Meanwhile, the New York Times reports that Trump supporters are not exactly fired up about repealing the healthcare law:
Those voters have been disappointed by Obamacare, but they could be even more disappointed by Republican alternatives to replace it. They have no strong ideological views about repealing and replacing the Affordable Care Act, or future directions for health policy. What they want are pragmatic solutions to their insurance problems. The very last thing they want is higher out-of-pocket costs.
Yes, well, duh. I’ve been saying this for years, haven’t I? And thank you, Kaiser Foundation, for actually asking people what they want. Because this conversation seems to have ignored the healthcare consumer, hasn’t it? We hear precious little from actual people about healthcare, but we sure hear a lot about what the insurance companies want, what the AMA wants, and what BigPharma wants. I’m tired of hearing what they want. If repeal is inevitable, shouldn’t we find out what consumers want (and don’t want) to replace it?
Things I don’t want:
• I don’t want to “shop” for healthcare or my health insurance. I hate shopping anyway, but who wants to “shop” for something like health insurance? People, I do not have the time for that! This infatuation with “shopping” and “marketplaces” in America is something I do not understand. People want to shop for fun stuff. They do not want to shop for un-fun stuff.
I don’t want to compare healthcare plans and read the fine print and find out who’s selling me a shit sandwich and who’s selling me a Tiffany watch. I don’t want to think I have the Tiffany plan only to find out, too late, that I bought a shit sandwich and oh well, sucks to be me. This is not how healthcare is supposed to work.
• I don’t want a “health savings account,” a tax deduction for making a contribution to said “savings account,” or a voucher, coupon or other gimmick. This is something else I don’t get. Conservatives are always saying you can’t throw money at a problem but isn’t that what these special accounts and vouchers do, at their heart? So I have a pile of money I can use as I see fit, so what. That’s great when I’m healthy, but what if something awful happens and my costs exceed what’s in the account? What if my kid gets leukemia and my husband gets in a car accident? Who has the time to keep up with all of the red tape and paperwork associated with these accounts? Everyone is already complaining about how complicated taxes are, but an HSA just adds to that. You have to keep every single receipt and keep up with your statements and there are fees associated with these accounts and it’s just a ginormous headache.
• I don’t care if I can buy health insurance across state lines. What is the point of this? Republicans always mention this as a key part of their plans, but how is this supposed to make my life better? I know the idea is that it will create “competition” and thus lower costs, but does it really? Where is the evidence of this? There is none. In fact, Medicare Advantage plans are uniform across the country, but there are still very limited choices, which means removing the hodge-podge of state regulations really doesn’t increase “choice.”
Healthcare is not laundry detergent. There are huge regional differences in people’s health. It’s well known that Southern states have some of the worst health statistics in the country: higher rates of obesity, diabetes, heart disease, etc. This is where insurance is more expensive. In states where people tend to be healthier — California, Colorado, Minnesota — insurance tends to be cheaper. So wouldn’t allowing someone in Alabama to buy insurance from Colorado actually increase costs because you’re adding all those unhealthy Southerners into the pool?
• I don’t want medical malpractice “reform.” This is another favorite Republican talking point: medical malpractice insurance is killing healthcare, frivolous lawsuits are killing healthcare, etc. It’s not true. And if some Doctor Fuckup injures a patient, that patient should have the right to sue.
Speaking of frivolous lawsuits, you know where they don’t have to worry about that stuff? Countries with a functioning healthcare system. Let my tell you about my American friend who opened a hotel in Norway. When he asked about liability insurance for the property, his Norwegian business partners looked at him like he was crazy. They don’t have that here, they said. What would be the point? My friend said, you know, if someone slips and falls in the lobby, they could sue to get their medical costs taken care of. They laughed at him. Why would someone do that? The social safety net already takes care of people’s medical costs in Norway! And a big ol’ lightbulb went off.
• I don’t want to have to fly to Poland to buy insulin. Seriously, you know your healthcare system is broken when this happens:
One man in Pennsylvania with Type 1 diabetes reported making frequent trips to Eastern Europe to purchase insulin at one-tenth the cost he paid here.
This is not unusual. I have a friend who lives part-time in India, part-time in the U.S. She broke her foot a few years ago and had it fixed in India for $15. She said this was a good deal, even when one includes the airfare, because back then she didn’t have insurance. This strikes me as ridiculous, but this is what right-wingers gleefully call “medical tourism,” as if flying to Thailand for your heart surgery makes sense. Yeah, if I’m going to Thailand it’s as a tourist, not a patient.
Okay, in summary: I don’t want red tape and paperwork, high prices, a lot of extra work and time spent figuring coverage out or getting the healthcare I need, or unreasonable restrictions on who I can see or what is covered.
What do I want? What does anyone want? This:
1) I JUST WANT TO SEE THE DOCTOR OF MY CHOICE WHEN I NEED TO WITHOUT DRAINING MY BANK ACCOUNT. 2) I WANT TO GET THE PRESCRIPTIONS I NEED FROM MY LOCAL PHARMACY WITHOUT TAKING OUT A SECOND MORTGAGE.
It’s really that simple. Just those two things. Any plan, be it from the Democrats or the Republicans, needs to address those two simple things. If it doesn’t, then I’m not interested.
I say “simple things” but I realize it’s far more complicated than that. But seriously, it shouldn’t be that hard to figure this out.