What is your health care reform solution

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Wednesday, August 05, 2009

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By DAN ROSS
Register Online Editor

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November 5th, 2009

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October 8th, 2009

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August 25th, 2009

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August 20th, 2009

Should marijuana be legalized?

Judging by the very large turnout at a forum this week in Napa on health care reform and the huge number of comments the article received on this Web site, people in this area are very passionate about how nationwide health care reform is being proposed.

Many of the comments indicate people realize a need for change but disagree on the proposed governmental changes.

So, here's your chance to lay out how you would propose to change today's health care system.

Try to do this in a constructive manner. Make your point without belitting the views of others. See if this can be done without the typical attacks of all conservatives (enter attack here) or all liberals (insert atack here).

Focus on what is positive change, avoid attacking other messengers, and let's see where this goes.

177 comment(s)

a teacher wrote on Aug 5, 2009 8:23 PM:

" Medicare for all. "

steph wrote on Aug 5, 2009 11:48 PM:

" Reform insurance marketing; force insurance companies to make the details of their plans more understandable and directly comparable. Have each company post their plan features on a legally-binding website hosted by the Federal government. Let people buy low-cost high deductible plans that actually cover catastrophies. Put our existing insurance bureaucrats to REAL work. That's why they get paid the big bucks.

Encourage more walk-in fee-for-service clinics. Allow fees from independent clinics to be applied toward medical plans with deductibles.
http://www.rncentral.com/nursing-library/careplans/20-surprising-ways-wal-mart-clinics-affect-us-healthcare

Support a reliable, honest information exchange, where people can get readable information on the REAL benefits and risks of healthcare interventions, from herbal products to MRI, allowing people to decide on the value of these options or at least have intelligent discussions with providers and avoid wasting money on unnecessary or dangerous options.

Reform welfare, including SSDI, where abuse is rampant. Get able-bodied people back to work and contributing to their own well-being. Stop encouraging entitlement mentality. We can't afford it. There is no free ride. Healthcare is a commodity--an expensive one. Everyone who wants healthcare insurance needs to contribute to its costs in some way. "

TAXPAYER wrote on Aug 6, 2009 8:47 AM:

" Go to the doctor, pay for it.

Private insurance can offer catastrophic
insurance only.

Government welfare can only offer catastrophic insurance. "

coigue wrote on Aug 6, 2009 10:08 AM:

" At minimum: 1. Insurance Companies cannot refuse to cover people, or kick people off insurance when they get really sick. 2. Everyone pays the same premium for the same coverage (TBD, but should include a reasonable co-pay, and access to preventative care, and catastrophic. 3. Govt guarantees that lifetime out-of pocket expenses do not exceed 50K IF and ONLY IF people are covered continuously throughout their lives. (with small breaks not to exceed 5 months. "

steph wrote on Aug 6, 2009 12:22 PM:

" Smokers, alcoholics, drug addicts, daredevil accident-prone folks, and the obese should have to pay more for the same coverage than folks who take better care of themselves. People who deliberately take care of their health should not have to finance the poor health habits of those who do not care for themselves.

I also like the idea of an insurance appeals process by a board of physicians and other healthcare workers and administrators and citizens--a good mix. Because some actions by insurance companies are deplorable and should not be permitted. On the other hand, not all demands should be payed for by the insured group that is sharing costs and risk. "

glenroy wrote on Aug 6, 2009 1:59 PM:

" Very well said Steph….. It’s called risk analysis and it exits on all types and forms of insurance except healthcare….largely because there is a lifestyle that enjoys a special status. You really should consider running for office... I can raise a few bucks to get you started.

Taxpayer….no doubt about it, if those who abuse healthcare were required to pay a little more per visit it would save a few billion dollars annually while relieving the Doctors who are being squeezed by Medicare which pays a much lower fee compared to the private carriers for the exact same service.

The libs are all over the place ranting about private healthcare not being affordable…nothing they’ve put forth will lower costs a single dollar, they just want the rest of us to pay their healthcare and they‘re quite prepared to ruin our quality care in the process. "

steph wrote on Aug 6, 2009 5:05 PM:

" And, lest we forget, we need torte reform across the US. "

Madison Jay Hamilton wrote on Aug 6, 2009 5:57 PM:

" I support Medicare for all! "

cab e-girl wrote on Aug 6, 2009 7:26 PM:

" Thanks Dan! Excellent for all of us novice world problem solvers :)

Tort-reform on all medical-malpractice, not just pain and suffering.

If there is $500 billion (where in the world did that number come from?) worth of fraud in the Medicare System, find it and change it.

Those who really cannot afford insurance, should be given a work option to pay for it. (Work a few day's a month to cover themselves and/or their-families-clean up highways, national parks etc.).

Stop paying for illegal aliens and legal aliens. When they come into the country, it should be on the condition that they pre-pay for a health plan. When their health plan runs out, so does their Visa. Those here to work need to buy their own plan upon entry to this country or their employer needs to buy a plan for them. If they are caught here without health insurance, they should be given a one way greyhound ticket.

The elderly, who have already paid into the Medicare system for years should be fully covered by Medicare as should the disabled.

Insurance companies need to be banned from disallowing folks with pre-existing conditions. It's just wrong. You can always do a high risk plan just like they do for high risk drivers, but denying coverage is plain wrong.

Implement Steph's plan for risk management. (I like that Steph!)

Make the co-pay much higher to visit a trauma center or hospital to encourage patients to see their physician before it becomes an emergency. "

Mr. Feasor wrote on Aug 6, 2009 8:56 PM:

" Provide a public option (basically, a cleaned up version of Medicare) to every American CITIZEN, or lawful resident. Preexisting conditions cannot be a basis for denying coverage.

Tax more if a citizen lacks private coverage, because this puts them on the public plan by default (something like $3,000.00 for married couples, $2,000.00 for singles, $1,000.00 per year for children...lower for younger taxpayers, reasonably higher for older ones).

If these amounts are not used up for the year, they are banked as credits throughout life. These credits can be applied towards - for example - catastrophic care deductible coverage for themselves or family members. But they are still taxed annually regardless of use.

Fix the annual healthcare tax to inflation. Thereby causing private plans to cap their charges in order to compete.

Make a standard nonemergency copay $40.00 (tagged to inflation every five years or so). This would encourage people to see a doctor and not wait until they have to go to the ER.

Continue providing the same tax benefits for those who have private insurance.

Don't deliberately squeeze private plans out of the market...like the proposed legislation will do.

For those who are here unlawfully, they get charged in full. If they return with further health problems, they are stabilized and referred to ICE for processing. "

Mr4 wrote on Aug 7, 2009 9:36 AM:

" 1. Universal Insurance Claims Form

In business, one thing that our government did right was to establish the Uniform Commercial Code. Established in 1952 this code simplified sales and commercial transactions across state lines making it much easier and more secure to engage in interstate commerce. The same thing is needed today in health care – specifically as it pertains to insurance. The advantages are many:

· A universal claims form will create enormous cost savings to providers who have to sort through different processes for different insurers.
· It will enable broader competition across state lines as providers can accept all insurers
· It can be used to create a clear insurance plan scorecard that patients can use to compare insurance plans – which procedures are covered and how much is paid – enabling the consumer to intelligently select the cost/benefit of an insurance plan.

2. Pre-Existing Conditions

The dilemma here is that private insurers are concerned that if they offer a great plan with extensive coverage, only the sickest patients will sign up - with healthy patients opting for a less expensive plan. The result of such cherry picking would be bankruptcy for the comprehensive plan. Government can help here by establishing or allowing a secondary risk pool that insurance companies can use to mitigate such risk. If this is done, more aggressive legislation can be enacted:

· Pass legislation prohibiting insurers from abandoning patients due to illness
· Repeal HIPAA – it was a dismal failure in addressing pre-existing conditions. All it did was add billions in unnecessary privacy busywork and IT costs.
· Eliminate COBRA - Allow patients to keep their plans indefinitely even if they change employers, and renew old plans even if the plan expires due to short term non-payment "

John Richards wrote on Aug 7, 2009 10:08 AM:

" Teacher wrote: " Medicare for all."

Even liberals like Representative Thompson admit there is some $50 billion per year waste and fraud in Medicare. You think we should emulate that system and make it even bigger? "

steph wrote on Aug 7, 2009 10:12 AM:

" I could get behind this:
http://www.robert-h-frank.com/PDFs/Emanuel-Fuchs.NEJM.3-24-05.pdf "

John Richards wrote on Aug 7, 2009 10:16 AM:

" Why should healthcare be free or low cost? Food isn't free, neither is housing, clothes, a good car, etc.
If you put in the effort to qualify yourself for a good job, you will have affordable health insurance. It's as simple as that. "

steph wrote on Aug 7, 2009 10:30 AM:

" One risk of government-sponsored "free" healthcare is decreased innovation.

http://www.nytimes.com/2006/10/05/business/05scene.html?_r=1&bl&ex=1160452800&en=6737dbf98961a2a6&ei=5087%0A "

diehard4ever wrote on Aug 7, 2009 11:04 AM:

" BEFORE we even THINK about this, we have a few larger problems to deal with:

~Illegals who use the ER for everything.
They are here because they can't get jobs in Mexico. Eliminate the gov't, so they can get jobs. They will go home. Eliminate the people in OUR gov't that are letting them get through. Adopt Mexico's current immigration laws.

~Korea, Russia, the Middle East and China are on the verge of blowing us up. Go in there, steal the nukes and bomb the facilities. We don't need Health Care if we are all dead.

~For the love of all things holy put someone in office who knows how to run a country.

~Drastically change Welfare so that you can't have a whole bunch of kids and get more money. The point of Welfare was supposed to be to take care of you while you get a JOB. Get a job or you're out. :)

I think that's it. When that;s done THEN we can worry about the uninsured (there won't be many since there will be more jobs previously filled by illegals).

Does anyone know the answer to these questions:

How will my plan be changed if we adopt ObamaCare? Will it be cheaper or more expensive for ME? Will I still have the same quality care that I had before? Will people over 65 REALLY have to go to a counselor every five years to discuss how they can "die early"? If I get a condition that causes me to start to go blind, will I have to wait until I am completely blind in one eye to get the medication I need to halt the condition?

Most of these are yes/no questions. "

freeport56 wrote on Aug 7, 2009 11:45 AM:

" 1. No need to socialize the system.
2. Remove illegal immigrants from everything except basic care.
3. Provide Tort Reform to every State to cap punitive damages.
4. Put Tarp and Stimulus money back into Medicare and Social Security.
5. Stop lying about the 45 million uninsured as it is a false number that includes;
a. 12-20 million illegal immigrants
b. 18-25 year olds that do not want to purchase health care
c. people making $50,000+ that do not want to purchase health care.
6. standaedize the insurance claim forms.
7. pre-existing conditions is the tough one. $1 million a year for cancer teatment for one person..maybe the government should just take on the preexisting conditions. there pockets are deep enough to pay for that kind of treatment.

Under HR 3200 there are annual caps for treatment and it is very dubious that under the bill, that kind of treatment would be allowed.

8. Citizenship requirement to reduce excess spending.
9. state and federal tax cuts so that more people can pay cash for services.
10. once you are insured through an employer, you always keep the insurance. "

post-it wrote on Aug 7, 2009 12:15 PM:

" The simplest way to reform the health insurance and tax code is to change the wage structure in America. By doing that, one would ensure that those that work have enough resources to purchase the coverage they need without having to overburden the more well to do with even higher taxes.

The problem is not the redistribution of wealth, it is in how we reward work to begin with. Multi-million dollar CEO's are not thousands of times more productive than line workers. No matter how good the CEO's initiatives, they do not happen without the participation of line workers and middle managers.

Pay the line workers enough that we don't have to worry if they can afford health care or if we have to raise taxes on the rich to give them access to health care. This could be accomplished without changing the total payroll. In this manner, taxes would only be needed to provide health care for those that are unable to work for it, or for catastrophic care.

Only when this happens will taxpayer's "go to the doctor, pay the doctor" be a workable method. I agree with him, this is the best methodology which would eliminate 3rd party decisions for basic care (and their 20% action on it). Eliminating this 3rd party would let patients in direct negotiation with their care provider. Insurance would only be required for catastrophic events like cancer or organ transplants (and all should share in the risk pool). We don't get car insurance to handle all the routine maintenance, why should heath "insurance" be any different? "

Mr4 wrote on Aug 7, 2009 2:01 PM:

" Hello bloggers.

This is potentially a great "forum" to propose solutions today's healthcare problem. But I think simple statements like "Medicare for all" do not add to anyone's knowledge.

I spelled out a couple of pieces to the puzzle above, touching on

1. Universal Insurance Claims Form, and
2. Pre-Existing Conditions

I submitted more, but detailed discussions regarding

3. Fraud and Abuse
4. Tort Reform
5. Phase out Medicare and
6. Phase out Employer Provided Healthcare

were blocked. If anyone is interested, please reply and I will be happy to elaborate. If not, in vintage Mike Thompson fashion, my comments will remain in the dark. "

steph wrote on Aug 7, 2009 3:18 PM:

" MISTER 4, I always enjoy your comments. Please elaborate. "

vocal-de-local wrote on Aug 7, 2009 4:22 PM:

" There's a huge bureaucratic system created around "justification of services". If some of this could be eliminated, it would reduce healthcare costs.

In Europe, physicians get bonuses for keeping their patients healthy. There's real incentive to get patients to reduce cholesterol levels, weight etc. A healthier population reduces costs.

Physicians alone should not carry the burden of a healthy population. People themselves should take ownership of their own health. Healthcare costs should be increased for those who are obese and have proof of the presence of lifestyle diseases, or proof that they are heading in that direction - eg. high cholesterol, weight, diabetes, athersclerosis etc.

