SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

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Republicans have been putting up bills for years, what are talking about?

Nothing can be passed, ever

techno-ag said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

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Well, if we're wishing on a star, hopefully the abysmal failure of Obamacare will keep Democrats out of power for a generation or two.

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The failure of Obamacare is going to have the opposite effect and will put Democrats in power. Premiums are astronomical. Democrats want the government to pay for it. That has a huge appeal. You can't win this by expecting people to realize that Democrats caused the problem, especially without a clear immediate solution.

UntoldSpirit said:

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techno-ag said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

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Well, if we're wishing on a star, hopefully the abysmal failure of Obamacare will keep Democrats out of power for a generation or two.

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The failure of Obamacare is going to have the opposite effect and will put Democrats in power. Premiums are astronomical. Democrats want the government to pay for it. That has a huge appeal. You can't win this by expecting people to realize that Democrats caused the problem, especially without a clear immediate solution.

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Agreed. We can stamp our feet all we want how it's not R's fault.

Don't matter at this point. Too many people rely on it including a lot of R voters.

Republicans want super high deductibles and low premium payment, that will land like the Led Zeppelin with voters.

No they don't Republican Business owners really like that solution but Boomer Republicans that are Medicare really like their Socialized medical coverage
If they have an elderly relative in a nursing facility they like Medicaid also

Sister in Dallas told me they got a letter informing them that their premium for the two of them was going to jump up $2400 a month (he is self employed).

I live in Latin America and our families pays about $600 month for private health insurance, that is similar quality health care as in the States. So my sis and brother law paying about $20K+ extra in 2026 out-of-pocket just in premiums in Texas than what I will have to pay for similar protections and services living farther south.

It does seem like health care costs have really gotten out of control in the States and I guess maybe about to get even worse in 2026.

Pumpkinhead said:

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Sister in Dallas told me they got a letter informing them that their premium for the two of them was going to jump up $2400 a month (he is self employed).

I live in Latin America and our families pays about $600 month for private health insurance, that is similar quality health care as in the States. So my sis and brother law paying about $20K+ extra in 2026 out-of-pocket just in premiums in Texas than what I will have to pay living farther south.

It does seem like health care costs have really gotten out of control in the States and I guess maybe about to get even worse in 2026.

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The legal system is a major problem here and in a lot of parts of the US economy. I have a friend that owns a very expensive home in Costa Rica, like $2.5M, and they have it in an AirBNB type business when they aren't using it personally. They asked their insurance person down there about general liability and were told that doesn't exist in CR. He asked what happens if someone slips and falls and the broker said they get up and keep walking. You can't sue for stuff like that down there apparently. Insurance is sky high in the U.S. in part because the threat of lawsuits is sky high.

Having said that I'm sure the day to day care in Panama is comparable but if you have something significant you're either going to the states or not getting care. The truly unique thing about America compared with the rest of the world is that we are able to treat anything as long as you have sufficient ability to pay for it. The rest of the world just can't do that. If you're important or wealthy enough you'll be sent to the states, if not you'll suffer with whatever it is til it kills you. We pay for access to the best care in the world if we need it. Nobody else in the middle or working class has that kind of access.

Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

Pumpkinhead said:

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Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

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All true. Now our salaries are higher as well so that's kind of relative.

Where in Panama are you? I was there for the invasion in 1989-90 and back a few months later in spring 90. Was at the airport in David when Noriega was captured. Some great memories there celebrating with the locals who were allowed to come into the airport each day for various reasons.

samurai_science said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

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Republicans have been putting up bills for years, what are talking about?

Nothing can be passed, ever

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Just yesterday, the democrats voted down an alternative proposal put forth by the Republicans.

It's just a convenient misstatement to claim Republicans have never proposed anything else.

And what is being eliminated are the enhanced subsidies for those above 400% of the poverty line. The vast majority of obamacare enrollees will continue to be subsidized, and will continue to pay an average of about $50 a month (far below what the majority of taxpaying citizens pay for private insurance).

Having said that I'm sure the day to day care in Panama is comparable but if you have something significant you're either going to the states or not getting care.

Have lived in Panama 25+ years now and the above depends on what you mean by 'significant'.

Had two kids born here, daughter in bad car accident and had to have back surgery for fractured vertebra here (surgeon was fantastic and she came out great), had an appendectomy here. Know people who got good cancer treatment here.

Yeah, I do think there would probably be some edge cases, some types of cancer for example, where I'd want to take that up to the States...but can only say having lived and raised a family for 25+ years here...have yet to run into one of those edge cases.

