Anything that can help the consumer pay for the services from the provider has the potential of disconnecting the consumer from the full financial impact of their decisions... whether it is insurance or a government entity. Either entity helps me afford service I probably couldn't afford on my own. A 10% increase in my premium is bearable if most of the money comes from others.

So, from a theoretical perspective, I can kind of get how the Republicans think that essentially pushing people towards fee for service is the best way to actually push costs down. Ideally, people would prioritize getting value for their money, pushing providers to reduce their profit margins and potentially operate more efficiently.

Practically, we can already see what happens when people are left to fend for themselves against the health care system when we look at the tens of millions of uninsured: they either endanger their lives or their financial stability. I don't think the American consumer is really equipped to negotiate this on their own; the pricing is opaque, the costs are high and the risks to their lives are often higher.

At some point, though, someone has to say "No, you can't afford that". All that these different plans are really doing is passing the buck on that hard decision. Do you want it to be your insurance company that says no, your government or your own checkbook?

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