A reasonably high annual deductible (per person), like $700, plus $25 copay per visit would be help control costs. No deductibles for children under age 12 though. Perhaps just a copay.

We must address how we are going to deal with illegal immigrants. Even if they are not included in a National Healthcare package, they will continue going to emergency rooms for care. Who pays? We cannot pretend that this isn't going to be an issue. It is. Employers of illegals need to be fined for hiring them. Those imigrants that do get hired need some type of "employer funded" healthcare insurance. This should not be subsidized by taxpayers. The employer will have a choice of either hiring citizens who will probably demand higher wages, or hire immigrants but pay the difference in their healthcare costs. "

Mr4 wrote on Aug 7, 2009 4:27 PM:

" Why thank you Steph, I always enjoy yours as well.

3. Fraud and Abuse

Today’s enforcement consists of Medicare witch-hunts against providers. While this should continue, some activity is just silly – such as the restriction on sales reps handing out logo pens to clients. The big savings being missed, however, are claims frauds being committed by patients. We need both improved legislation and better administrative enforcement of false health claims as well as Workers Compensation (state) fraud.

4. Tort Reform

Mike Thompson had one (yes, sadly, just one) legitimate point at the recent “Forum”. He noted that tort reform was a state’s issue, not a federal one. And to the extent that many healthcare negligence and malpractice suits apply state tort laws, Mr. Thompson is correct – the federal government has no authority to intervene. Notwithstanding the hypocrisy of the fed also not having the authority to run national healthcare, there is something that can be done. Like the Uniform Commercial Code noted above, the federal government can and should create a Model Tort Reform template that may be optionally adopted by each state – essentially recognizing the unique challenges in healthcare and limiting punitive and pain-and-suffering damages in healthcare cases.. Further, per their authority under the FDA, the fed can limit liability for all procedures, drugs and devices that have cleared the rigorous FDA approval process. This does not protect companies against fraud, so those of you who want to chase conspiracies against evil drug companies: relax – that is another fight.

For #s 5 and 6, please inquire further - they are actually the biggies. I don't want to break any rules. Just took a week off for that! "

Ruff Limblog wrote on Aug 8, 2009 5:52 AM:

" Many of the slogans here are not solutions.

For instance, much of the money in medical malpractice is spent on care for the victim.

My mom's last husband had a 'blue-baby' son from his prior marriage. The money gotten from a medical malpractice victory set up a fund that would provide medical and home care for the cruelly mentally and physically handicapped youngster who still has to crawl on the floor (now over age 50) to get around.

Universal healthcare would remove the need to sue doctors to get enough money to pay for continuing patient care when malpractice occurs.

Universal healthcare as a right of citizenship would actually lower the amount of healthcare litigation.

Also, California has 'tort reform' and 'insurance' is still going up.

If you want to cut healthcare costs you need to go after the 'administration costs' of healthcare denial meaning hundreds of billions spent to legally deny healthcare to their own 'insured'.

~Ruff "

Bill wrote on Aug 8, 2009 12:59 PM:

" Mr. 4 makes some reasonable points. It appears there is hope for a national health plan, or at least the tacit admittance that one is vitally necessary. Many of the points outlined are under discussion and part of current negotiations in the health care debate and may be included in the final bill, some of them will not make the cut.

There is a case made that reform is something we can not afford to overlook and that we as nation risk a rapid decline to our ability to weather medical necessity unless we address this issue frankly. Tort reform while an important part is separate issue from the current bill and should be addressed broadly not just on health terms. What ever tort reform may be needed it should not be an objection to passing health care reform now.

The points about fraud blame the same old culprits taking advantage of the system. We are not talking workman’s compensation here or welfare queens. There exists a virulent form of legalized fraud, double billing and denial of service in the insurance industry and this must be addressed. It is insurance that we are talking about, specifically access for all or as many as allowable.

There is an important need for a basic insurance model that is affordable to all citizens. Current insurance is not meeting the obligation of a large portion of our population. Many of the abhorrent practices of insurance companies must be ended and ended by legislation. There must be room here some place for a workable solution. No one will be completely satisfied but we must make progress on this vital issue. It will be a great shame if this opportunity is allowed to perish. "

Ruff Limblog wrote on Aug 8, 2009 1:19 PM:

" Where are the Random Thoughts and Rants user blogs?

Are we having yet another change to the way the user blogs are handled without advance notice?

~Ruff "

misfit wrote on Aug 8, 2009 4:25 PM:

" Steph...what do you do for someone then who inherits high cholesterol...or is born with a birth defect or cerebral palsy...Do we just put them down? Who says you take such good care of your body? Oh...you run, NO, "Power Walk" I bet. Good for you. I know someone who died while running because he had a bad heart that he didn't know he had. I guess he should have taken better care of himself.
Also,
Absolutely NO ONE is worth multi million dollar salaries except maybe, pediatric surgeons. That is it! Certainly not health care execs who profit on the misfortune and illness of American citizens. They run their companies based on the value of their stock and not for it's responsibility to their customers. This is why we buy such crap these days. Nothing lasts, the word "service" is almost not in the English language anymore. It's only about how to scam money out of the working class and not give anything in return. Those of you who support this religion of Capitalism at any cost are corporate fascists and I'll take a socialist over a fascist any day.
I do believe that we need to start taxing for each child rather than giving a tax credit for each child. It taxes our resources, adds more waste to the environment, burdens our educational system, etc. Why do we give a credit for this? That's about as conservative a view one would ever get from me...but, doesn't it make sense on some level. Now, I'm sure we wouldn't have anyone claiming ownership of these kids but, I'm sure we can work that out somehow. "

pharper wrote on Aug 8, 2009 5:26 PM:

" I don't think eliminating the Mexican government will change anything. Last time we eliminated a government (Chile) they ended up with a dictator who slaughtered thousands of people - better than a Socialist, I guess!

Healthcare should belong to legal residents of the United States, citizens or not. Illegal immigrants should be entitled to use the services of an emergency room or clinic...as long as they pay. Who cares if they use them or not as long as they pay for it?

I don't know enough about insurance plans to be specific, but I think a strong solution would be for the government to automatically provide healthcare to all citizens, but give them the option to refuse government care and choose their own private healthcare and insurance plan (which they would pay for themselves). That way, people who wouldn't be able to afford it otherwise (or who just feel comfortable being insured by the government) are covered, and those who feel more comfortable with private insurance companies can have the coverage they choose. "

steph wrote on Aug 8, 2009 6:09 PM:

" misfit--
I don't know where you got the idea that I think people with inherited problems or catastrophic non-self-induced illnesses should be "put down".
Hmmm....

And, by the way, I am not obese, don't smoke, and don't drink excessively, nor do I use drugs or engage in risky behavior. Apart from driving, that is. I do try to exercise and watch what I eat. I don't let anecdotes of people dropping dead while exercising deter me from trying to live a healthier lifestyle.

But if I'm sharing risk with someone else by pooling my money together with them to cover serious costly illnesses ("insurance") and that other person engages in risky behavior, thereby increasing MY costs, then that's not really an ideal situation, is it? I may not want to be forced to share your risk with you. I'd rather share risk with people who are more responsible. Then if one of us gets cancer or some debilitating neurological illness, for example, there WILL be money in the pool to cover the associated costs. Make sense?

I also don't want people looking at the risk pool with dollar signs in their eyes--deciding they don't want to add any money to the risk, but they want to have the pooled risk funds cover themselves anyway, and PARTICULARLY if they don't care for themselves. I don't want people demanding Cadillac care out of that pool of money, either. I don't want frivolous lawsuits out of that pool of money. "

steph wrote on Aug 8, 2009 6:10 PM:

" Our social security system and Medicare system are a ponzi scheme, where young productive people contribute to the financial and physical care of old people. One of the problems we face in this country is our aging population without enough young people to shoulder this burden. I don't know why we should discourage people from having children. "

freeport56 wrote on Aug 9, 2009 8:45 AM:

" Put all elected officials on Medicare and Social Security. "

freeport56 wrote on Aug 9, 2009 8:58 AM:

" The proposed system will work it's way to rationing....then the seniors can kiss there health care good-bye.

A reference to Europe's health care system, what a joke. Funny how no mention was made of the time lines for treat, crushing government agencies, and long waits for service.

Besides, when you actually look at the numbers(45 million w/o HC)-, there are 12+ million illegal Immigrants using the system, 19-25 year olds that are not buying health care, people who earn over $50k per year who do not buy insurance.....Why destroy the entire system to what will amount to about 5-10 million in dire need.

Those of you who think that pre-existing conditions should be covered for all, H.R. 3200 will not do that. Those of you at Monday's Forum(HA!) heard Ira tell you he spends $1 million per year on treatment. You really think the Government will pay that for millions of people? The bill does not call for that, plus in covering the PEC's, it will break the private insurance backs and your Blue Cross\Blue Shoeld\Kaiser...etc., will collapse. Just the facts.

Those screaming loudest for the passage of this bill do not care about that. Destroyed the health care system for 70-80% who like what they have to force insurance on illegals, those who do not want it, and those with PEC's.

Da Komrade! "

a teacher wrote on Aug 9, 2009 3:43 PM:

" Hey freeport, you don't actually read statistics, do you? If you looked at the Kaiser Foundation site about the uninsured, you'd find that the reason that 20 - 29 year olds don't get insurance is that they can't afford it. The median income for that age group is substantially lower than older adults.

As for the more wealthy group, you don't know they don't have insurance. Could be pre-existing conditions for instance. Kaiser seems to think it's an affordability issue. You should actually read the reports. "

Mr4 wrote on Aug 9, 2009 5:29 PM:

" Bill,

Prior to adding insurance regulation, we must first:

5. Phase out Medicare

Medicare is broken and cannot be fixed. It is essentially a Ponzi scheme that will forever be subjected to demographic shifts such as we are beginning to see with our aging Baby Boomers. It is also an irresistible temptation to greedy politicians who constantly steal from the trust fund. And while it is absolutely essential that we protect those who have faithfully paid into the system and planned their later years based on its promise, we do not have to repeat the same mistake for future generations.
· The solution lies in long-term or lifetime private insurance. A small increase in premium for those who are young can easily cover the increased costs that they will incur at an older age. And, in fact, if the amount of their current payroll deductions for Medicare were simply applied to such long-range coverage, the problem would be solved with money left over.
· The establishment of a minimum standard of coverage can protect the actual coverage provided. And the solvency of the insurer can be protected by the secondary risk pool referred to earlier.
· The trickier legislation required is to come up with a completely fair way to transition out – giving those who have paid into the system a reasonable way to transition to the insurance plan so that they may receive the same or better coverage in their retirement years without a significant change in their ongoing contributions.
· The Medicare payment schedule can remain – they are the standard by which insurance companies base their reimbursement today, and they can remain so in the future – see Universal Insurance Claims Form "

Mr4 wrote on Aug 9, 2009 5:32 PM:

" Bill,

Another way that legislation can help is to free up market forces in a way that puts positive pressure on insurance companies to be competitive and not subject to windfalls.

6. Phase out Employer Provided Healthcare

It is time that we give up the illusion that employers are capable of providing adequate healthcare. The interest of the employer is not the same as the interest of the patient, so it is the patient who should choose his own insurance. Choices should not be limited by those made by the employer.
· Eliminate employer selection of “qualified” health plans. Allow employees to choose from any plan they like.
· Allow employers and employees their currently enjoyed tax advantages by allowing employer to pay into a generic health plan fund for the employee. From this fund, the employee buys what he wants. The employer can suggest plans, but not mandate them. The tax benefits remain if the employee buys into a legitimate health insurance plan – tax penalties accrue if he does not. But responsibility falls on the employee – he/she must make the decision. This way there is much more competitive pressure on insurers to produce efficient plans. Fat, windfall-creating plans will not survive. And of course the employee remains free to pay extra if he/she wants to buy more coverage "

Bill wrote on Aug 9, 2009 8:06 PM:

" Mr. 4, Intriguing.

Phasing out Medicare is not an option. Politically unfeasible, unrealistic and virtual suicide I won’t even go there with my thesaurus. Should Medicare be reworked...Possibly but not gon’na happen on either parties watch. Most of the confusion of older Americans over the current bill centers on a perceived decrease in current benefits. That large and active portion of the population is simply not going to let go of what they feel they have won through years of struggle. Some of the major problems with Medicare such as over billing on immediately becoming eligible may be addressed but not phased out. These are questionable insurance company practices that must stop.

The dictates of reality tells me this is not an option. It is already fraught with scare tactics of euthanasia, procedure denial and suggestions of rationing.

Phasing out employer mandated options and replacing them with the form suggested is a feasible proposition. It all depends on the details. Again there must be coverage provided for all employees that guarantees portability and protection from preexisting conditions and will not max out if said conditions exceed certain boundaries of coverage.

Legislation and regulation are the only way to approach these problems. They will not be resolved by ignoring them and we need to address those needs now. There will never be a perfect acceptable solution but there must be an attempt and a beginning.

There is a workable plan before us that can be modified. Asking for pre conditions of phasing out existing working plans will not serve the nation constructively. "

Mr4 wrote on Aug 9, 2009 9:11 PM:

" Bill,

I think there is some common ground here. By eliminating the employer involvement we not only increase insurance company competition but we also illuminate one of the real issues: wealth redistribution.

If we as a society want to subsidize the poor so that they can get health care, OK, let's get that issue out into the open - I think there will be more general acceptance than many expect. Much better than hiding it behind some illusion that we are really trying to optimize our health care system.

