Social Question

wundayatta's avatar

Why do some conservatives seem to favor increasing both health care costs and taxes?

Asked by wundayatta (58367 points ) August 25th, 2009

I do not mean this to be a rhetorical question. It seems to me that conservatives who are opposed to allowing Medicare to negotiate, as a whole, for discounted prices on pharmaceuticals is a deliberate attempt to increase the cost of the program. Similarly, the opposition to expanding Medicaid to cover the homeless, or other folks without health insurance is a deliberate attempt to increase health care costs.

It is well known that people without insurance tend to wait longer to get care, and when they do get care, it is in the most expensive fashion: the emergency room. Since ERs can not turn anyone away, and they must keep on providing health care until the person is healthy enough to be discharged, we can say that all health care is provided for all people living in this country.

What results when people can not pay for health services is called “uncompensated care.” Hospitals get paid for uncompensated care in two ways. First, they charge those who are privately insured more. The insurance companies then raise insurance premiums to cover the higher rates they pay for hospital services. Second, hospitals receive what are called “disproportionate share” payments from the government. These are additional funds under the Medicaid program for hospitals that have a higher burden of uncompensated care.

Yet many conservatives are opposed to programs that expand health insurance coverage to those who can not pay. In essence, this position favors increased taxes and increased private health insurance rates.

Now the politicians can’t all be in the pockets of the health insurance industry, although many of them are. A lot of this opposition to expanded coverage is ideological in nature. It is an article of faith about the value of “competition,” even when there is and can be no free market.

However, most conservatives say they are against higher taxes, and for increased efficiency. Yet opposition to expanded coverage results increased taxes and lower efficiency.

What gives? These are well-known facts. Certainly, the link is indirect and understanding cause and effect requires a complex understanding. However, in general our Congress critters are well-educated, and can understand complex issues if they wish to. I honestly can’t understand how conservatives are thinking about this. It must give them an extraordinary feeling of cognitive dissonance. How can they reconcile their positions when these positions violate their basic principles so strongly?

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18 Answers

ragingloli's avatar

they have an inability or unwillingness to form complex chains of thoughts.
they think “providing healthcare to more people equals more costs” that is where they stop thinking. they don’t incorporate the ER situation into their thoughts.

dpworkin's avatar

They are, as Jno. Swift once said of lawyers, a race of man, bred from birth to argue, with words multiplied for the purpose, that black is white, or white black, according as how they are paid.

Darbio16's avatar

If you want to break the country down into classes, go with Patriots vs. those who wish to destroy and enslave us. The old idea that there are only 2 schools of thought is ridiculous. Liberal vs. Conservative is a joke. Most politicians are centrists. Think Arlen Specter. It’s divide and conquer here and they are doing a damn good job. Conservatives in D.C. are probably much different by virtue than those in the general public. Either way both sides are brainwashed then made to follow.

As some may already know from various other posts of mine, it is the government that is fucking everything up here. Not just the so called conservatives. We are in a fascist nation. They are concerned only with profits. We gotta rise up, instead of lay down and expect heath care. First care about your health, I’m talking to the 60% obese and all those who smoke/drink/do drugs, then we can talk about health care.

wundayatta's avatar

@Darbio16 Do you consider yourself a conservative, or something else? Let’s take it as given that labels do not really cover all that a person is, but ask you to make a forced choice.

It sounds like you have an alternative proposal for health care reform. Let’s suppose that people who are obese or abuse drugs all get themselves into good shape. How would you run the health care system?

It’s a big assumption, of course. What do we do about people who are mentally ill, homeless, or poor, and do not have the ability or the knowledge to lose weight or use legal drugs to deal with depression and the like. How do they get healthy? Or do you not care—if they’re poor or ignorant and had the opportunity to make decent money or get an education, it’s on them, and no one else should care or provide any assistance?

Darbio16's avatar

Society will stop helping eachother if we think the gov. is just gonna do it for us. Alot of people realize that they could go work 40 longs hours to get a few hundred bucks a week. Or just do nothing and have the gov. provide a few hundred bucks a week.

Same with health care. First they put restrictions on the type of people that can provide health care. That is in part why costs are up, lack of competition. We are entitled to life, liberty and the pursuit of happiness. Socialism always leads to oppression. We somehow got this idea that we deserve more than we work for. I do care for my fellow citizen, but its a tough love.

Give a man a fish and he will have food for the day. Teach a man to fish, and he will have food for life. Ever wonder why the FDA suppresses natural medicine while at the same time tells you that all health problems can be fixed with a pill. They want to take every bit of independence from us. Most pills we take are derived from plants, but the gov. , or rather big pharma, doesn’t want you to grow things on your property that will lead to a healthier life.

