Conservative economists and GOP lawmakers have been making similar arguments since high-deductible health plans started to catch on two decades ago.A) People who need healthcare do have “skin in the game.” Their skin.
Back then, a backlash against the limitations of HMOs, or health maintenance organizations, propelled many employers to move workers into these plans, which were supposed to empower patients and control costs. A change in tax law allowed patients in these plans to put away money in tax-free health savings accounts to cover medical bills.
“The notion was that if a consumer has ‘skin in the game,’ they will be more likely to seek higher-quality, lower-cost care,” said Shawn Gremminger, who leads the National Alliance of Healthcare Purchaser Coalitions, a nonprofit that works with employers that offer their workers health benefits.
“The unfortunate reality is that largely has not been the case,” Gremminger said.
B) The Raw Story article starts with an anecdote: a pregnant woman develops a heart condition during pregnancy. Due to her high deductible ACA policy (which has lower premiums; no judgment here; been there, done that), ends up with $13,000.00 in medical debt. Where was she supposed to go for “low cost “ healthcare? A public hospital? The kind closing down because the ACA is closing down?
C) I live in one of the major medical centers in the country. The hospitals here do not compete with each other for patients like retail stores do. The idea of “high quality low cost healthcare” is like the idea of a low cost, high quality car: you get what you pay for, and even then you might get a lemon. A bad car purchase might hurt you financially. Bad healthcare can kill you; or leave you worse off than you were.
Federal rules that require hospitals to post more of their prices can make comparing institutions easier than it used to be.Republicans consider that “decreasing the surplus population.”
But unlike a car or a computer, most medical services remain difficult to shop for, in part because they stem from an emergency or are complex and can stretch over numerous years.
Researchers at the nonprofit Health Care Cost Institute, for example, estimated that just 7% of total health care spending for Americans with job-based coverage was for services that realistically could be shopped for.
Fumiko Chino, an oncologist at the MD Anderson Cancer Center in Houston, said it makes no sense to expect patients with cancer or another chronic disease to go out and compare prices for complicated medical care such as surgeries, radiation, or chemotherapy after they’ve been diagnosed with a potentially deadly illness.
“You’re not going be able to actually do that effectively,” Chino said, “and certainly not within the time frame that you would need to when facing a cancer diagnosis and the imminent need to start treatment.”
Chino said patients with high deductibles are often instead slammed with a flood of huge medical bills that lead to debt and a cascade of other problems.
She and other researchers found in a study presented last year that cancer patients who had high-deductible health insurance were more likely to die than similar patients without that kind of coverage.
Aside from the fact that, if you have cancer, at least in Houston, you want to go to M.D. Anderson. But they don’t offer discounts. OTOH, cancer treatment ain’t exactly like buying a toaster. Not that Trump and the GOP actually give a shit. Trump and the OBUglyB shifted funding from cancer research to making America free from brown people so Stephen Miller would feel safe.
Which is precisely what happened to Ms. Monroe, the woman who developed heart problems during pregnancy. She had a health savings account; it emptied out rapidly.Trump has no real plan to stop the Obamacare spike. 📈
— Rep. Darren Soto (@RepDarrenSoto) December 8, 2025
Health savings plans are helpful, until the money runs out. Then you’re screwed. https://t.co/JHfNbKraK5
For her part, Monroe and her family were forced to move out of their house and into a 1,100-square-foot apartment.
She drained her savings. Her credit score sank. And her car was repossessed.
There have been other sacrifices, too. “When families get to have nice Christmases or get to go on spring break,” Monroe said, hers often does not. '
She is thankful that her children are healthy. And she continues to have a job. But Monroe said she can’t imagine why anyone would want to double down on the high-deductible model for health care.
“We owe it to ourselves to do it a different way,” she said. “We can’t treat people like this.”
Well, we shouldn’t. This whole issue is about: “Fuck the people.”
Burns asked, “In the meantime, I mean, two weeks, Mr. President, people will see those premiums go up. So will you tell Congress to extend those Obamacare subsidies while you work out another deal?”They’ll just go down to Walmart and get it off the health insurance shelf. I hear prices are pretty good there.
“I don’t know. I’m gonna have to see. I’d like to get better health care. I’d like to have people buy their own health care, get much better health care, and what I want to do, for example, I want to give the money to the people, not to the insurance companies,” he replied, at which point she interjected. “So right now, people are buying their holiday presents. They’re planning for —.”
“Look, don’t be dramatic,” Trump sneered as she protested, “No, no.”
“Don’t be dramatic,” he repeated.
“They’re planning their budgets for next year, Mr. President," Burns continued.
“Here’s what I want to — I know. And what I want to do is help them,” he replied as she pressed, “So will their premiums go up?”
“I’m giving them money," Trump snapped.
"I want to give the money to the people to buy their own health care. That’s a good thing, not a bad thing. The Democrats don’t want to do that. They want the insurance companies to continue to make a fortune. The Democrats are owned by the insurance companies. They want the insurance companies to get these trillions of dollars,” he stated.
“Trillions of dollars goes to the insurance companies. I want that money to go to the people and let the people go out and buy their own health care. It works like magic. But you know who doesn’t want it? The Democrats, because they’re corrupt people, because they’re totally owned and bought by the insurance companies.”
After some back and forth, Burns pointed out, “That’s going to take time, sir.”
“Ready?” Trump fired back. “ I want to give the people better health insurance for less money. The people will get the money and they’re gonna buy the health insurance that they want.”
"Don’t be dramatic.” Coming soon to a campaign ad near you.
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