If the current plan does no more than two things: 1)guarantee that private options remain free and available and 2) remove the employer mandates, then my objections would largely evaporate.

The problem is that the current plan does neither. "

Mr4 wrote on Aug 9, 2009 9:44 PM:

" Re the phasing out of Medicare, I agree that it is politically unfeasible, especially with the number of Baby Boomers getting ready to drain it. Nontheless the system is clearly not sustainable as it sits.

Something that is politically unfeasible is not necessarily wrong. Expediency does not change wrong to right.

But as the Baby Boomers age and stop voting as a block, the time may be ripe to correct this massive wrong. "

Bill wrote on Aug 10, 2009 9:13 AM:

" We need a viable insurance option for all Americans. An option that is affordable and workable reducing the scope to only the poor denies the magnitude of the problem. Lets be clear we are talking about an insurance option that is available to virtually all Americans, including working and middle class Americans, we are not talking about another special segment program. We are not speaking of subsidizing the poor. Rather the issue is access to vialble affordable health insurance for the major portion of the populace.

If those who wish to opt out of their plans to join the new option wish to do so, then that appears acceptable, or remain and enjoy the perceived benefits. The greatest mistake would be to ignore that there is a crisis in health care in this country. It is becoming increasingly difficult for much of the working population to gain access to health plans that provide for their needs.

Employer mandated programs may have to fall by the wayside but only if there is a recognition and commitment to the general health of those employed as a vital asset to be nurtured by the economic system. That means strict regulation of those insurance plans employees need. Employers cannot dodge their responsibility, their wealth depends upon a healthy society and to confuse this plan as wealth redistribution is merely pushing political buttons. Not having a system that alleviates the problem of affordable access threatens the wealth of all, not just the few.

Relying on emergency room or welfare is not an option that can continue. It is in all our economic and health interests to implement a plan now, not later, that attempts to address this need. "

Bill wrote on Aug 10, 2009 10:10 AM:

" The deeper we go the more the fine knives are pointed. That baby boomers vote as a block is not a sustainable reason to deny health care coverage. Devolving to generational warfare while popular is non productive. Boomers share the same concerns as the population as a whole and do not adhere to a distinctive political philosophy across their generation. This stereotype is not helpful in seeking reform but a hindrance.

Recognizing that a large segment of the population is approaching the age that will require increased medical attention is one pre condition that we cannot avoid. Abandonment is not a reasonable choice. These are the same people who have generated much of the wealth of this country in the decades of their lives and who have supported the old age of past and present generations. They have served as honorable citizens no matter how generational revisionists find it popular to stylize them, as only concerned with their immediate wants. This is a mythical misinterpretation of a generation much maligned and stigmatized by the current perception of the 60’s.

It is by no means accurate or reasonable. There goes my thesaurus.

For individuals truly attempting to glean fact from fiction it might be helpful to examine this bill from the same set of blue prints. I don’t think most of us could wade through the legal terminology of the Bill itself but there might be a web site such as the Kaiser Family foundation that would be helpful. If this is not neutral enough is there another? "

freeport56 wrote on Aug 10, 2009 10:55 AM:

" a teacher-

Your condescending question really does not deserve a response. but here it is.

The age group you cited was not the one I cited, 18-25 year olds.

Your attempts at supporting a Marxist|Lenin approach to health care is a sham. H.R. 3200 clearly outlines, without the details from Ways & Means and Energy & Commerce Committees, the complete subjugation of the American people. It clearly denies their rights, forces them like cattle into a system of health care that is unsustainable. Make no bones about it, there will be rationing of services. No Marxist \Socialist program survives without it. Two of Barry's advisor's are currently working on those "Emergency" plans, based on eugenics.

Support the Bill if you want. Envision the medical utopia you think the Democrats are going to bring you. Then read the Bill, it is a nightmare and an end to the Bill of Rights.

I do not trust the men\women who wrote the laws governing the medical insurance industry and who now calls them evil, to do the right thing. This legislation will end all private insurance. Those sentiments are contained right in the bill. "

5th generation napan wrote on Aug 10, 2009 1:15 PM:

" Easy. just provide every American with the same medical coverage that the Senate gets for themselves!

Standardize medical pay and fees across the nation (I know that will never happen). Why should I pay $95.00 for a chest X-ray, in Michigan (which my plan covers) and $500.00 for a chest X-ray at the queen of the valley (which my plan doesn't cover, even though the plan doctor sent me there)?

And finally the bs lawsuits need to be delt with. The cost of paying for out of court settlements even though they cost more than going to court only encourages more frivilous law suits. Overall we are paying for it.

I know how the Canadian system works first hand. You get free medical and emergency services, but if you want your own doctor or a regular check up, for get it. You'll wait months for a specific doctor or you can get a regular one you never met pretty quick.
So unless you trust a computer to have your file right or you want to keep your own file its really not that great of a system.

I dont have the answer of how to set up the healty system. All I know is $1300.00 per month for 80% coverage and limited list of doctors in Napa is unaffordable. Buts thats all my employer offers. "

Mr4 wrote on Aug 10, 2009 2:10 PM:

" Bill, you wrote:

"Lets be clear we are talking about an insurance option that is available to virtually all Americans"

Why? Do people all drive the same cars, live in the same homes, wear the same clothes, take the same vacations? I don't believe health care needs to be exactly the same for all.

A goal of reducing health care costs is admirable - both sides agree on this. But being in the health care industry since 1982 I have seen the exponential increase in cost and wasted effort because of increased regulations, not due to an absence of same.

You wrote: "That means strict regulation of those insurance plans employees need."

Maybe so, but the best regulator of insurance companies is the open market - not federal code. Right now insurers are limited by state and federal laws that prevent competition. That is why employers typically offer only a couple of options. That system promotes fat, wasteful insurance contracts - the very contracts that lead to the seemingly obscene compensation for some insurance executives. Open competition prevents that from happening. I love it when my business competitors get fat and greedy - I charge in like the cavalry!

Finally, regarding the Baby Boomers (I am one), I didn't follow your thoughts. This group has been both powerful and productive, and they deserve respect. They do however, think and act different than the GI's, and the Silent's before them, and the X'ers and Millenials who followed. My comment is that the Medicare phase-out should occur because it is the right thing to do. The idea is generation neutral. But the Boomer's current size and age may prevent it. "

Mr4 wrote on Aug 10, 2009 2:22 PM:

" Bill,

For a fantastic book on generational behavior patterns, with phenomenal relevance to the issues we are seeing today, please refer to :

The Fourth Turning by William Strauss and Neil Howe (1997).

This book is not politically biased at all. It simply looks at how and why generations change over the years, going back in anglo-American history to the Middle Ages. It also describes how predictable generational clashes have significantly shaped world events in the past, and are likely to continue in the future.

Superbly researched, brilliantly written!

And for anyone interested in history and it's proper perspective, this book is a must read. "

Bill wrote on Aug 10, 2009 4:15 PM:

" I'll check that book out. Hope it’s in the liberal local library or in paperback. Should I use my Abby Hoffman technique? You are pulling out your expertise again instead of convincing me by the persuasiveness of you own words and cutting and pasting mine.
You don’t strike me as a person lacking in written skills and have made some sound statements.

I will not follow you down that free market road it has already been discredited as an economic cure all. Like wise I will not bore you with my own credentials or expertise if I am unable to lay out a decent argument with out appeal to my own authority then it will fail. To buy in adamantly to one school of thought, fresh or saltwater, will not serve our purpose. If indeed our purpose is to reach an understanding. While I may accept some of the Chicago school teachings as having merit you have already denied any merit to many of the Economists that do not strictly adhere to your philosophy.

Already the broader philosophy and not the reality becomes the issue and instead of seeking any real points we will wind up at loggerheads over how many Angels can dance on the tip of a needle. This Bill is too important for that and there is no use in continuing. I am interested in what would make this Bill better or workable but not in thrashing out the over arching socio-political economic Strum und Drang.

You are committed to a philosophy that is at least to my view unsupportable and un changing and a philosophy that has no room for modification has no merit maybe there should be another thread for that. "

dinosilver wrote on Aug 10, 2009 6:37 PM:

" Medicare for all is probably not a good solution. Right now it is funded by a lifetime of working so Part A is no cost, and Part B is either about $100 a month upward to $300+ per month depending on income levels during retirment. If someone wants to buy into Medicare Part A, it is $400+ per month. Sure, if we opened Medicare for purchase by all - it would mean $500 a month premium for Part A and Part B. I would hardly call that affordable!!!! "

a teacher wrote on Aug 10, 2009 8:39 PM:

" "The age group you cited was not the one I cited, 18-25 year olds."

Who are part of the 20 to 29 year old demographic . They would have an even lower median income. If they are in college, they are probably covered on their parents health care plan or on a college plan. If they are not in college, do you think they will be in a position to afford it? "

Madison Jay Hamilton wrote on Aug 11, 2009 9:04 AM:

" Single-payer, not-for-profit health care is the easiest, cheapest, most efficient manner of financing health care available.

Anything short of that is an attempt to protect the insurance industry, one that benefits from special regulations that allow them to collude while setting prices. "

a teacher wrote on Aug 11, 2009 10:56 AM:

" Germany has an interesting Health Care system. It's not government run or tax funded. It's funded by it's citizens and their employers. It covers everyone. It's also the oldest in the world - Bismark instituted it in the 19th century.

Their solution - Make insurance mandatory and heavily regulate it. It sounds like the Massachusetts model. "

Mr4 wrote on Aug 11, 2009 11:13 AM:

" Bill,

I enjoy our exchanges - I hope you do too. And please take my occasional wizecracks about thesauri and such with the light humor in which they are intended.

"I will not follow you down that free market road it has already been discredited..."

This one puzzles me - especially as it relates to health care. First, I would like you to give me an example in any industry how the free market has been discredited. I am certain that I could ably demonstrate how it was a distortion of the free market that caused any perceived problem.

And specific to healthcare, we are so far removed from having a free market today that it is silly. Employers buying healthcare for employees? Government restrictions on insurance competition? Both providers and patients are currently in the dark about what they are getting.

I appreciate your interest in suggestions to making the current bill better, but H.R. 3200 contains so many provisions that are utterly destructive to many of best features of current American health care that it is not a reasonable starting point.

As to the book, I am sure you can find it in any liberal library or bookstore - and my copy is in paperback. It is purely academic - refreshingly, no politics at all. "

post-it wrote on Aug 11, 2009 11:20 AM:

" No one is speaking about the Wyden-Bennett Plan, which is voucher based

http://www.csmonitor.com/2009/0810/p09s01-coop.html "

post-it wrote on Aug 11, 2009 11:58 AM:

" MR4,

The market works great if people are deciding whether they drive a Mercedes or a Chevy, as while these items both provide the same basic function, there can be significant cost differences. Consumers can decide which mode suits them best, depending on their means to purchase. Those with more means can decide to have either the Chevy or the Mercedes, those with less means may only have the choice of a Chevy or even have to rely on public transit (the public option) or their feet.

With health care, we all potentially could be in need of Mercedes level care but only have Chevy resources or even worse. The current market cannot change this unless A. resources are distributed differently or B. healthcare is allocated differently.

Simplistic maybe, but tell me how your plan makes it any different? "

steph wrote on Aug 11, 2009 1:19 PM:

" post-it:
I posted a voucher-based plan above.

steph wrote on Aug 7, 2009 10:12 AM:

" I could get behind this:
http://www.robert-h-frank.com/PDFs/Emanuel-Fuchs.NEJM.3-24-05.pdf " "

Mr4 wrote on Aug 11, 2009 2:29 PM:

" Post it:

The answer to your question is private insurance. People buy insurance for the very reason that you describe - they may need the "Mercedes" treatment some day.

There are plenty of people with lower-cost insurance that receive these expensive treatments - transplants, neurosurgeries, etc.. Kaiser is full of them.

But the problem today is that because we allow our employers to select the insurance options, these options are severely limited - usually only a couple of choices per employer. The employer doesn't care - more choices means higher administrative costs to the employer. Only very large employers can afford more than a couple of options.

And once an insurer locks up a big employer contract, what incentive is there to stay sharp? It is very expensive for an employer to change, so insurers get away with their denial of coverage game very easily.

So the answer is to give consumers more choices, not fewer! Everyone should be able to select Major Medical only, low cost HMO (e.g Kaiser), higher service HMO (e.g Mayo), fee for service, PPO, etc.

The problem with H.R. 3200 is that it forces everyone to drive a Yugo. The claim that "you can keep your existing insurance" is illusory. Yes, you can keep it today, but you can't change to anything other than the public option. And government will strictly control all future "private" options so that they are in lockstep with the Yugo plan. That creates a complete breakdown of the free market - the result being a complete loss of future innovation. "

a teacher wrote on Aug 11, 2009 2:45 PM:

" "The claim that "you can keep your existing insurance" is illusory. Yes, you can keep it today, but you can't change to anything other than the public option"

Yeah, really? Where does it say that?

"That creates a complete breakdown of the free market - the result being a complete loss of future innovation. "

Really? How come most of the important medical advances have come from academia or in the field, outside of the free market? "

Mr4 wrote on Aug 11, 2009 2:48 PM:

" Steph,

Thanks for that New England Journal of Medicine voucher article. Lot's of good ideas in there!

But you know that "v"-word is being received just like the "r"-word. "

Mr4 wrote on Aug 11, 2009 3:09 PM:

" I don't think so teach:

I started making superconducting magnets in 1982 for a new thing called Nuclear Magnetic Resonance - later to be named MRI. I have been in the healthcare technology field every day since.

I have been at the heart of the industry/academia partnership the whole time working locally with places like UCSF and Stanford and nationally with places like Thompson's exemplary Mayo and Cleveland Clinics.

