You know that guy you sit next to on a plane and he strikes up a conversation, and soon you are telling him your views of anything and everything? I'm that guy.
So Sunday evening we're flying out of Atlanta to another hard-core red state and there's two of us sitting there on a very full flight. I'd already told him what I do - he asked - so I asked him what he did.
"I'm a medical doctor," he responded. Hmmm, interesting. I'm immediately thinking that it would be good to get his views on ObamaCare, seriously hoping for some validation of our point of view of course. Boy did I NOT get any.
So it turned out that he's a Republican. Considering that he's in his late 50's and lives in the hinterlands of the very conservative state that we were headed to I guess that shouldn't have been a big surprise.
Well, I get him talking and pretty soon I'm hearing every Republican/Fox talking point about ObamaCare. Since the conversation now occurred over 24 hours ago I can only relate the general outlines of his arguments, but boy are there some doozies.
PLEASE understand: These are his arguments, certainly NOT mine. I will not bother with refuting each of them. I couldn't argue every one of these with him and I just let him continue to spew his rancorous Foxian opinions.
I number the points to simplify your commenting on them:
1. THE PROBLEM is the poor people accessing the medical system
Medicaid is worst of all systems and the Medicaid patients are the worst patients to have. It doesn't pay enough to cover the cost of delivering the care, and the people who are on Medicaid access the system for anything and everything because they are sitting at home doing nothing and they just make up maladies in order to go to the clinic. They are extremely demanding of what they get. They feel entitled to care (apparently this happens more with people on Medicaid than with people with regular insurance and/or a copay) and they pay nothing for it.
2. Poor people accessing the system do not appreciate what they get and often denigrate the FREE care they get.
Hospitals have implemented a system of measuring patient satisfaction of the care that they received. When patients need to be told they have to use less pain killer lest they develop an addiction to it but they want more of it, they take the survey and rate the care they got very poorly. But it's the truth and as a doctor he has to do what is best for the patient even if the patient thinks that something else should be done. Ditto treating of people who are already addicts.
3. Single Payer cannot work in the US
The countries that have single payer government systems have a single culture in which everyone plays by the same rules and expectations of people in the culture are uniform. Since we have many different ethnicities a single payer health care system cannot work in the United States.
4. The contention that the administrative overhead of a single payer systems is only 2-3% is a lie. They say that in an attempt to get us to accept a single payer system but the real cost is more like 15%.
5. Most or all people with individual policies are getting notified that their policy has been canceled.
After telling him that I buy my own insurance as an individual he asked, "So have you gotten your cancellation letter yet?"
"No, I received a 'grand-fathered" letter,' I told him. He was noticeably shocked with this.
"Oh, I guess you were lucky," he responded.
6. Insurance companies are the bad guys - NOT!
In an effort to find some agreement on anything I thought this would be a winner. I proposed that the real bad guys in all this were the insurance companies. "Absolutely not," he responded. It's all about a government takeover of the health care industry, he contended. The government just keeps adding more and more rules and regulations to the point that you can't do much medicine anymore. The insurance companies are just businessmen trying to make a buck.
I pointed out that I deeply resented the insurance companies' destruction of true insurance. Insurance, I asserted, is supposed to be a system of shared risk in which I pay in a little, hoping that I get nothing in return because I don't want to be ill at all, but if I do get sick I don't go bankrupt. But they raise my rates if I start incurring significant medical expenses, eliminating the concept of insurance because they have to make a profit off of me. He basically didn't respond to this and changed the subject.
7. There are only a few choices on the website and the choices are more expensive.
While he explained some facet of his distorted opinions he happened to mention that people were being forced into one of a very small number of options on the website. I interrupted him and said that in Virginia there were many options in each of the metal levels with each of the participating insurance companies having at least one in each metal level and often several offerings in a level. He was shocked with this. He is no longer in private practice but works for a large hospital and gets his family's medical insurance from them of course. Thus he really knows nothing about the website other than what he has learned on Fox.
I told him that my current health insurance and an equivalent plan on the exchange were about the same price, but that it was hard to compare because they aren't exactly the same, but I am having trouble determining what the differences are. He was gratified that it was difficult to compare so that he could continue to rant about how screwed up the whole thing is.
8. People don't get the subsidies for health insurance until they file for their income tax refund.
Poor people, he contends, are not going to be able to pay the insurance bill in the meantime, and as a result, they are not going to have insurance when they get sick. His contention is that when all is said and done FEWER people will have health insurance than did before Obamacare came along.
9. The solution to 50 million uninsured Americans
Everyone should have a Health Savings Account (HSA). For the poor, the government would put money into their account, while the non-poor would put their own money into them (apparently with tax benefit for having done so). The money could only be spent on medical care. Then each person would have to ration how often they access the system to ensure that they have money when they need it. Money that is left over goes to the person eventually. There would be a level of cost at which insurance would kick in any and pay everything (apparently government based for the poor).
10. Ultimate problem with the ACA
The idiots in the Obama administration have created a system that is going to increase the demands on the health care system, but they haven't done anything to increase the number of people delivering care, so the system is destined to fail. The poor people gaining access to adequate healthcare are going to make it difficult for responsible (working) Americans to get adequate health care.
Which of course is contradictory to what he claimed in item 8. He is actually expecting that Obamacare is going to be fabulously successful in getting people insurance so that they will get seen at clinics where they can be properly diagnosed and treated instead of in the emergency rooms. Oh, the horror!!
General Comment:
The only differences I could discern between his opinions and those of the Republican Party were when Republican policies would result in him getting less money. He doesn't want Medicaid to end. Medicaid mostly sucks because the government doesn't pay him enough for the services he provides. His solution (HSA for everyone) is to make sure everyone has a finite pile of money that they can ONLY spend on paying him and others in the medical profession.