I used to consider myself a conservative republican. then, just a conservative. Now, I’m a human being. That’s how i view everyone now. Even if you would rather have some false label, you are still but a human. Its human nature to care for one another. The government imposes restriction on care you can receive and by whom. Here is an article from a local opinion newsletter in my community.

http://www.everyonesopinion.org/apps/blog/show/1059902-deregulate-healthcare

It was written by doctor so I would tend to listen to her before a Washington bureaucrat. This system does need reformed. But do not be fooled into thinking that the government will be at the rescue. Insurance companies call the shots, they really are the bad guy in most cases. I’ve been trying to tell everyone that we are a fascist nation. The merger of the government and corporations. We all talk about corporate crime and their lobby to congress and we see the frivolous lawsuits, but many fail to see that it is nothing more than fascism.

Vincentt's avatar

Perhaps they first want this, and then use the enormous costs as an excuse to allow ER’s to deny people care. That would make it cheaper, I suppose. Though then again, somebody will have to clean the dead bodies off the street.

Also, @Darbio16Socialism always leads to oppression. Where do you get that from? I live in a socialist country, but I’m not oppressed.

wundayatta's avatar

Only women with children can get government support. Not men. Not women without children. So there are plenty of people out there who would have to work to make money to live on. Yet they don’t. Why do they not work, in your opinion? Why do they stay homeless?

Second, most people believe in caring for others, but they want to do it in a consistent, fair way. That’s why they form a government to organize help instead of giving money to charities who provide help. Government is supposedly more accountable. Obviously that last point is something you wouldn’t agree with. However, do you think there is enough information to make private charities accountable enough?

Government justifies restrictions on health care providers as a way of trying to help us all be safer from charlatans and quacks who sell all kinds of things as “health care” that are proven to either do nothing or make people even sicker. You have a caveat emptor approach, but that would require every citizen to have the knowledge of a doctor in order to be an informed consumer. Is that really how you want to make decisions about which provider you get care from?

I don’t think people think they deserve more than they work for, but let’s assume you are correct. What about people who are incapable of work or only capable of doing work that does not provide sufficient resources so they can afford health care or education or anything else required to make themselves better off? Do we just let them die? Is that morally acceptable? Because that is the only option to providing government assistance for people who are disadvantaged.

I totally agree with teaching a man to fish. But if you don’t have society sharing the cost of teaching the dude to fish, then he has to pay for it himself. Since he doesn’t know how to fish, he has no money, and thus can’t afford the education. Am I missing something here?

As to growing your own drugs and it being forbidden by government, even when those drugs are proven to help, I agree with you. The government is stepping too far there. However, I do believe that is the will of the people, although I think it is the will of the people due to ignorance and fear.

If insurance companies are the bad guy (and I happen to agree with you there, too), and government cooperates in allowing the health insurance companies to be bad (and again, I agree with you), you believe that makes the US a facist nation. I agree with you to some extent. However, I believe it is not totalitarian facism, so we, the people, have an easier time trying to regain the power to guide the government. Never-the-less, it is extremely difficult, for many people cooperate with the government in letting it be facist.

I don’t think that it is possible to teach people that the corporations and government do hurtful things. Nor do I think that government is hurtful and inefficient in all cases; certainly not enough to eliminate government. Even if I were on the side of eliminating government, I think people would just reinvent it.

Therefore, while we may agree on this issue in part, I don’t think we should throw out the baby with the bathwater. Further, I think it is bad tactics to advocate such a thing. It makes people think you are a kook, and that is why people seem not to listen to you.

When I was in my teens and twenties, I, too, considered government to be facist. Now I don’t think that term is helpful. I think that while it may be an accurate description of our world, the myth of the United States is too strong for people to be able to see this, and even if they see it, to allow themselves to essentially insult themselves for allowing it to continue. Quick revolution is not a realistic option, I think. The only effective thing to do is to work within the system, flawed as it is.

cwilbur's avatar

I think the health care system is so badly broken in this country that it must be broken into pieces and rebuilt from the ground up or replaced. Unfortunately, the only entity with enough power to do so is the government.

The conservatives opposing health care reform are primarily interested in increasing costs for other people. It doesn’t matter to them if some poor sucker can’t get health insurance and needs to pay $75,000 out of pocket because of a medical emergency; it doesn’t matter to them if some poor sucker without health insurance had to pay $25,000 for an emergency room visit when a $100 doctor’s office visit six months ago would have fixed the problem. So long as they continue to have insurance, they don’t care how much other people are paying.