I cannot think of a single medical innovation that was ever brought to clinical use on a human being that did not have the financial and technical support of private industry - the free market!

Here is a post from Scott Atlas, MD - a friend of mine down at Stanford:

http://www.forbes.com/2009/07/21/rationing-health-care-opinions-contributors-scott-atlas.html "

post-it wrote on Aug 11, 2009 3:45 PM:

" Mr$,

I don't think Jonas Salk, Wilhelm Roentgen and Madam Currie were in it for the free market riches... Pretty common therapies they developed are used very commonly today. I also believe they were largely supported by university grants and not business agents looking for profits. "

jersey guy wrote on Aug 11, 2009 4:30 PM:

" The "free market" gave us Viagra and Botox. "

Mr4 wrote on Aug 11, 2009 4:39 PM:

" Ah, the Bolshevik colors come out.

One of my competitors (and former employer) today is Siemens. They made Roentgen's ideas practical.

http://health.siemens.com/med/rv/roentgen.asp

Bill Brody, the president of the Salk Institute, comically, was a Stanford Radiologist - a good friend and colleague of Dr. Atlas. As an entreprenuer, he helped found an MRI company called Resonex based in Redwood City.

http://www.salk.edu/about/brody.html

With regard to Madame Curie, her work with Radium may have led to the development of some of the radiation therapy used today, but she died long before companies like Varian brought the technology to clinical use.

What else have you got? "

Mr4 wrote on Aug 11, 2009 6:16 PM:

" Post-it: This is too good to resist! An excerpt from Joanas Salk's biography:

Salk's vaccine was composed of "killed" polio virus, which retained the ability to immunize without running the risk of infecting the patient. A few years later, a vaccine made from live polio virus was developed, which could be administered orally, while Salk's vaccine required injection. Further, there was some evidence that the "killed" vaccine failed to completely immunize the patient. In the U.S., public health authorities elected to distribute the "live" oral vaccine instead of Salk's. Tragically, the preparation of live virus infected some patients with the disease, rather than immunizing them. Since the introduction of the original vaccine, the few new cases of polio reported in the United States were probably caused by the "live" vaccine which was intended to prevent them.

That about says it all. "

a teacher wrote on Aug 11, 2009 9:01 PM:

" "I started making superconducting magnets in 1982 for a new thing called Nuclear Magnetic Resonance - later to be named MRI. I have been in the healthcare technology field every day since."

You left out the part where Paul Lauterbur and Sir Peter Mansfield did the research at Stonybrook and University of Nottingham did the research that made the MRI possible. At best you can argue is a partnership between business and academia.

In fact, I think you would be hard pressed to find a medical advance that was pioneered by some company first. Usually a profitable idea is marketed, but not invented by a business.

It makes you wonder what good ideas were passed over because they weren't profitable. "

a teacher wrote on Aug 11, 2009 9:08 PM:

" So, Mr4, what's your point about Dr. Salk? Are you arguing that his discovery is less great because he couldn't foresee everything?

The view is pretty good from the rear view mirror. "

Mr4 wrote on Aug 11, 2009 9:20 PM:

" Geez, teach!

Salk was fine, it was the U.S Public Health authorities that botched it up!

You trying to get me banned again? "

Bill wrote on Aug 11, 2009 9:54 PM:

" There is no such thing as a free market or free trade, some human mechanism always controls markets. Governments principally perform this function some times dictators, kings and corporate entities but all markets are controlled, regulated or managed in some form. When they are not closely monitored they fall prey to excess.

It is economic balderdash to believe that markets or trade are free. They are invented by humans who describe and define them which in and of itself denies freedom of markets. The rules are made by humans and some times they work well and other times the do not. There is absolutely no demonstrated universal law as in physics that proves free markets exist as there might be proof of free radicals in chemistry. Economics relies on the human experience and interaction not the laws of nature.

As social scientists economists form theories sometimes workable and sometimes not they do not possess absolute scientific truth but an approximation of variable human behavior. Trade barriers are used to protect infant industries and the U.S. has used them quite effectively and now I can expect a lecture on Riccardo and comparative and absolute advantage. Save it I understand economics quite well.

I also understand that health care is not the same as the auto industry, machine manufacturing or home building Apples and orange can be compared in argument but credulity stops at chickens and rocks. Health is something we all need not a Yugo, Towne house or a washing machine. If these arguments were not so well written (Except when he feels it necessary to lift others words out of context or accuse people of being Bolsheviks) I would question the intelligence of the writer but the writer definitely underestimates the intelligence of others. "

steph wrote on Aug 11, 2009 10:15 PM:

" What's wrong with Botox and Viagra? Quite a bit of the profit from those drugs is out-of-pocket, from people who choose to bear the expense of these medications. That's capitalism at its finest.
Then again, there is a segment of use of these medications that is paid for by insurance companies for medical problems you may not imagine. Viagra by another trade name (Revatio) is used for treating pulmonary hypertension; Botox can be used to treat painful muscle spasms, excess sweating, and even migraines.
Viagra's most common use is not illegitimate, either.

Try again.

Viva la Free Market! "

Mr4 wrote on Aug 11, 2009 10:44 PM:

" Teach,

Given the fact that doctors usually come out of Medical Schools it is hard to combat your brilliant conclusion that academics playes a role.

I won't argue that academia plays a critical role (both public and private), but they don't make products for clinical use.

Bill Cook's Cook Catheter, Earl Bakken's Medtronic Cardiac Pacemaker, Jarvik's Artificial Heat and hundreds of thousands of other inventions were produced privately and of course clinically tested in academia.

With specific reference to MRI I am amused that you wish to challenge me. Lauterbur got the Nobel Prize, but he never built a machine that could scan a human - that honor (being the first) went to the entrepreneur Raymond Damadian of Fonar Corporation. Likewise, Mansfield developed an MRI scanning technique called Echo Planar Imaging (EPI) and shared the Nobel. But he too never scanned a human on a machine he builit. In fact, the EPI sequence never got used clinically for more than ten years because industry had not yet manufactured the components to make it work. The devices he used were made by private companies such as Technicare, Diasonics, Picker International, General Electric, Siemens and Philips.

It makes you wonder how many good ideas remain buried in academia. "

post-it wrote on Aug 11, 2009 11:30 PM:

" Mr4,

Bolshevik? When caught with your pants down you result to name calling?

Your comments lead one to believe that only inside the box of capitalism is where all discoveries are made. However, if not for publicly funded research, they would not have had the opportunity to commercialize these applications. Jonas Salk developed the polio vaccine while working at the University of Michigan doing research for the federally funded National Foundation for Infantile Paralysis which later became the March of Dimes. I don't see how your friend has any relevance to this therapy. Either way it runs counter to your point that industry is the only reason these things happen.

Unfortunately, your Utopian view of market economy does not, nor will it ever exist. In fact if we had a true market economy there would be no limitations on immigrant labor. So if we eliminated the limits on H1-B visa's would your employer choose you or a cheaper immigrant? Would the conservatives have their battle cry of illegal immigration? The dirty secret about immigration is that conservative business interests loves the cheap labor. They also like the ICE raids as they own the contract prisons and take government money to the tune of $90/day to house immigrants prior to deportation. But then we are getting off topic. "

steph wrote on Aug 12, 2009 12:04 AM:

" Effective governments show restraint in regulation of markets, only to protect citizens from fraud--lying, cheating, stealing--and unsafe (health-wise) practices.

To the extent that governments overreach, or underprotect, choice, and its offspring, innovation, are squelched, to the detriment of all citizens, and, I maintain, citizens of countries who passively benefit from open and fertile US markets.

This legislation seeks to overreach, I'm afraid, by putting government in charge of healthcare decisions in a historically proven inefficient and expensive manner that will put a burden on our economy and on scientific innovation and consumer choice.

I posted a link above that shows the US outspends other first-world nations by vast amounts in fruitful and profitable research; our friends around the world benefit from the best of this research without the investment, and they regulate their costs, foisting cost recovery back to US markets, and chastise our “excesses”.

That said I do believe there is room for improvement in our system. Firstly, I believe we need better sharing of successful practices that emphasize efficient use of resources and best outcomes. I do believe there is waste in our system that could be conserved and realized as cost savings that could be passed to consumers. However, I do not believe the US government is the best arbiter of such change. Current inefficiencies and senseless regulatory practices in government-sponsored healthcare and other government agencies prove my point. Special interests, including corporate interests (example: Pharma involvement in Medicare Part D rules) are over-represented in our corrupt legislative processes. Don't believe for a minute that one political party has a hold on this shameful practice, either.

The truth is, there is nobody representing the US taxpayers in our governments. This is a power grab. "

a teacher wrote on Aug 12, 2009 8:50 AM:

" "Given the fact that doctors usually come out of Medical Schools it is hard to combat your brilliant conclusion that academics playes a role.

I won't argue that academia plays a critical role (both public and private), but they don't make products for clinical use."

As condescendingly nasty as that was, it is my argument. The free market MAY be important in CAPITALIZING on innovation, but the innovation mostly comes from other sources. Your ridiculous argument that "socializing" health care will kill the engine of innovation is wrong on two fronts.

As you show in your brief history of the MRI, the invention or the device would not be possible with out the research to be exploited.

AND...

There is a difference between the delivery of health care and the tools that doctors use. The government is currently looking into improving the delivery of health care in an efficient and cost effective way. They are not looking to socialize the medical technology industry. "

John Richards wrote on Aug 12, 2009 9:57 AM:

" Teacher wrote: "the reason that 20 - 29 year olds don't get insurance is that they can't afford it."

That's funny, because they seem to find the funds to buy the latest iPhone and iPod, stylish clothes, and a fancy set of wheels. It's all a mater of priorities. "

Bill wrote on Aug 12, 2009 10:09 AM:

" There may be corrupt legislators and the legislative process may be arcane but it is not intuitively dishonest. We have a process of governance, whether we agree with the result or not, that allows us to formulate policy, law and rules of conduct. It is immensely flexible and the current proposal has allowed the legislature wide latitude in developing a program necessary for the continued good health of all Americans.

If this August break concentrates only on the nay sayers at every turn and the deniers of necessity then the country is ill served by the opposition to health care reform. Continuing under the current form is blindness and condemns major portions of society to increasing medical care costs and continuing inadequacies.

Premiums have ballooned beyond the ability of many Americans to maintain a proper level of health protection. The practices of private insurance have not demonstrated that they alone are trustworthy with our delivery system if anything the opposite has been demonstrated. People who felt they had adequate protection lose their homes and families are broken apart. Pre existing conditions prevent others from gaining adequate care. Others must make the choice between providing minimal housing and food for themselves and their families or fore go proper health treatment.

The bogeyman tactics of government control fear mongering are not solutions or viable criticisms. Suggesting at every turn that socialized medicine is the creeping evil serves the purpose of ignorance not the health of America. Blaming corrupt democratic systems or calling them socialistic insinuates that democracy is evil. We live and vote collectively that does not make us communists or programs that serve our basic needs socialist. "

John Richards wrote on Aug 12, 2009 10:15 AM:

" Teacher wrote: ""The claim that "you can keep your existing insurance" is illusory. Yes, you can keep it today, but you can't change to anything other than the public option"
Yeah, really? Where does it say that?"

See page 16, SEC. 102:
(1) LIMITATION ON NEW ENROLLMENT.—
(A) IN GENERAL.—Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1."

For more on why this will kill off private insurance plans, see
http://wizbangblog.com/content/2009/07/20/barack-obama-inadvertently-tells-the-truth-about-his-health-care-plan.php "

freeport56 wrote on Aug 12, 2009 10:26 AM:

" Fixing the health care system:

Get Government the heck out of it! "

steph wrote on Aug 12, 2009 11:36 AM:

" Teacher, don't forget that the free market--corporate endowments and grants--also often funds innovation, often in university settings.

And inasmuch as the public sector is not profitable, private enterprise also funds all the tax revenues. "

Bill wrote on Aug 12, 2009 12:15 PM:

" Sorry, I can’t let this quote go.

“And inasmuch as the public sector is not profitable, private enterprise also funds all the tax revenues. "

If you receive a government paycheck or one from a nonprofit non-governmental enterprise you pay taxes, you contribute to tax revenues. If you have income you pay income tax, if you purchase anything you pay sales tax if you own your own home or rent you pay property tax, if you drive even though you do not contribute to private enterprise you pay gasoline taxes.

The public sector does not fund all tax revenues. "

steph wrote on Aug 12, 2009 12:48 PM:

" Only insofar as I have a job to go to! "

Bill wrote on Aug 12, 2009 1:13 PM:

" Misleading excerpts from the bill by John Richards also point to an effort to frighten and confuse the issue. The following is the preceding paragraph of the Bill, which he has conveniently left off. Same page, preceding paragraph to the one cited.

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT
COVERAGE.
(a) GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘‘grandfathered health insurance coverage’ ’means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

There are other salient features of the bill that are described in subsequent paragraphs I urge you all to try to follow it even though it is difficult to read. It is indeed long but to cherry pick it is a disservice and appeals to a darker nature intent upon promoting misunderstanding. "

DJ-LLsyawlla wrote on Aug 12, 2009 1:22 PM:

" Hey Do we know anyone that gets lots of money in contributions and is a blue dog Dem???
The word below surprising, is anyone surprised?
If you look at the money flow it isn't a surprise.

