Marcus

    Well it would mean really making some companies pay taxes and it would probably just about wipe out health insurance companies so there are likely some really entrenched interests out there as Dunc points out.

    I suspect the health insurance industry is the main stumbling block.

    Which is unfortunate as the USA seems to pay a very high amount for generally mediocre or poor health care. I don’t think there is any doubt that if you can access it, the finest US health care is the equal of any in the world. The problem is accessing it.

    We have some serious holes in our health coverage but nothing like the USA does and we pay a lot less overall and if the Federal and provincial governments would get their act together we could plug a lot of those holes and deliver health care probably at an even lower cost.

  5. Johnny Vector says

    I work for the (US) government, and as a result I have one of the better insurance plans in the US. In addition, I funded my Flexible Spending Account this year at a level that I expected would leave me with close to the maximum carryover ($500) at the end of the year. This is about as good as it gets in this country.

    A month ago my wife had what turned out to be a small stroke. Total of 5 days in the hospital, a bunch of various tests. I have now used up almost the entirety of my FSA for the year, to cover the out of pocket expenses (about $1500). Apparently you’re supposed to plan your emergency medical needs more carefully. My bad.

    I can’t even imagine what it’s like to have a high-deductible plan. And yet the Republicans call this “the best health care system in the world”. Oh, and “freedom”. Well, thank heavens for that. Personally I could use a little less of that freedom if you don’t mind.

  6. cartomancer says

    Noam Chomsky is rather fond of pointing out that if the US had a proper national health service along British, Irish or Canadian lines then it would save so much money that there would be no national defecit at all (indeed, there would be a year on year budget surplus). It is entirely down to the vested interests of insurance companies that the US languishes in the state it does. Well, okay, and the big pharmaceutical companies too.

    We look on aghast in the UK as successive Tory governments mess with our NHS and fail to deliver sufficient funding for it, but even with their malevolent influence we’re miles ahead of where the US is for delivering healthcare to the most vulnerable and most at risk. It’s pretty obvious -- if an industry has to deliver its services and provide profits for corporate shareholders then it’s going to cost a lot more than if it just has to deliver its services. Countries with state-run health services consistently top the charts of most cost-efficient healthcare providers in the world.

  7. DonDueed says

    Johnny Vector, I do have a high-deductible individual (i.e. not family) health plan. Last year I had one medium-serious health emergency plus some medium-complex dental work, along with more routine stuff like a colonoscopy. My total out-of pocket expenses (including insurance premiums and my HSA payouts) came to more than $8,000.

  8. busterggi says

    You have to remember that to Trump medical care consists of paying a doctor to write a bad letter saying you are in perfect health -- no actual check-up required.

  9. Dunc says

    And yet the Republicans call this “the best health care system in the world”.

    You just have to understand their metrics. Sure, in terms of patient outcomes it’s terrible, but in terms of profit and shareholder value, it’s fantastic. No other “health care” system in the world comes close to providing the same level of investment growth and capital protection.

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