Now note I'm referring to the private health care system here, used by the middle and upper classes. Not the public Social Security funded system that the lower income portion of the population uses. There is a notable difference in waiting times and quality of service in the public health care system versus the private.

But the private system is really solid, with many of the specialized doctors having done residency in the United States or Europe. Good facilities. Has always seemed to me like basically what you can get in the U.S. to tackle most health issues, just a lot cheaper.

LOYAL AG said:

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Pumpkinhead said:

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Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

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All true. Now our salaries are higher as well so that's kind of relative.

Where in Panama are you? I was there for the invasion in 1989-90 and back a few months later in spring 90. Was at the airport in David when Noriega was captured. Some great memories there celebrating with the locals who were allowed to come into the airport each day for various reasons.

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All true. Now our salaries are higher as well so that's kind of relative.

Exactly right. Presumably the sweet spot is a middle or upper class U.S. comparable income while paying Panama prices for something like private health care. If I had to take a rough guess, I'd guess about 20% of Panama's current population is living in that sweet spot. But just a rough guess.

LOYAL AG said:

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Pumpkinhead said:

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Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

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All true. Now our salaries are higher as well so that's kind of relative.

Where in Panama are you? I was there for the invasion in 1989-90 and back a few months later in spring 90. Was at the airport in David when Noriega was captured. Some great memories there celebrating with the locals who were allowed to come into the airport each day for various reasons.

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Wife and I still working and live in Panama City. If you haven't been here since early 90's, you'd maybe not recognize the place. Panama really boomed over the past two+ decades plus since I've been here.

Yes. Republicans have to both point out that Dems have caused this problem and continued to slow it to become worse AND propose a solution that is acceptable enough to the public to pressure Dems into folding. Dems are NOT going to fold AT ALL if they believe politicsl momentum is on their side, and right now they do, due to the Rocky unclear perception of the economy. The Republicans need to get the economic picture looking much better to the public ASAP and then present a healthcare fix that sells to the public, and yes, that will require promising the public that they will get more than they are willing to pay for, because that is all the public wants to hear from either party.

samurai_science said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

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Republicans have been putting up bills for years, what are talking about?

Nothing can be passed, ever

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Prior to Trump's first term, the Republicans and Paul Ryan boasted of multiple plans to replace Obamacare.

When it got to the nut cutting, they didn't have jack *****

9 years later they still don't have jack **** to realistically replace or modify it..

backintexas2013 said:

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We will never do what's necessary to lower prices. It's harsh medicine that we aren't willing to take so we will remain sick and prices will continue to go through the roof.

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Been saying this since Hillary started pushing for reforms in the 1990s. The biggest problem with healthcare in the United States is expectations.

Ever since the market distortion that began with employers providing insurance as a fringe benefit, we have come to expect health are that is immediate, expect healthcare that is the best available, and expect healthcare that is paid for by someone else.

As was often said, if you think healthcare is expensive now, just wait until it is free.

SA68AG said:

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samurai_science said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

---

Republicans have been putting up bills for years, what are talking about?

Nothing can be passed, ever

---

Prior to Trump's first term, the Republicans and Paul Ryan boasted of multiple plans to replace Obamacare.

When it got to the nut cutting, they didn't have jack *****

9 years later they still don't have jack **** to realistically replace or modify it..

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Why is the answer always to replace it with more government? Why not just get the government out of it?

Hubert J. Farnsworth said:

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SA68AG said:

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samurai_science said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

---

Republicans have been putting up bills for years, what are talking about?

Nothing can be passed, ever

---

Prior to Trump's first term, the Republicans and Paul Ryan boasted of multiple plans to replace Obamacare.

When it got to the nut cutting, they didn't have jack *****

9 years later they still don't have jack **** to realistically replace or modify it..

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Why is the answer always to replace it with more government? Why not just get the government out of it?

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That is the actual answer here.

northeastag said:

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samurai_science said:

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SA68AG said:

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The inability of Republicans to come up with a viable plan to reduce the costs of health insurance, could very well cost them the mid-terms.

People's premiums really are doubling and unfair or not Republicans will get the blame.

---

Republicans have been putting up bills for years, what are talking about?

Nothing can be passed, ever

---

Just yesterday, the democrats voted down an alternative proposal put forth by the Republicans.

It's just a convenient misstatement to claim Republicans have never proposed anything else.

And what is being eliminated are the enhanced subsidies for those above 400% of the poverty line. The vast majority of obamacare enrollees will continue to be subsidized, and will continue to pay an average of about $50 a month (far below what the majority of taxpaying citizens pay for private insurance).