And increasing taxes? Well, look at the state of the federal budget. Taxes are going to have to go up sooner or later. Right now we’re gambling that we can delay that, and that the economy will recover and thus keeping the same tax percentage on greater income will lead to greater revenues, but it won’t hurt as much. This may or may not be true; it’s a pretty theory, but whether it’s true or not, we will have to pay our debts eventually.

wundayatta's avatar

@cwilbur Conservatives may be interested in increasing health care costs for other people, but they can’t be immune from that. If health care costs go up for other people, they will go up for everyone, including the conservatives. For better or for worse, we are all in this together.

It’s perfectly obvious. Conservatives can’t possibly not know this. I know people think they can be ignorant, but if so, that’s unconscionable and stupid. Why would people remain deliberately self-destructive? I can’t buy the ignorance argument, tempting as it might be. I can buy an ideological argument, so long as there is one sufficiently compelling to make one work against one’s own self-interest.

cwilbur's avatar

@daloon: Except that it’s not clear that increasing health care costs for other people increases health care costs for all people.

I have health insurance, and my insurance company negotiates rates for everything. So something like strep throat—something I dealt with last week—winds up costing me $40 out-of-pocket on top of my approximately $45 a month health insurance premium.

Now consider someone who’s uninsured. Emergency room visits cost at least $100 just for showing up. Prescriptions, tests, all that—it could easily turn into a $500 problem by the time the person gets over strep throat. If there’s less government support and that winds up turning into a $1000 problem, well, that patient’s healthcare costs just doubled, but there’s no measurable effect on mine, because my insurance company has just as much bargaining power as it did before health care reform.

The attitude is not that they want health care costs to go up, but that they really don’t care if health care costs go up for the uninsured. So long as they don’t lose their privileges, they don’t care what happens to other people. It’s not obviously against their self-interest, because if health care costs go up for the uninsured, there’s no pressure on the insurance companies to pay more and thus to raise their rates.

We are all in this together, but some of us are paying disproportionately more because we don’t have the power to bargain collectively.

wundayatta's avatar

@cwilbur However there is a cost-shift and it’s already built into your insurance premiums, and unless you are somehow incredibly lucky, your health insurance premiums are going up at a rate that exceeds that of overall inflation. It’s hard to track down exactly how much of that is due to the transfer of uncompensated care onto the bills of those who can pay for care, but talk to any hospital CFO or any hospital economist, and they’ll tell you it’s there. It should be obvious to anyone who thinks about it for two seconds.

dalepetrie's avatar

Essentially, I don’t think it’s an intentional thing, nor do people realize they are doing it. For a variety of reasons, it’s a matter of not being able to see the writing on the wall, and being inclined to believe what they are told, rather than thinking it out.

cwilbur's avatar

@daloon: Oh, sure, there’s a cost shift. The hospital has to pay its bills.

But the question they’re asking is, which will cost me more, the status quo or reform? Many of them seem to think that reform will both cost more and lower the quality of care they receive, and so they are against reform.

Darbio16's avatar

Government sponsored health care isn’t the only form of reform. People think that the government already had too much, that is the problem.

wundayatta's avatar

@cwilbur I know they think it will cost more, and that’s what I don’t understand. There is ample evidence to suggest that universal coverage, while it may increase taxes, will generate an overall reduction in health care spending. I mean, why would you be against letting a large customer use their purchasing power to negotiate larger discounts with big pharma?

cwilbur's avatar

Because you don’t want your taxes increased, even if the increase in taxes is less than your health insurance premium.

Because you have been raised to think that big government is always bad and free market solutions are always good, even when faced with concrete objective evidence that this is not the case—that some government programs work and the unregulated free market produces disasters.

Because you think that having a job or enough assets to pay for health insurance yourself is a reward from God, and thus, logically, not having a job or not being able to afford health insurance is a punishment from God for being unworthy.

Because you’ve got yours, so what do you care if other people have health care?

Because you are so terrified of socialism that anything that remotely hints at it cannot be trusted, even if it is clearly a better solution.

I could go on.

wundayatta's avatar

If ideology is what drives the opposition to health care finance reform, how can it be countered?

Zuma's avatar

@daloon It can’t be countered. Ideology is a set of simplifying assumptions that obviate the need for critical thought. Ideologues are not arguing in good faith; they are arguing from presuppositions. They can only be marginalized.

When they were in the ascendancy they did everything they could to de-fund and marginalize liberals, from union busting, to election rigging, to using the Justice Department to go after Democrats and lay off Republicans. I am not saying that we should politicize government to the same degree. But we can and should restore the separation of church and state.

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