"The House Blue Dogs and conservative Democratic senators are doing just about everything they can to cripple real healthcare reform," writes The Nation's editor and publisher Katrina Vanden Heuvel. Surprisingly, mainstream media continue to label them as moderate, centrist and guardians of core American values. "

Mr4 wrote on Aug 12, 2009 2:01 PM:

" Taking the day off - gotta go exploit the proletariat! "

steph wrote on Aug 12, 2009 5:03 PM:

" Today's Wall Street Journal sure has a few good ideas about health care reform. Mr.4 will surely like the editorial by Whole Foods's CEO. "

XMAN wrote on Aug 12, 2009 6:54 PM:

" While visiting Canada some years back it was election time in British Columbia. One of the issues on the ballot was for the residents of B.C. to give up their National Health Plan and to collectively subscribe to U.S.A. Medicare. The U.S. had agreed to provide it if that was the way the vote went. The concept was narrowly voted down because there were those who argued that while Medicare was overall, better in some ways, in other ways it was equally inefficient and ineffective.

It is not uncommon for Canadian (or British patients in Britain) to worsen or expire while waiting on long waiting lists for health care. Their systems are overwhelmed because the health care is "free." People are running to the doctor every time they sneeze. I've seen this happen here too and the Congress, in drafting HR3200, is well aware of it. That is why there is a bureacratic panel for the oversight of patient traffic flow throughout the system. Otherwise, the overflow will break it down, overwhelm it and it won't work.

Do we need health care reform in the U.S.? Yes, we need it desperately. Do we need some "Utopian" formula sloppily and hurriedly put together by a bunch of politicians who call it HR 3200? Many of us and maybe most of us believe it to be a step in the wrong direction. We oppose it vehemently.
You may have noticed.

Madison Jay Hamilton says "Medicare for all." What's wrong with that? I think it is sound thinking and then let's clean up Medicare. It is fraught with cheats and fraudulent claims. "

steph wrote on Aug 12, 2009 11:09 PM:

" Who will pay for "Medicare for all"? Who is going to pay for the increasing costs of "Medicare we already have"? Medicare is going BROKE. "

littlered56 wrote on Aug 12, 2009 11:27 PM:

" I wish the NVR would publich the Health Care plan so we could leasrn the truth of its context.
Also Blue Cross and Blue shield are in fact Not for Profit companies and have never ben Health Insurance company. Also is it a fact group Health Insurance offered to Employers and business owners have much less premiums than the individual policy premiums. I sold life and health insurance for many years and NEVER wrote a policy for less than 50 to 60 % commissions for the first year premiums .
30% there after in many cases.

Socialized medicine scares me a lot less than people scared of socialzed medicine! "

John Richards wrote on Aug 12, 2009 11:51 PM:

" Bill, there was nothing misleading about the section of the bill I quoted. In effect it says, no new enrollees for private plans. That is different from your point about grandfathering existing enrollees. The two concepts don't negate each other.
The URL I cited explains why the "no new enrollees" provision will kill off private insurance plans. "

littlered56 wrote on Aug 13, 2009 2:19 AM:

" so, if you can afford the Mercedes and the best health care Insurance you get the best health care and you get to live longer, than the poor people who can not afford the mercedes, and the better health insurance and health care.
I wonder what religion teaches it is better for you to have the best and let the poor do with out??
Whats next only the wealthy get to send their kids to school, or have the police help them or have fire services.
We all pay taxes and we all get the services from taxes. We have universal fire protection and police protection, and univeral education so why can we not have universal health care.
We pay taxes to save a house from burning down but we can not pay taxes to save lives.
I want to know what religion and church in Napa teaches this is acceptable????? "

5th generation napan wrote on Aug 13, 2009 7:44 AM:

" Sadly enough any system, even our current system will fail until we correct the fundamental problems.

Frivolus law suits, out of court settelments because its cheaper even though the doctor was correct. Double and inflated billing. Unethical perscriptions, and testing just so the doctor and have a higher billing to insurance companies. Fraud, corruptions, and lack of oversight are all contrubuting factors to a failed system and will be the same contributing factors to whatever new system is put in place.

Until we clean house of the fundamental problems that caused the existing system to fail there is no way a new system will work.

The crack down needs to be done now and fix what we have instead of putting a corvett body over a model T frame and engine. "

Bill wrote on Aug 13, 2009 8:10 AM:

" You are mistaken and still misleading John Richards.

You chose to quote only the second paragraph, which was a partial definition of what the plan proposed. The paragraph I quoted was the lead paragraph and the one immediately preceding the one you chose and the following paragraph to yours directly contradicts your contention by stating the ability to add new dependents. The definitions and descriptions continue in that section

Instead of reading and digesting the entire section you chose to use one paragraph out of context.

That is misleading.

The inability to place the entire section here limits proper response but what you have attempted is to deliberately misrepresent the intention of this portion of the Bill.

I have urged others and now you to attempt to read a difficult piece of legislation. Try to interpret it as best you can but please be careful about drawing conclusions that are not there.

The attempt to spread confusion and fear over this Bill is approaching monumental proportions. A URL citation is not fact. Is it a difficult section yes but nowhere does it deny that current plans will be discontinued. Rather the grandfather clause guarantees that current plans will continue. Further reading outlines what will be necessary for future plans and prohibits arbitrary rate increases and the use of preexisting conditions to deny coverage among other stipulations.

I must assume that you have already made up your mind about this bill as so many here have and that is your prerogative. If you wish to spread falsehoods and misconceptions that is also your prerogative and it is my prerogative to point out that you are factually misleading. "

John Richards wrote on Aug 13, 2009 12:55 PM:

" Bill, you are confusing the grandfather clause with the new enrollee clause. The two are NOT the same. The grandfather clause does not guarantee that current plans will continue. It only guarantees that a private plan will be allowed to keep its existing enrollees. No new enrollees will be allowed unless the private plan meets all the onerous criteria of Exchange membership. As the old enrollees die or transfer out, the private plan will also die. "

John Richards wrote on Aug 13, 2009 1:10 PM:

" littlered56 wrote: "what religion teaches it is better for you to have the best and let the poor do with out?"

Not sure why you brought up religion.
It has very little to do with this issue.
First, let's dispose of the red herring of the poor doing without. The poor have the ER, and services like Planned Parenthood and Clinic Ole. So contrary to what you suggest, they're not doing without.
Secondly, there are indeed different levels of medical care, just as there are different quality levels of food. Are you suggesting that the poor should be subsidized so they can eat filet mignon every day? I can only afford the low option of Kaiser HMO for my healthcare. I don't expect or demand silver platter type health services. "

glenroy wrote on Aug 13, 2009 1:41 PM:

" 5thgeneration.... I hear ya....been saying the same thing since we started providing benefites.... "

littlered56 wrote on Aug 13, 2009 1:57 PM:

" The health care issue goes beyond Napa and the clinic Ole. There are thousands of people who are doing with out good medical care due to not having health care.
We pay taxes into our community, state and federal government to have the "services" they provide. Fire protection, and police protection. We have become a country that will allow our tax dollars to save our neighbors house were it to catch on fire.While not offering our neighbor good health care, to save their lives.
I question what religion teaches it is morally better to save a mans home from fire yet, refuse him affordable health care.
It is ludicrous to suggest the poor in our nation are not doing with out good health care. "

Bill wrote on Aug 13, 2009 2:25 PM:

" Oh! Yes J.R. Brilliant observation, all plans will need to conform to new standards such as not bumping the premiums for a few unless the premiums are raised for the entire group or that ongoing plans must not use preexisting conditions such as propensity for diabetes to deny coverage. Again, Nowhere does it state specifically that new members cannot be added to existing plans. They key words are “Except as provided” all plans will have to conform to the new rules as out lined and follow the restrictions or not be considered as qualifying. That makes the playing field even. Insurance companies do not get to continue their questionable practices indefinitely. The idea of reform is to reform those bad practices that are built into the present system you don’t get to continue denying coverage after a certain date. "

Bill wrote on Aug 13, 2009 4:55 PM:

" It is an Ah Ha! Moment, to borrow a phrase from Mensa.

Oh! Yes J.R. brilliant observation, all plans will need to conform to new standards such as not bumping the premiums for a few unless the premiums are raised for the entire group or that ongoing plans must not use preexisting conditions such as propensity for diabetes to deny coverage. Again, Nowhere does it state specifically that new members cannot be added to existing plans. The key words are “Except as provided” all plans will have to conform to the new rules as out lined and follow the restrictions or not be considered as qualifying. That makes the playing field even. Insurance companies do not get to continue their questionable practices indefinitely. The idea of reform is to reform those bad practices that are built into the present system insurance companies don’t get to continue denying coverage after a certain date or add people to a plan that is bogus. "

John Richards wrote on Aug 13, 2009 7:21 PM:

" Bill wrote: " all plans will have to conform to the new rules as out lined and follow the restrictions or not be considered as qualifying."

That makes the promise "You can keep your existing plan" ring rather hollow. Your existing plan may be changed to the extent that you don't recognize it, or it may go out of business because management considers the Exchange rules unworkable or too onerous.
Another half-truth exposed... "

XMAN wrote on Aug 13, 2009 9:55 PM:

" All this nit-picking over finite details is not a solution. Medicare for all. Now there's a solution. "

Bill wrote on Aug 13, 2009 10:26 PM:

" Sorry about the double clutch J.R. I wasn't certain if the censor bit me.

It's all about what you want to see. I don't think I can convince you that you might be wrong but It was fun trying. Thanks for keeping it alive.

The whole purpose of the Bill may just be about making health insurance more responsive. I don't think Kaiser will go under but plans that do not conform to the standards expressed will simply not be able to claim payment as in the form of Medicare payments as they now do unless they conform. The whole section is about defining this

They will have to change and accept me or my dependents should I or they contract diabetes etc. If the Big insurance corporations can’t play in that area they will stick to the sucker that will pay their premiums even though when they hit a certain level of payout they will drop him like a hot potato because his cancer will just cost them too much.

Some how I just don’t see the corporate insurance conglomerates going under due to this Bill, I could be wrong especially if they invest in derivatives. That’s how they make money you know, not providing health care but investing in things like real estate etc.

Does AIG have a health plan? "

Hear Ye wrote on Aug 14, 2009 1:04 AM:

" http://www.nytimes.com/2009/08/14/health/policy/14panel.html?_r=1

I know those with some common sense are way beyond this but... "

hogwild1030 wrote on Aug 14, 2009 7:11 AM:

" How about if we start with every child & every pregnant woman in the United States getting Health Care, free physicals, immunizations, and free medical advice from RN's. There are tons of unemployed Pediatric Nurse Practioners. Pay a $20 co pay for ill visits. Even going that far would save so much money...And be absolutely wonderful for the families. "

anticommie wrote on Aug 14, 2009 10:10 AM:

" If the the liberal socialists want their haelathcare they could start by taking the $150 million the Organizing for America Org. is spending on their TV ad campaign, and Share their wealth around to eachother instead of FORCING the rest of us into their ridiculous concepts. "

itsbushesfault wrote on Aug 14, 2009 1:27 PM:

" I feel its time for real true reform. Which means keeping the politicians out! And truly have solutions. Health care made simple is easy and efficient to run. We would be saving money, and live instead of worrying about who is going to pay. I must start out by saying that the United States has the greatest health care in the world. And if you don’t believe that then we will never have true reform.

Groups
Patient Rights: senior’s , minorities,, non-citizens, children, workers

Doctors: I would like it to be filled with real patient doctors .

Hospitals

Lawyers

Insurance

Pharmacy

Business

All to have both sides

And lastly have non-partisan economist

Have an health convention with we put these men and women in a room for how long its going to take and just Fix what is broken.

And finally and have true on honest infomercials how its going to make all live better in the United States, and maybe even the world.

As you can see I let the politician out of this ordeal, and that’s the greatest step that everone should agree on.

Stop letting them divide us! there both looking for the same thing, POWER!
Thinks about it! "

Mr4 wrote on Aug 14, 2009 4:30 PM:

" http://myprops.org/content/1961-Reagan-Speaks-Out-Against-Socialized-Medicine/

As relevant today as it was in 1961 "

littlered56 wrote on Aug 14, 2009 8:34 PM:

" Oh my Gosh!! Oh my golly!! boys and girls. You must pay strict attention to what "Reagan"said 48 years ago about socializsed medicine. You remember that intellectual genious who sold arms/weapons to the Iran contras! You remember that great caring guy who closed the mental hospitals and then suggested they liked to sleep under bridges.
So we should go back 48 years ago to deal with the health care problem in America today.
Maybe we can sell some more arms to the Iran contras and find more bridges for the poor and needy to sleep under.
Reaganomincs remember that??? Ah yes just what we need today !!!
It is discusting we can move no further in medical care for the poor and neddy than we did 48 years ago....That is the change the republicans have to offer???
I know we can do better in American today! "

Madison Jay Hamilton wrote on Aug 14, 2009 10:14 PM:

" The United States does not have the greatest health care system in the world. The United States pays more for health care and gets less in return than citizens of many other countries. Americans are not even close to being the healthiest people in the world. It's about time that Americans get what they pay for. The priority of Big Insurance and Big Pharma is vacuuming the maximum number of dollars from customers. Too often, Americans can't trust unelected business leaders. Elected politicians are more accountable to all of the country's citizens and are now tasked with reforming a corrupt, inefficient health care system. Health care reform is needed now. In the meantime, more and more Americans die or go bankrupt every day. "

duck wrote on Aug 14, 2009 11:20 PM:

" It is very strange that most of those up against President Obama's health care reform are over 65 and are , most likely, satisfied patients of Medicare. Medicare IS a government program that has been working quite well, I must say, for quite some time. Would you like to privatize Medicare and hand it over to the money grabbing nincompoop insurance companies? Is that your choice? Wake up! "

anticommie wrote on Aug 15, 2009 5:49 AM:

" duck wrote on Aug 14, 2009 11:20 PM:

"Medicare IS a government program that has been working quite well, I must say, for quite some time."