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Well said. CMs listen up. Those who really need it will still be getting it.

Pumpkinhead said:

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Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

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Something else that has a huge cost component in the US compared to other countries is the cost of compliance with all the additional regulatory, accreditation, and CMS/NGO requirements that the US system is burdened with. Other countries just don't have to deal with the same level of oversight we do. The road to hell is paved with good intentions; no clearer example of that exists than HIPAA. Compliance costs are empty costs. Healthcare is not any "better" or more efficient because of HIPAA.

Whole thing is going to break. It's inevitable. I predict we move to UHC with the next Democrat administration. We are at the financial tipping right now. It's here.

YouBet said:

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Whole thing is going to break. It's inevitable. I predict we move to UHC with the next Democrat administration. We are at the financial tipping right now. It's here.

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I can think of all kinds of reasons why that shouldn't happen, but your scenario is more likely. We continue moving leftward toward full blown socialism. Once we reached the point where 50% of income earners don't pay a net income tax, the die was cast. It's easy for people to vote for government benefits when someone else pays for it.

YouBet said:

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Whole thing is going to break. It's inevitable. I predict we move to UHC with the next Democrat administration. We are at the financial tipping right now. It's here.

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If that happens it'll be terrible. Quality of care will decline drastically like it does in all other socialized medicine countries.

Yes, quality of care will dramatically decline. It will be a disaster. All we can hope for is that some kind of private model survives it that those of us with the means can opt into that isn't catastrophically expensive.

YouBet said:

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Yes, quality of care will dramatically decline. It will be a disaster. All we can hope for is that some kind of private model survives it that those of us with the means can opt into that isn't catastrophically expensive.

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Start thinking about medical tourism now. We do a lot abroad now at a fraction of the cost and same level of care, or better in some cases.

YouBet said:

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Yes, quality of care will dramatically decline. It will be a disaster. All we can hope for is that some kind of private model survives it that those of us with the means can opt into that isn't catastrophically expensive.

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You can bet the legislative body will continue to be eligible for a top-notch health insurance plan, while the rest of us chumps are on our own

YouBet said:

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Whole thing is going to break. It's inevitable. I predict we move to UHC with the next Democrat administration. We are at the financial tipping right now. It's here.

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You thinking UHC insurance ,ie. Medicare for all, or VA style where everyone works for the gov?

if I were a doc, I'd opt for the latter. That way, I don't have to carry insurance and can't be sued. The Dems want to screw the docs with Medicare for all - much lower payouts - but keep them private so the lawyers can sue them.

Logos Stick said:

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YouBet said:

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Whole thing is going to break. It's inevitable. I predict we move to UHC with the next Democrat administration. We are at the financial tipping right now. It's here.

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You thinking UHC insurance ,ie. Medicare for all, or VA style where everyone works for the gov?

if I were a doc, I'd opt for the latter. That way, I don't have to carry insurance and can't be sued. The Dems want to screw the docs with Medicare for all - much lower payouts - but keep them private so the lawyers can sue them.

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I'm not completely sure; I haven't thought through the mechanics of it yet other than I really do think we are on the cusp of a major change/another step towards UHC. This has always been the plan by Democrats as they themselves have stated. They've successfully achieved getting the current system to the point of being unaffordable which conveniently plays right into their current "Affordability Crisis" political campaign. And now you are about to have a ton of Middle Class Americans who on the brink of financial hardship over 2-3x monthly increases. That is not sustainable and it's going to tank the economy even further.

Spitballing:
The main lament you hear from Democrats is that it didn't work because they never got enough healthy payers to buy into it. (The eternal excuse for the left - it would have worked IF.....). So, one way to force that is to incentivize big companies to drop healthcare coverage as a benefit. Massive pool of workers there. Saves the company a massive amount of money with the only real alternative for workers being Obamacare or the next version of it. I don't know what that incentive would look like - possibly a tax break...don't know. They would then make another promise that with the injection of all of these new healthy workers that costs would fall.

Burpelson said:

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Republicans want super high deductibles and low premium payment, that will land like the Led Zeppelin with voters.

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Most people that won't like that already vote democrat

G Martin 87 said:

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Pumpkinhead said:

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Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

---

Something else that has a huge cost component in the US compared to other countries is the cost of compliance with all the additional regulatory, accreditation, and CMS/NGO requirements that the US system is burdened with. Other countries just don't have to deal with the same level of oversight we do. The road to hell is paved with good intentions; no clearer example of that exists than HIPAA. Compliance costs are empty costs. Healthcare is not any "better" or more efficient because of HIPAA.