That system is bankrupt just like social security. There is an estimated $34 TRILLION pricetag on future entitlements of medicare when more and more people stop working and retire. Do you think this will be any different?

Madison Jay Hamilton wrote on Aug 14, 2009 10:14 PM:

"The priority of Big Insurance and Big Pharma is vacuuming the maximum number of dollars from customers."

Big Pharma companies are lobbying with Obama to pass this legislation. Why do you think that is? Do you think maybe they are guaranteed business over the next 50 years? The left has complained for years that the pharmecutical companies were the enemy, and now they love them for supporting this bill.

littlered56:

I would take Reagan over any other president of modern history. The man believed in individual freedom, where the left is teetering on tyranny through statism. "

Raven wrote on Aug 15, 2009 8:06 AM:

" First of all, anticommie...has medicare or social security missed a payment of any kind? Then by default, they cannot be bankrupt, let us gets the terminology straight. This bill will help reduce the fiscal impact on Medicare in the future.

As for Reagan , while espousing fiscal discipline, he managed to double the national debt.....fine example for you I can see. "

anticommie wrote on Aug 15, 2009 10:44 AM:

" Raven:

Reagan was far from perfect, after all he was a politician. You write of debt? Obama has QUADRUPLED the national debt in less than a year!!

As far as the late payment argument, the government is spending BORROWED money on a program that WILL eventually backrupt this country. Supporters of social security would love to say there is a nice little government nestegg that is set aside just for these programs, BUT THERE IS NOT. The government issues IOU's to itself and uses the money taxed from you and me from social security and places it into the general fund. There is NO money magically set aside to fund this, why would you think healthcare would be any different? It is the largest Ponzi Scheme ever manufactored, and I dont buy into it.

This bill will reduce the fiscal imapct? You really believe that? You give more faith in this government than I could ever think of doing. Time after time after time, the government never gets things right. I dont want imcompetent people in Washington making decisions for me, and thinking they know what is best for ME and my own, that is my job. "

alucawanza wrote on Aug 15, 2009 1:10 PM:

" Reagan was an actor with first stage alzheimers. Every part of his life was following a script and performing. Except when he was napping.... "

Raven wrote on Aug 15, 2009 1:25 PM:

" Neither medicare nor social security is borrowing money to meet their obligations at this time anti, so again, the bankrupt argument is pure fiction.

and no one is saying that either program will not need adjustment at some time to continue to remain solvent....one thing helath care would do is reduce the fiscal impact upon medicare....health people when they are younger reduce the need for services when they are older, reducing the cost..seems quite simple anti....

regarding the debt....the national debt in 2008 was just less than 10 trillion dollars...in 2001 was 5.7 trillon....the estimate for 2009 is 12.8....so there has been no quadrupling of the debt.... "

steph wrote on Aug 15, 2009 7:51 PM:

" Raven--
Please document your claim that universal healthcare reduces need for services when people are older. More accurately, you claim that "healthy people when they are younger reduce the need for services when they are older, reducing the cost..seems quite simple" but you cannot demonstrate this is true, either. Universal access to healthcare does not necessarily make people healthy, nor is it inexpensive to "make" people healthy when they are unhealthy. Unfortunately, our healthcare system does not have a magic want to undo unhealthy lifestyle habits.

Your version of common sense does not count. Show me a study that proves your supposition. I think you'll be shocked at what you find.

Universal healthcare doesn't keep people from blowing out their knees and hips, doesn't keep people from needing drugs to treat hypertension and diabetes, doesn't keep people from developing alzheimers, doesn't keep people from needing costly urological procedures, nor from needing chemotherapy. The list goes on and on. Dialysis? Expensive. Lots of people on dialysis have had plenty of access to healthcare their whole lives, and it didn't reduce their healthcare costs.

http://content.nejm.org/cgi/content/full/358/7/661?query=TOC "

misfit wrote on Aug 15, 2009 8:53 PM:

" Steph...perhaps if people saw the doctor more often, for routine check-ups and any lifestyle issues affecting their general health were dealt with sooner, there would be less need for more invasive procedures down the road. People who don't have health care do not have regular check-ups when the blood work alone can cost close to 1000.00. Even with insurance some co-pays and deductibles are unaffordable especially in this economy. Going to the doctor and checking in and having access to services that focus on prevention and early detection will play a part in the future needs and health care costs. Yes, people will still break their hips but, maybe if they were diagnosed with or educated earlier about osteoporosis and put on proper, affordable medication for that...maybe, just maybe, no broken hip which often leads to a very extended hospital stay for the elderly. Or how about being able to have a yearly mammogram or a colonoscopy? These are costly even with insurance. These are a few examples of what many people have to go without, not because they don't want to pay their way but, because they cannot. Health care needs to be affordable and putting the fox in charge of the hen house has not worked and will not; maybe for the share holders but not for the customers. These may not be the best examples of how preventative care can lessen costs later but, denying this coverage or having it be cost prohibitive for many people, has assured early and needless death for many of them. Now, that's what I call euthanasia so, the hypocrisy of it all is stunning. "

Raven wrote on Aug 15, 2009 11:21 PM:

" steph, misfit kind of covers it all but the latest that comes to mind is a study released this week that shows the employee wellness programs reduce employer health costs and increase employee productivity.

and there is this...

In the U. S. Department of Health and Human Services study “Prevention Makes Common Cent$,” the median return on investment from nine disease management and wellness programs sponsored by companies such as General Motors, General Mills, Motorola, Chevron, Johnson & Johnson
and Procter and Gamble, was $3.14 for each dollar invested.1 The same study found that disease management programs saved from $7.33 to $10.38 for each dollar invested. "

steph wrote on Aug 16, 2009 1:11 AM:

" misfit--
Medical intervention that seems like it might save money doesn't always save money, and cost saving associated with prevention of one illness isn't necessarily reproducible for all other disease states. You'll have to look at studies. I pasted a link that I encourage you to read. Some "preventive" healthcare is cost-effective, but a lot isn't.

You can't make blanket statements that all preventive healthcare saves money.

It may not seem nice that some people don't have insurance--I agree with you. But the specific focus of my objection is the unsubstantiated declaration that universal healthcare would save money for Medicare. I don't believe anyone has demonstrated that for Americans.

Raven--
I took the time to review the study you cite. The study looks at voluntary programs that focus primarily on wellness programs for employees of corporations--programs designed to get people to reduce their weight and stop smoking, which showed short-term ROI. I'm sure if Americans ate, smoked, and drank less, our healthcare costs WOULD be much lower in the short run AND long run. You don't need to have access to a doctor or ED to do this. "

Raven wrote on Aug 16, 2009 9:09 AM:

" Go to the AMA, to kaiser and to the PEW institute for more studies s well as the New England Journal of Medicine, which has a study that breaks down the cost effectiveness "

misfit wrote on Aug 16, 2009 10:13 AM:

" But what about those who choose to ride motorcycles or simply, just drive. That is a risk they are taking as well. The problem Steph, is where do we draw the line? We are all paying now for all of these things. I am paying for people with osteroporosis as well as those who are overweight, drive carelessy or drive drunk. I also pay for every child born without health care coverage who then needs care. But, I think it's more like the question of renting vs. buying; if you're paying anyway... I just want to see it simplified and single payer would do that. Maybe we should look at our system of taxation at the same time; have a more expansive vision of this issue and all of it's repurcussions. However, Obama is not all wrong with this. He, at least has the right intention of wanting to see every American covered by affordable, quality healthcare. What is the intention of these angry mobs, basically stating, "I have mine so, s-c-r-e-w everyone else". That is what they are saying. What does that say about Americans? It is not American, it is not humane and it certainly is not Christian. Clouding the issue with false information and accusations of Death Panels diminishes the process required to achieve the goal and it demeans everyone who takes this seriously. Just giving it any attention whatsoever, says alot about the charachter of this country. It's so selfish, dishonest, childish and mean spirited. Why can't the opposition to health care reform be honest and argue from an honest place instead of fabricating lies and untruths that they know their unquestioning followers will run with. How can anyone be proud of that? "

Dhappel54 wrote on Aug 16, 2009 11:43 AM:

" If I told you I had a product to sell you that cost 50% more than any other product on the market, provided you with worse service and produced poorer outcomes, you'd likely question the market viability of that product. Yet that is an accurate description of our national health care system. We spend 50% more than any other industrialized nation on health care per capita, cover fewer people and have worse outcomes (life expectancy, infant mortality) (Source: World Health Organization http://www.photius.com/rankings/healthranks.html).
That, in a nutshell, is the problem. What's causing the problem and what can be done to fix it? That's where we may all differ.
Our current insurance industry centered health care system perpetuates the problem because all of its incentives are geared toward covering only the healthiest individuals and denying treatment to those who need it. That's how you maintain profitability. In addition, the insurance company lobbyists have succeeded in getting billions of dollars in subsidies from the publicly administered Medicare system in the form of Medicare Advantage--which provides few or no additional benefits but costs taxpayers a fortune.
Lastly, i have yet to hear anyone provide a single example of insurance companies providing added value in terms of improving health care delivery.
From the above, it should be clear that I think a publicly run single payer system (also known as medicare for all), with healthcare being delivered via our current private practitioner system. This eliminates a huge amount of administrative costs (Medicare runs on @3% admin costs--private insurers, when you total paperwork, marketing costs and profit come close to 30%) and does not impact on the care provided. "

steph wrote on Aug 16, 2009 3:30 PM:

" In order for single payor to reduce costs and be "fair" it must outlaw private pay fee-for-service or private insurance.
Americans will not stand for elimination of choice.

The argument that goes "I got mine, now scrw you" is false. Because in truth the argument should state, "I worked for mine, you are not entitled to take from me to get yours." Nobody gave me mine, I worked for it. Most Americans worked for theirs and do not want to sacrifice choice and quality or pay much higher taxes to fund a big government program.

Insurance companies organize risk pools (it is NOT true that they don't cover expensive illnesses--that is just patently false) and guard the risk pool from unreasonable costs (like not covering experimental, unproven, expensive treatments or excessive tests/treatments). They negotiate for lower costs in order to keep (barely) monthly premiums more affordable to the people who do have insurance (the majority). Medicare does NOT provide health care; Medicare contracts with insurance companies and physician groups to provide care.

As for the argument that we are already paying for the uninsured, that may be true, but the uninsured don't utilize the healthcare system as much as insured people do, or people covered by government programs for the poor, elderly, and disabled. The CBO took all that into consideration when they came back with a figure of $1 TRILLION extra for the House's bill. The CBO didn't say that we'd come out even or ahead by covering the currently uninsured; they said the bill would cost $1 TRILLION. Where's the money coming from? "

Hank wrote on Aug 16, 2009 4:04 PM:

" Steph-I agree with you wholeheartedly and I think you've answered the recurring question of: "If you don't like our health care reform, what do you suggest?'. "

John Richards wrote on Aug 16, 2009 4:10 PM:

" I see in todays news that the boisterous town hall meeting are having the desired effect. Obama is backpedaling furiously, offering to eliminate the public insurance option. The so-called 'death panel' counseling provision was dropped by the Senate a few days ago. Pretty soon this will look like the GOP version of health insurance reform... "

Raven wrote on Aug 16, 2009 6:37 PM:

" in other words none, jr? "

alucawanza wrote on Aug 16, 2009 7:02 PM:

" JR: Do you know what the death panel nonsense was really about? It was about meeting with your doctor or a legal aide and writing a living will. I have one. That's what that was about. That was what the counseling was for. To plan what will happen when you are unable to decide for yourself. It protects your wishes. Now it's been dropped. Hope you've got one so your wishes are known.

What GOP version??? "

kevin wrote on Aug 16, 2009 8:16 PM:

" Overhauling health-care system tops agenda at annual meeting of Canada's doctors

SASKATOON — The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.

Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.

"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.

He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.

http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw "

a teacher wrote on Aug 16, 2009 8:22 PM:

" The GOP version? What's rthat take two aspirin and get lost? Don't get sick? Make sure you you can afford health care?

Tough luck?

Seriously, you'd better hope it doesn't come to the GOP version. The people will see that there isn't one. "

steph wrote on Aug 16, 2009 9:38 PM:

" The whole death panel argument is ridiculous and dishonest and makes the GOP operatives look bad. It just does. There's no death panel.

The bill is talking about advance directives.

http://www.caringinfo.org/PlanningAhead/AdvanceDirectives/WhatAreAdvanceDirectives.htm "

steph wrote on Aug 16, 2009 9:40 PM:

" I wish we could keep the discussion honest. Clouding the real issues with made-up ones detracts from intelligent discussion. On both sides. "

Bill wrote on Aug 17, 2009 10:29 AM:

" Notice how it is being suggested that the Canadian system be changed, overhauled or adjusted not scrapped.

We need to change, overhaul and adjust our health care delivery system and that is what has been suggested.

No one is suggesting scrapping the present system. We need more than minor tweaks and depending on the current system to change itself is not a logical option.

No single side will get exactly all the things it wants from the current Bill and it will be changed in may ways but we need health care reform and to do nothing is not a viable option.

Affordable access, premiums and pre-existing conditions must be addressed by this reform. On going care for serious illnesses that cannot be sustained by the individual’s pocket book alone or immediate care for medical emergencies that now cost tens thousands of dollars and threaten many Americans with destitution by merely braking a leg must be a part of this reform. The hodgepodge of insurance schemes offered today does not meet the needs of American business or individuals.