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I asked A.I. why health care costs and insurance premiums in Panama are significantly cheaper than in the United States (as mentioned seems my sister in Dallas for 2026 may be paying 4-5X the costs in health insurance premiums compared to if she lived in Panama), and below is what it spit out, including the point that you mentioned about the effects of government regulation:

1. Lower Cost of Living & Service Prices

• Medical servicesdoctor visits, hospital stays, diagnosticscost far less because wages, facility overhead, and general living expenses are lower in Panama.
  
  • A specialist consultation may cost around$40$50 in Panama versus several hundred dollars in the U.S.
  • Public clinic visits may be $2$5, with inpatient stays around $10/dayall paid out-of-pocket.

2. Dual Public-Private System & Subsidized Public Care

• The Caja de Seguro Social (CSS), funded by employer-employee contributions, provides universal public healthcare access.
• Public sector services are heavily subsidized, enabling extremely low costs for medical consultations and hospital stays.
• This makes insurance optional for routine care; many rely on public hospitals or low-cost pay-as-you-go clinics.

3. Lower Legal & Administrative Overhead

• Panama has minimal medical malpractice litigation compared to the U.S.leading to significantly lower malpractice insurance costs for physicians.
• Regulatory systems are simpler with less overhead, reducing carriers' administrative costs and enabling lower premiums.

4. Simpler Insurance Market & Regulation

• The insurance market allows up to 100% foreign investment and has light compulsory coverage rules. Premium tax is minimal at around 2%.
• Local insurers dominate, and international plans are optionalwithout burdensome regulations that drive up costs in the U.S.
  
  5. No Profit-Driven Complexity or High Deductibles
  
  • Panama's insurers typically offer straightforward, lower-margin plans without high deductibles or complicated cost-sharing schemes. Premiums mirror actual service costs, unlike U.S. plans with hidden administrative costs.
    
    6. Lower Wages in Healthcare Sector
    
    • With lower salaries for physicians, nurses, administrative staff, and support personnel, the overall cost of healthcare delivery is lowerdirectly influencing insurance pricing.

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Cliff Notes version according to A.I., in the United States there are a lot of lawyers, salaries are high, there is a lot of government regulation and bureaucratic complexity, and the insurance companies are greedy. The U.S. has been super challenged trying to figure out some sort of workable 'Public-Private' model that provides the have nots some form of a safety net without more and more hurting the haves.

In fairness to the United States, dealing with a population of 350 million is lot more complicated than dealing with a population of 4 million.

Pumpkinhead said:

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LOYAL AG said:

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Pumpkinhead said:

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Yeah, my understanding is legal liability is a large part of the issue. You are paying some premium in the U.S. just to pay all the lawyers or for protection from all the lawyers.

Also, because the average salaries in general are simply higher, everybody in the medical and insurance industry is paid more, from the janitors to the executives, so the cost of doing business is simply higher...and the consumers (the customers) of that business have to pay extra to pay for all those salaries and compensation plans.

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All true. Now our salaries are higher as well so that's kind of relative.

Where in Panama are you? I was there for the invasion in 1989-90 and back a few months later in spring 90. Was at the airport in David when Noriega was captured. Some great memories there celebrating with the locals who were allowed to come into the airport each day for various reasons.

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Wife and I still working and live in Panama City. If you haven't been here since early 90's, you'd maybe not recognize the place. Panama really boomed over the past two+ decades plus since I've been here.

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We've been planning a vacation in CR for seemingly forever with a two day jump down to Panama as a quick detour. I'd love to get back down there for sure. We've talked about the idea of retiring in CR or Panama one day so getting her down there is an important first step. Glad to hear it's doing so well.

TexasAggiesWin said:

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Unfortunately, this is the message being spread, and we have a country full of idiots that will buy this message.

Always was designed to fail and be replaced by Fed Single payer . Anyone that says otherwise is ignorant or lying.

The claims made about reducing premiums/costs and keeping your doctor if you like your doctoe… always were malicious lies designed to mislead .

TexAgs91 said:

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Over_ed said:

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Since Obamacare is crappy plans matched with high prices, this will be the end of Obamacare.

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About damn time.

John McCain gets credit too though. Otherwise it would have been gone months after Obama left office.

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McCain was a scumbag. Burn baby burn

I hope McCain's family realizes his legacy was to f* the US over. What a *******.