For American business to remain viable it needs a healthy population to draw from and market to. The current system costs too much and delivers too little. "

Alter ego wrote on Aug 17, 2009 10:32 AM:

" And who are those "advanced directives" aimed at?

The old, senile, sick. The ones with no family and no support.

Have you looked at the forms? The default answer is always the one the government wants: no tubes, no feeding, no surgury. If someone is confused or doesn't understand, that's what ends up on their "directive".

It may not be a "real" issue to some of you, but to many of us, the idea of the government pushing it's "death" agenda on the weak and elderly is totally unacceptable.

But where else can they find the savings to pay for socialized medicine? After all, the majority of health care expense is in the last six months of life.

They are just going where the money is. "

shareathought wrote on Aug 17, 2009 11:09 AM:

" It may be that "...the GOP version of health insurance reform... " is no reform. "

steph wrote on Aug 17, 2009 3:04 PM:

" Alter ego--

So it's ok to put taxpayers on the hook for thousands of dollars a day for life support in an ICU for an elderly person with a terminal illness like Alzheimers or Parkinson's, all because the person in question never signed a "Do Not Resuscitate" order?
Is it wrong to ask people to decide how they want to spend their last days/weeks/months if they have Alzheimers? Surely you've thought about this yourself. You know, if I have Alzheimers or Parkinson's disease and get to the point where I am unable to care for myself and have no idea where I am or who I am, I do NOT want heroic measures taken to save my life.
Maybe you do, and, generously, that is your choice. I do hope you have an Advanced Directive that says so, or your children or spouse will decide for you. "

steph wrote on Aug 17, 2009 3:09 PM:

" This is the sticking point of "Single Payer" that Americans just won't stand for--no way:

http://www.pnhp.org/facts/singlepayer_faq.php#buy_healthcare

Why shouldn’t we let people buy better health care if they can afford it?
Whenever we allow the wealthy to buy better care or jump the queue, health care for the rest of us suffers. If the wealthy are forced to rely on the same health system as the poor, they will use their political power to assure that the health system is well funded. Conversely, programs for the poor become poor programs. For instance, because Medicaid doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered politically important. Moreover, when the wealthy jump the queue, it results in longer waits for others. Studies in New Zealand and Canada show that the growth of private care in parallel to the public system results in lengthening waits. Additionally, allowing the development of a parallel, private system for the wealthy means the creation of a permanent lobby for underfunding public care. Such underfunding increases the demand for private care. "

steph wrote on Aug 17, 2009 3:11 PM:

" Here's another idea for HEALTH reform: off-road bike paths for all!

Also, better city/rural planning that includes family walking zones.

We need to encourage more physical activity that is safe and accessible. "

Bill wrote on Aug 17, 2009 4:27 PM:

" Wowzrs!! Steph you go Girl.

Great web site, yeah more bike trails more small clinics (er...planning?) I think you gotta lot of good ideas in spite of objectivism. "

kevin wrote on Aug 17, 2009 6:36 PM:

" You will never be able to prevent private insurance without changing the US Constitution.

Even the Canada Supreme Court recently confirmed that the people had a right to buy their own insurance to compensate for the miserable public system they are forced to endure.

Supreme Court Challenges Canada's Health-Care Assumptions

http://www.thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=M1ARTM0012787 "

Mr4 wrote on Aug 17, 2009 9:36 PM:

" Who kidnapped Steph? "

John Richards wrote on Aug 17, 2009 10:50 PM:

" "" You will never be able to prevent private insurance without changing the US Constitution."

Not only that, but I think the Supreme Court would strike down any attempt of the federal government to go into direct competition with private companies. It smacks of unfair competition, since the feds have virtually unlimited resources, and can afford to undercut everyone else's prices. "

John Richards wrote on Aug 17, 2009 10:55 PM:

" "Eliminate COBRA - Allow patients to keep their plans indefinitely even if they change employers, and renew old plans even if the plan expires due to short term non-payment."

Uhhh, who would make up the difference between the former employee's normal premium payment and the total cost of the plan? The employer is not going to contribute when the employee is no longer employed there. "

Raven wrote on Aug 17, 2009 11:16 PM:

" kevin, where does it say you can't have private insurance? "

steph wrote on Aug 18, 2009 7:59 AM:

" Ha, Ha, Ha.

Honesty is the best policy. Honesty lends itself nicely to credibility.

But, my favorite poster Mr.4 (you and cab e-girl would make a nice couple...) what exactly do you object to?

Perhaps some misunderstand my post about single payer lock-down as an endorsement thereof? Nothing could be farther from the truth. No American, including myself, would stand to be told that we may NOT buy healthcare "out of turn." THAT is dangerous and chilling.

And for that reason, single-payer is not feaseable, because single-payer revolves around that concept of central control of all healthcare costs. I have given other reasons why I am against this, like doctors leaving healthcare, like research dollars leaving healthcare. The world depends on our research dollars!

And many other suggestions for reforming US healthcare have been given here, suggestions that would not involve US takeover of healthcare, and much less than the US takeover of a $1 TRILLION liability that is NOT sustainable.

Some of my favorite suggestions are yours, Mr.4--interstate insurance plans, for example (widen the risk pool, decrease redundancies!)

There's no eugenics plan with Congress's plan, just a quick path to economic ruin and the rapid erosion of the best healthcare in the world. "

Bill wrote on Aug 18, 2009 1:34 PM:

" When more clinics are spoken of are those clinics that have on duty a licensed physician, registered nurse or some other health care practioner?

What would induce private enterprise to promote these clinics? Are medical professionals and insurance companies willing to see the rise of Wal-Mart style medicine for the masses where the range of minor cuts, abrasions, sniffels, sneezes, head aches and high temperatures plus heart rate, blood pressure, and congestion is read and diagnosed by a computer?

Many people know how to operate computer programs but that does not mean that they are qualified diagnosticians. A draftsman operating a CAD program is not an engineer or architect.

There is a reason why it is called the art of medicine. So much of it is inherently intuitive that it cannot be relegated to a machine. Physicians don’t necessarily appreciate being compared to a mechanic even if many of the functions they perform are centered on mechanics. Professionals that are not physicians often preform these functions but there is generally a licensing or performance regulation and direction by a physician.

I don’t see this happening unless government plays a role. I’m not sure the Wal-Mart model would be acceptable to even Conservative, much less Liberal, view points. I don’t think we can wait for private enterprise to catch up to this perspective and it also appears as a lessening of quality care if a widening of access. "

Bill wrote on Aug 18, 2009 1:44 PM:

" " Reform insurance marketing; force insurance companies to make the details of their plans more understandable and directly comparable. Have each company post their plan features on a legally binding website hosted by the Federal government. Let people buy low-cost high deductible plans that actually cover catastrophes”

This is quite a load for the Federal government to take on with out regulating insurance companies more severely than the current bill would. While I would like to see the risk pool expanded to include every body and straightforward insurance policies become standardized. I don’t think I want the Feds to run, enforce or dictate marketing plans.

Have them write the standard rules that must be adhered to and then enforce those rules. Even I have my limits for government. "

steph wrote on Aug 19, 2009 9:33 AM:

" Maybe the new pot dispensary will decrease healthcare costs.

I mean it.

Maybe marijuana will help people with chronic pain and anxiety issues.

The costs are out-of-pocket and affordable, from what I can gather.

On the other hand, we know what pot does to the waistline. This could increase healthcare costs.

And, we know what pot does to one's initiative and drive and work ethic. This could decrease revenues and make people less employable, and decrease tax receipts.

Hmm... We'll see.

I still don't want to pay more taxes for these folks to lay around. "

post-it wrote on Aug 19, 2009 3:41 PM:

" Steph, at least they will likely have a smile on their face. "

freeport56 wrote on Aug 19, 2009 4:02 PM:

" Steph-

it should certainly help the restaurant business in Napa "

ADark1 wrote on Aug 19, 2009 6:57 PM:

" Use the most effective model. After initial implementation, THEN work the bugs out!

Some of you would be surprised to know that social security and medicare were also delayed forever! THe LONGER we wait the MORE it will cost!

I Still insist we mine ALL of our borders
will cut down greatly on the illegals program.
Have a publc option. I do find it ironic that those in big business now decry competition!...Oh yes, BGTW?, have a padded room ready for those that think they have a "RIGHT" to wear semi-automatic weapons in a place where the president of the United States is speaking!

There should be NO charge for them! "

Mr4 wrote on Aug 19, 2009 9:43 PM:

" Steph,

Your post on Aug 17, 2009 3:11 PM threw me for a loop.

You cited the PNHP, a small fringe group (17,000 physicians out of about 1.7 million - approximately 1%) whose stated mission is to achieve Single Payor National Health Insurance.

Their claims are absolutely false, stating outrageous things such as:

*national healthcare is not related to socialized medecine
*we already ration, thus no change
* All medical research is publically funded, thus no change (WAY FALSE!)
* A government plan will not add a bureaucracy
* There will be no change in physician reimbursement
*Bureaucracy should control who gets new technology

...

On and on.

Maybe you had a TIA?

I forgive you. "

steph wrote on Aug 20, 2009 8:34 AM:

" No, I cite the PNHP because they are the most organized proponents of "single payer" care that is being advocated for by people who are either misinformed as to what "single payer" is, or have no idea what the mandates and consequences of single payer are.

And one of the most troubling aspects of single payer is what I posted from the PNHP website: In order for single payer to work, government has to have ALL control of healthcare costs by controlling THE ONLY supply of healthcare. In other words, as in Canada pre-2005, all healthcare provided by the government is the SOLE source of that healthcare, whether or not you can afford a different provider out-of-pocket, or by a supplemental insurance plan. Under single payer, if government provides MRI, you MUST use government providers for MRI, waiting as long as it takes to get your MRI if you are deemed eligible. And you may NOT pay for MRI at a non-government provider, and you may NOT pay for a supplemental insurance plan that will pay for MRI from a non-government provider. Canada had private clinics that were ONLY for non-Canadian use! Imagine pressing your nose to the outside window and being told you may not use the clinic because you are a Canadian--you have to use the government clinics--and wait. Wonder why Canadians came to the US to buy healthcare before the 2005 Supreme Court ruling that overturned the ban on supplemental healthcare?

Single-payer advocates who know what they're talking about want a system like the pre-2005 Canada system, and they outline their reasons in the passage I posted.

Can you imagine? "

steph wrote on Aug 20, 2009 10:24 AM:

" By the way, I know the PNHP is a fringe group; I wrote this to our friend the bauhausfan on another thread a while back. "

Mr4 wrote on Aug 22, 2009 9:51 AM:

" Steph,

Thanks for the explanation. I misinterpreted your prior post.

See what happens (Mike Thompson) when you read something too quickly? "

John Richards wrote on Aug 22, 2009 12:50 PM:

" misfit wrote: "the intention of these angry mobs, basically stating, "I have mine so, s-c-r-e-w everyone else."

No, they're saying, I like my present insurance, so don't s-c-r-e-w it up. These are hard-working, average Americans who have paid their dues. They don't want their taxes increased or their health plan messed up, so that the lazy free-loaders can have coverage. "

John Richards wrote on Aug 22, 2009 12:58 PM:

" Raven wrote: "where does it say you can't have private insurance?"

Obviously it doesn't say so outright. But the policies in HR3200 are such that private plans would be driven out of business. "

Raven wrote on Aug 22, 2009 10:15 PM:

" so it doesn't say it...good....and since you don't have a price for the public option how can you say it will drive the private companies out of business...isn't competition the lifeblood of capitalism?

(btw, what stops the companies from being driven out of business now?...is it collusion between the companies?)

and there is this from the AP today...

"There is a serious problem with the lack of competition among insurers," said Republican Sen. Olympia Snowe of Maine, one of the highest-cost states. "The impact on the consumer is significant."

Wellpoint Inc. accounted for 71 percent of the Maine market, while runner-up Aetna had a 12 percent share, according to a 2008 report by the American Medical Association.

Proponents of a government plan say it could restore a competitive balance and lead to lower costs. For one thing, it wouldn't have to turn a profit.

A study by the Urban Institute public policy center estimated that a public plan could save taxpayers from $224 billion to $400 billion over 10 years by lowering the cost of proposed subsidies for the uninsured, while preserving private coverage for most people.

"Right now, there's no incentive for insurers or big hospital groups to negotiate with each other, because they can pass higher payments on through premiums," said economist Linda Blumberg, co-author of the report. "A public plan would have the leverage to set lower payment rates and get providers to participate at those rates."

so where is the competition now? "

steph wrote on Aug 23, 2009 11:27 AM:

" That's right, Raven, it wouldn't have to turn a profit.

It could lose all sorts of money, thanks to the government's ability to print or borrow more money.

If the goal were to move to single payer, then it could undercut all the competition to make that happen. IF that was the goal.

That's not the goal, do you suppose?

And then everyone would be happy with their free healthcare.

Well, their $1 TRILLION for now healthcare. Of course, single payer advocates believe someone else is going to pay that $1 TRILLION bill, and that healthcare quality will be maintained. On average. Healthcare quality will be averaged. "

steph wrote on Aug 23, 2009 11:34 AM:

" Raven--

From the article you cite:

"The fear and concern is that the public plan could become the market-dominant plan," said Dr. James Rohack, president of the American Medical Association. "When you've got the federal government involved, it can infuse money into a plan to keep it solvent even if the premiums are lower than its actual costs."

Not brain surgery to figure out. "

Raven wrote on Aug 23, 2009 6:53 PM:

" and did you miss that part of the bill which says it will be funded by the premiums of the subscribers?

and if the companies truly are competitive that shouldn't be an issue steph.... "

steph wrote on Aug 23, 2009 9:40 PM:

" Raven--did you not read the part about the federal government INFUSING MONEY INTO THE PLAN?
That is not competition! "

Mr4 wrote on Aug 23, 2009 9:51 PM:

" Raven,

You are a hard one to convince because you choose to ignore the facts.

The bill says it will be funded by the premiums? Does that mean that it's expenditures will be limited by revenues it receives? Where does it say that?

And your Maine example is good one. Insurance regulation has effectively limited insurance competition down to only two or three companies. Blue Cross, United Healthcare, Kaiser Permanente and others are nowhere to be seen. It is not because thay don't want to do business there - it is because they can't! "

John Richards wrote on Aug 23, 2009 11:05 PM:

" Raven wrote: "since you don't have a price for the public option how can you say it will drive the private companies out of business...isn't competition the lifeblood of capitalism?"

Fair competition is good, but Obama will infuse the public plan with gobs of taxpayer money. That's not fair competition. We have to find more ways for the insurance companies to compete with each other. "

Raven wrote on Aug 24, 2009 4:53 AM:

" As for ignoring the facts, read it again Mr4, nowhere does it say it has increased regulation...matter of fact, Maine is one of the least regulated states ... the point is that even w/o regulations, there is no true competition between these companies. And like any other company as expenses go up, so do premiums. "

Raven wrote on Aug 24, 2009 4:59 AM:

" As for facts, kaiser operates in just 9 states...is govt regulation keeping them out of the others and if so, what regulation? "

kevin wrote on Aug 25, 2009 6:39 AM:

" raven, I don't know for sure, but I think they are DIFFERENT Kaiser's in each state. At least when I travel, if I have to use their facilities, I have to get a new member card and a new number... "

Mr4 wrote on Aug 25, 2009 10:24 AM:

" It is a little more complicated than that. Every state has its own health insurance regulations. Some are exclusionary and others simply burdensome.

Adding to the regulatory complexity is the employer situation. Since employers typically contract with insurance companies (not individuals) states with large employers tend to have more limited insurance competition. If one insurance company ties up a large employer, competitive insurance companies cannot get to a critical mass that would justify the administrative costs of doing business in a particular state.

Kaiser is a good example. They want to expand to other states, but given existing employer contracts they are finding it difficult to find locations where it is economically feasible to do so.

So the solution is two-fold: (1) Wean ourselves from employer-provided insurance, and (2) reduce the state-by-state regulatory burden by establishing model (not mandatory) insurance rules that enhance transparency in insurance plans and enable individuals to make intelligent choices for themselves.

Kevin, 90% of Kaiser is in California and Hawaii. Outside of C&H they have a piecemeal organization with many outsourced contracts - but it is still the same organization. "

giandy wrote on Aug 25, 2009 7:39 PM:

" Am a senior, on Medicare and Tricare so my Health care financial needs are minimal. I personally want everyone to have the same health care available to them.
Most people do not have any real medical problems until they pass 60. Back before the 60's California women were in great shape!) but I digress.
i am for Single Payer but since Obama took it off the table, I will settle for the Public Option. Yes, its meant to give competition to the Insurance Cos. Thats the only way to bring premiums down. Our country's guiding principle is Greed and its a pipe dream to expect the Insurance companies to lower their premiums because they want to help the people.
Social Security and Medicare were enacted by leaders who genuinely wanted to help the people and in spite of the Republicans and Democrats who stood in the way.
Someone mentioned that Rep Thompson was a Liberal. Maybe, but he belongs to the Blue Dogs, who have weakened the Public Option by having the Government negotiate prices and costs with doctors and hospitals individually instead of giving them (hospitals and doctors) the standard Medicare payment. This (according to Mike Ross, Blue Dog leader) makes the Insurance companies competitive with the government program.
Any senior may remember Art Finley. He used to have a childrens program on TV in San Francisco back in the 60s. The program was call Mayor Art. He resides in Montreal, Canada now and is very agitated and upset at the lies told in this country about the Canadian Health Care system. He is now 86, in great health and his premium is$57month. "

John Richards wrote on Aug 25, 2009 11:29 PM:

" "his premium is $57month"

R-i-g-h-t. And his sales taxes are a measily 13%, see
http://en.wikipedia.org/wiki/Sales_taxes_in_Canada "

Mr4 wrote on Aug 26, 2009 9:36 PM:

" Giandy,

You sound like a very nice person.

But unfortunately you are not seeing beyond the tip of your nose. You are happy to be receiving your Medicare and military (Tricare) benefits but you have no idea whatsoever who is ultimately paying for it. In your myopic world, the payments are simply coming from "the government". How nice!

What you don't understand is that this "government" gets its funding through the de-facto enslavement of the governed. While you may have put in a few dollars yourself through payroll deductions throughout your career, others are forced against their will to contribute massive sums to your benefit. You may not care, because those people are "rich" and are not to be pitied. They obviously got rich through the exploitation of the masses! You have no clue that these same people are the ones who supply most of the real and rewarding jobs in this great country.

The populist politicians you so adore, such as the "Blue Dogs", are merely a part of the mob robbing from those with ability and giving to those with a need. Classic Karl Marx. The only difference is that these supposed "Blue Dogs" occasionally pay lip service to a bit of fiscal responsibility. They are not really serious about it, but they play the game in order to give the appearance of moderation and compromise to the masses. At the end of the day they always vote for the same wealth redistribution schemes as the ultra-leftists. Mike Thompson is a poster child for this public fraud.

It is time for you to take off your rose-colored glasses, giandy, and see the world as it truly is! "

John Richards wrote on Aug 27, 2009 2:57 PM:

" Mr4, I consider myself a conservative, but I'm not so opposed to Medicare and Tricare as you seem to be. Tricare is nothing but the equivalent of a standard health plan between a large employer (Defense Department) and its employees (military personnel).
People who receive Medicare benefits have (for the most part) paid into it all their working life. It is gradually becoming insolvent because the government has extended benefits to those who have not paid into it. That aspect needs to be addressed. "

Mr4 wrote on Aug 27, 2009 4:45 PM:

" John Richards,

The idea behind Medicare (and I suppose Tricare) is that it is a form of national insurance. People pay into it through payroll deductions and reap the benefits when they retire (or become disabled). To the extent that Medicare does this, it is minimally acceptable. I say minimally because a similar program could likely be much more efficiently managed by the private sector.

The real problem with Medicare is that our politicians have expanded the program far beyond its original charter to the point that money paid in has no connection with money paid out. The debt is simply being pushed out to future generations so that it becomes someone else's problem. And with the current demographic reality of aging Baby Boomers the policy is creating a crisis.

That is a dishonest way to run any program, and it should not be continued for future generations.

We need to wean ourselves out of this Ponzi scheme. This does not mean cutting off those who have faithfully paid into the system and planned their finances accordingly. These people must be fully protected. It means that we must realistically face the immediate problem (not deny it, Raven!) and develop a plan that will not ruin future generations. "

giandy wrote on Aug 27, 2009 9:19 PM:

" Mr4..I know exactly who pays the bills. I always felt if you are paying a lot of taxes its because you are making a lot of money and should be happy that you are able to pay a lot of taxes.
I am an unabashed Socialist when it comes to Health Care. Single Payer is the way to go but Obama was too timid to push it.
Have any other countries with Socialized medicine collapsed? become a satellite of the Soviet Union or China? Not lately.
A fellow from Austraia posted on a blog about Australian experiences with Medicare for all. The Labour party enacted it, then the Conservatives gained power and repealed it. The Labour party put it back in when they came into power.
That was 30 years ago and unfortunately for the Australians, Socialized Medicine is entrenched and no one is too bothered except some Conservatives.
By the way, read Nicholas Kristoff's column today. Its about Health Care and explains why we need a change. "

Mr4 wrote on Aug 28, 2009 8:41 AM:

" Giandy: "Have any other countries with Socialized medicine collapsed?"

Yes. The Soviet Union.

But I never claimed that our country would "collapse", just that our world-leading health care would be forever degraded.

I read Mr Kristof's article in this morning's New York Times - thank you for the reference. It talks of a disgruntled insurance company employee who got motivated by Michael Moore's propaganda movie. Big deal.

The article goes on to urge for changes in the way insurance companies operate. I completely agree, and if you look above in this blog you will find numerous suggestions and some sound discussion on that very subject.

The fact that a few Australian sheep (who have never experienced a better system) opt not to fight is irrelevant.

Up to this point in time, our Republic has been protected against "unabashed socialists" by our form of government - specifically our Constitution and more specifically the Tenth Amendment.

When you say that you are an unabashed socialist "when it comes to health care", you must understand the consequences. It does not and cannot stop there. While you are apparently passive (are you Australian?) when it comes to socialism relating to banking, auto manufacturing and energy, are you also willing to go there for food, housing and clothing?

You say single payor is the way to go. Please explain why? And specifically, please explain how single payor will advance the development of medical science for the improvement of all. I look forward to responding. "

anticommie wrote on Aug 28, 2009 11:10 AM:

" Raven wrote on Aug 23, 2009 6:53 PM:

" and did you miss that part of the bill which says it will be funded by the premiums of the subscribers?

and if the companies truly are competitive that shouldn't be an issue steph.... "

Well isnt that how the private insurance companies pay for the funding? And, isnt that what you government takeover advocates say is wrong with the private sectors method? Do you really think that the premiums paid by the people will ultimately pay for the funding? Or do you supposes it will be MORE borrowed money from countries like China? "

giandy wrote on Aug 28, 2009 2:48 PM:

" Mr4..
Loss of individual freedom is being sold to the people by entities who will gain by their stupid and ignorant actions.
Nicholas Kristoff's column was right on! in exposing the evils in the current Health Care system. Mr. Potter is reviled and excoriated because he found his soul and exposed whats really going on.
Remember when Arianna Huffington was a Republican? Bill Maher said she was beautiful but evil. She finally found her calling and is now a progressive fighter for the people.
I was sick once as a young man back in the 40s. The doctor drove from his home to my parents to treat me. All for $5. Can you imagine that happening now?
Expanding populations are the root cause of the loss of Individual Freedom. To coin a military term people are assets, not individuals. The more assets, the more profits. Thats really why illegal immigration has not been stopped.
With expanding populations governments are too busy taking care of the masses to worry about the individual.
As a small tribe, we could take care of ourselves. Neighbors helped, the shaman came over when you were ill. We knew who the best men were and they led us.
Back to Health Care. So Russia collapsed. But they were not of the West. They are not like us. They are not our friends. They don't place the same value we do on individuals, so their system failed.
Are we different? No other country in the Western world has repealed their Medicare for all, and yet we, who supposedly are so superior, refuse our citizens the Health care most other countries do. "

Mr4 wrote on Aug 28, 2009 4:56 PM:

" giandy:

You wrote: "So Russia collapsed. But they were not of the West. They are not like us. They are not our friends. They don't place the same value we do on individuals, so their system failed."

I find that personally insulting. My family came from Russia - in fact, I never met my grandfather because he was killed by Stalin before I was born. They are exactly like us. They are us.

Statism ruined that country just like it can ruin this country.

Wake up! "

Raven wrote on Aug 29, 2009 9:16 AM:

" no anti, what is wrong is watching those premiums and the health care costs rise at double and more than the costs of providing that care does... "

Mr4 wrote on Aug 29, 2009 10:48 AM:

" This month's Atlantic contains a well-written article (by a Democrat, no less!) that accurately identifies many of the sources of high cost and poor quality in our health care system. While I don't buy all of the recommendations, it represents the kind of logical approach that we need to take in order to improve the system.

http://www.theatlantic.com/doc/200909/health-care "

giandy wrote on Aug 31, 2009 1:50 PM:

" Mr4...sorry if I (inadvertently) insulted your ethnicity.
I could have just said: Mr4, you are implying that Russia's Health System was a major contributor to their financial collapse....really?
All I know about Russia's Health care is what I read in spy novels where the soviet agents always have steel fillings in their teeth. lol "

giandy wrote on Aug 31, 2009 4:47 PM:

" Mr4...an article at msnbc.c om explains the Canadian system pretty well.
I will check the Atlantic Monthly article.
If our system wasn't as corrupt as it is, we wouldn't need National Health.
Was that a misprint? where United Health CEO earned? $700 million? I read somewhere his salary is something like $100,000 an hour.
It must be a mis-print. Sort of a little excess there, dont you think?
If thats true we need a Health care bill with a strong Public Option. at the very least.
I will go read that article in Atlantic Monthly. I hope its not one of the Democrats in name only fellows. Some are called Blue Dogs.
By the way I am Independent but don't see any Republican out there who is worthy of being voted into office. I vote for what I think is right. "

steph wrote on Sep 2, 2009 6:34 PM:

" Socialism (even in healthcare) does not place value on individuals. Decisions are made for the greater good.

Giandy, I think you need to reconcile your beliefs. "

giandy wrote on Sep 2, 2009 10:08 PM:

" Steph.
Its very difficult in the world we live in to have your beliefs set in concrete.
Is Social Security socialistic? Is Medicare Socialistic? Yes!
Are the people on these programs happy with them? Yes!
Now we need Universal Health Care. Is it a Socialist program? Yes!
We must temper individual freedom with the governments role of caring for its citizens. If you want to have your private insurance ...great! I wouldn't try to stop you. That's your choice and because of the Public Option your premiums will be lower and affordable. Should they get too high, you can always opt for the Public Option.
Wouldn't that be a good thing? For you and everyone.
Decisions are made for the greater good....Steph, that is the whole point. Decisions have to be made for the greater good. Why do we have criminal laws? To protect us from people who would victimize you unlawfully.
Because of our corrupt political system the people are being victimized and the government should, must step in and protect its citizens. "

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